Aims.
Aims. The aim of this study was to identify any progression between
benign
Introduction: The purpose of this study is to demonstrate that definitive surgery (extraperiosteal excision) is required in patients with
A nine-year-old girl presented with a four-year history of progressive bowing of the left tibia. She had been seen in our clinic three and four years earlier, when no treatment was advised. She had been complaining of mild pain in the left leg for one month but was otherwise not very perturbed about her deformed leg. Examination showed bowing of the left tibia, no leg length discrepancy, no limp, and a normal left knee and ankle. Radiological examination showed features of osteo-fibrous dysplasia of the left tibia, with eccentric expansion of the cortex, intracortical osteolysis, marginal sclerosis encroaching on the medulla and diffuse lesional calcification. No other bones were involved. Because of the progressive bowing of the tibia and the mild pain, the recommended loose observation of the patient was abandoned. Daily treatment with 30 mg IVI pamidronate for three days resolved the pain. One month after the latest presentation the lesion was biopsied. Histological examination confirmed the diagnosis of
The purpose of this study is to demonstrate that definitive surgery (extraperiosteal excision) is required in patients with
Introduction and Aim: The purpose of this study is to demonstrate that definitive surgery (extraperiosteal excision) is required in patients with
Aims: Purpose of this study was to obtain long term follow-up in patients with
We report a case which highlights the progression of
We present a retrospective study of patients suffering from a variety of benign tumours in whom external fixators were used to treat deformity and limb-length discrepancy, and for the reconstruction of bone defects. A total of 43 limbs in 31 patients (12 male and 19 female) with a mean age of 14 years (2 to 54) were treated. The diagnosis was Ollier’s disease in 12 limbs, fibrous dysplasia in 11, osteochondroma in eight, giant cell tumour in five,
The authors aim to report the long-term follow-up experience in the reconstruction of bony defects by Ilizarov’s distraction osteogenesis using bone transport method following en bloc resection of bone tumors. En bloc resection was performed nine patients with bone tumors between October 1991–January 2000. The mean age of the patients was 19.3 years. Histological diagnosis was osteosarcoma in four cases, Ewing sarcoma in two cases, giant cell tumor (aggressive) in one,
Young active patients with malignant tumours arising in the distal fibula, requiring excision, present a challenge to the treating surgeon. Wide local excision is advocated, to achieve clearance, however, disruption of the ankle mortise results and fusion is often required to restore stability. The loss of movement is poorly tolerated in the younger patient and leads to progressive degenerative changes in surrounding joints. Excision of the distal fibula lesion followed by harvesting of the proximal fibula and using this graft to recreate the ankle mortise restores ankle stability and retains ankle movement. Between 1998 and 2007, we have performed this technique on 4 patients. Diagnoses were Ewing’s sarcoma, chondrosarcoma, parosteal osteosarcoma and
The purpose of this study was to review the outcomes of patients treated with injectable calcium phosphate cement (Norian SRS, Norian Corporation, Cupertino, California) for contained bone defects after resection of benign or low-grade malignant bone tumours. The clinical records and radiographs of 17 patients who had been treated with calcium phosphate cement were reviewed, looking for incorporation into bone, reabsorption of the material and complications. The 17 patients had a mean age of 29.8 years (range 7 to 64). The diagnosis was giant cell tumour in 9 cases, fibrous dyplasia in 2, low grade chondrosarcoma in 2, and one each of enchondroma, chondromyxoid fibroma,
Intercalary allografts following resection of a primary diaphyseal
tumour have high rates of complications and failures. At our institution
intercalary allografts are augmented with intramedullary cement
and fixed using compression plating. Our aim was to evaluate their
long-term outcomes. A total of 46 patients underwent reconstruction with an intercalary
allograft between 1989 and 2014. The patients had a mean age of
32.8 years (14 to 77). The most common diagnoses were osteosarcoma
(n = 16) and chondrosarcoma (n = 9). The location of the tumours
was in the femur in 21, the tibia in 16 and the humerus in nine. Function
was assessed using the Musculoskeletal Tumor Society (MSTS) scoring
system and the Toronto Extremity Salvage Score (TESS). The survival
of the graft and the overall survival were assessed using the Kaplan-Meier method.Aims
Patients and Methods
In 1999, we developed a technique for biological
reconstruction after excision of a bone tumour, which involved using
autografts of the bone containing the tumour treated with liquid
nitrogen. We have previously reported the use of this technique
in 28 patients at a mean follow up of 27 months (10 to 54). In this study, we included 72 patients who underwent reconstruction
using this technique. A total of 33 patients died and three were
lost to follow-up, at a mean of 23 months (2 to 56) post-operatively,
leaving 36 patients available for a assessment at a mean of 101
months 16 to 163) post-operatively. The methods of reconstruction included
an osteo-articular graft in 16, an intercalary in 13 and, a composite
graft with prosthesis in seven. Post-operative function was excellent in 26 patients (72.2%),
good in seven (19.4%), and fair in three (8.3%) according to the
functional evaluation system of Enneking. No recurrent tumour occurred
within the grafts. The autografts survived in 29 patients (80.6%),
and the rates of survival at five and ten years were 86.1% and 80.6
%, respectively. Seven of 16 osteo-articular grafts (44%) failed
because of fracture or infection, but all the composite and intercalary
grafts survived. The long-term outcomes of frozen autografting, particularly using
composite and intercalary grafts, are satisfactory and thus represent
a good method of treatment for patients with a sarcoma of bone or
soft tissue. Cite this article:
Congenital pseudarthrosis of the tibia (CPT)
is a rare but well recognised condition. Obtaining union of the pseudarthrosis
in these children is often difficult and may require several surgical
procedures. The treatment has changed significantly since the review
by Hardinge in 1972, but controversies continue as to the best form
of surgical treatment. This paper reviews these controversies. Cite this article:
We compared the accuracy of the growth remaining
method of assessing leg-length discrepancy (LLD) with the straight-line
graph method, the multiplier method and their variants. We retrospectively
reviewed the records of 44 patients treated by percutaneous epiphysiodesis
for LLD. All were followed up until maturity. We used the modified Green–Anderson
growth-remaining method (Method 1) to plan the timing of epiphysiodesis.
Then we presumed that the other four methods described below were
used pre-operatively for calculating the timing of epiphysiodesis. We
then assumed that these four methods were used pre-operatively.
Method 2 was the original Green–Anderson growth-remaining method;
Method 3, Paley’s multiplier method using bone age; Method 4, Paley’s
multiplier method using chronological age; and Method 5, Moseley’s
straight-line graph method. We compared ‘Expected LLD at maturity
with surgery’ with ‘Final LLD at maturity with surgery’ for each
method. Statistical analysis revealed that ‘Expected LLD at maturity
with surgery’ was significantly different from ‘Final LLD at maturity
with surgery’. Method 2 was the most accurate. There was a significant
correlation between ‘Expected LLD at maturity with surgery’ and
‘Final LLD at maturity with surgery’, the greatest correlation being
with Method 2. Generally all the methods generated an overcorrected
value. No method generates the precise ‘Expected LLD at maturity
with surgery’. It is essential that an analysis of the pattern of
growth is taken into account when predicting final LLD. As many
additional data as possible are required. Cite this article: