Our objective was to predict the knee extension strength and post-operative function in quadriceps resection for soft-tissue sarcoma of the thigh. A total of 18 patients (14 men, four women) underwent total or partial quadriceps resection for soft-tissue sarcoma of the thigh between 2002 and 2014. The number of resected quadriceps was surveyed, knee extension strength was measured with the Biodex isokinetic dynamometer system (affected side/unaffected side) and relationships between these were examined. The Musculoskeletal Tumor Society (MSTS) score, Toronto Extremity Salvage Score (TESS), European Quality of Life-5 Dimensions (EQ-5D) score and the Short Form 8 were used to evaluate post-operative function and examine correlations with extension strength. The cutoff value for extension strength to expect good post-operative function was also calculated using a receiver operating characteristic (ROC) curve and Fisher’s exact test.Objectives
Methods
The authors added a classification of posterior pillars to Herring’s classification of lateral pillars in a retrospective study of 33 patients with Perthes disease. Anteroposterior and frog position lateral radiographs taken approximately two months later from first visit, were evaluated. All patients were treated by a non-weight-bearing method (continuous traction and wheel chair activity). The outcome was evaluated by the Stulberg method. The mean age at follow-up was 18 years (range,14.2 to 26.9 years). Thirteen hips were in Catterall group II, 18 were in group III, and two were in group IV. Twenty-five of the 33 hips were in Stulberg class I or II (with good results), and eight hips were class III. Nine hips were in Herring group A, 20 hips were in group B, and four were in group C. Eleven hips were in our group A with the posterior pillar classification, 16 were in group B, and six were in group C. Group A, with a lateral or posterior pillar had good results without exception. Concerning Herring’s classification, all four heads had become aspherical in group C, however, 16 hips were good results and four hips were poor in group B. The outcome was poorly related to the classification in 20 patients with 20 affected hips in Herring group B when only lateral pillars were used in classification. When both lateral and posterior pillars are considered in classification, results can be predicted more accurately than when only lateral pillars are considered. This more accurate prognosis at an early stage of Perthes disease can facilitate effective treatment selection.
