Vascularized Bone Grafting for Bone Defects after Removal of Bone and Soft Tissue Tumors in the Limb-Saving Procedures

Introduction Humeral fractures comprise from 5 % to 8 % of all fractures. Nonunion rate of humeral fractures is 5.5–8.7% with open reduction and internal fixation (ORIF) technique and 3–5.6 % with the use of locked intramedullary nailing technique. Its frequent causes are infection, poor vascularity, severe comminution or technical errors. Purpose Analysis of effectiveness of vascularized bone grafting and non-vascularized bone grafting in humeral nonunion and defect treatment. Material and methods Surgical management of 69 patients with humeral nonunion was performed from 2010 to 2017 at a single institution in two groups. Vascularized bone grafts were used in 41 cases and non-vascularized ones in 28 cases. X-rays and CT-scans of all the patients were studied. Results In the vascularized bone grafting group, union was achieved in 36 cases (88 %) after four to 6 months; in non-vascularized bone group union was achieved in 20 cases (71 %) after eight to 12 months. Conclusion In post-traumatic humeral nonunion and bone defects, after two or more failed surgical procedures performed previously, vascularized bone grafting yields more satisfactory results and reduces the total healing time.

Download Full-text

Vascularized bone grafts for post-traumatic defects in the upper extremity

Archives of Plastic Surgery ◽

10.5999/aps.2020.00969 ◽

2021 ◽

Vol 48 (1) ◽

pp. 84-90

Author(s):

Giovanna Petrella ◽

Daniele Tosi ◽

Filippo Pantaleoni ◽

Roberto Adani

Keyword(s):

Upper Extremity ◽

Bone Grafting ◽

Femoral Condyle ◽

Bone Grafts ◽

Bone Defects ◽

Tissue Loss ◽

Surgical Reconstruction ◽

Non Union ◽

Post Traumatic ◽

Vascularized Bone

Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5–6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

Download Full-text

Localization of Gallium-67 in Peritoneal Cells by Electron Microscopic Autoradiography

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100072460 ◽

1973 ◽

Vol 31 ◽

pp. 404-405

Author(s):

D. C. Swartzendruber ◽

Norma L. Idoyaga-Vargas

Keyword(s):

Clinical Trials ◽

Soft Tissue ◽

Tumor Tissue ◽

Soft Tissue Tumors ◽

Clinical Usefulness ◽

Electron Microscopic ◽

Normal Cells ◽

Electron Microscopic Autoradiography ◽

Peritoneal Cells ◽

Gallium 67

The radionuclide gallium-67 (67Ga) localizes preferentially but not specifically in many human and experimental soft-tissue tumors. Because of this localization, 67Ga is used in clinical trials to detect humar. cancers by external scintiscanning methods. However, the fact that 67Ga does not localize specifically in tumors requires for its eventual clinical usefulness a fuller understanding of the mechanisms that control its deposition in both malignant and normal cells. We have previously reported that 67Ga localizes in lysosomal-like bodies, notably, although not exclusively, in macrophages of the spocytaneous AKR thymoma. Further studies on the uptake of 67Ga by macrophages are needed to determine whether there are factors related to malignancy that might alter the localization of 67Ga in these cells and thus provide clues to discovering the mechanism of 67Ga localization in tumor tissue.

Download Full-text

Benign Skin and Soft-Tissue Tumors of the Hand

Clinics in Plastic Surgery ◽

10.1016/s0094-1298(20)30610-6 ◽

1987 ◽

Vol 14 (2) ◽

pp. 403-412

Author(s):

Saleh M. Shenaq

Keyword(s):

Soft Tissue ◽

Soft Tissue Tumors ◽

Tumors Of The Hand

Download Full-text

Percutaneous Imaging-Guided versus Open Musculoskeletal Biopsy: Concepts and Controversies

Seminars in Musculoskeletal Radiology ◽

10.1055/s-0040-1717113 ◽

2020 ◽

Vol 24 (06) ◽

pp. 667-675

Author(s):

Violeta Vasilevska Nikodinovska ◽

Slavcho Ivanoski ◽

Milan Samardziski ◽

Vesna Janevska

Keyword(s):

Soft Tissue ◽

Complication Rate ◽

Core Needle Biopsy ◽

Multidisciplinary Team ◽

Gold Standard ◽

Needle Biopsy ◽

Soft Tissue Tumors ◽

Open Biopsy ◽

Core Needle ◽

Similar Accuracy

AbstractBone and soft tissue tumors are a largely heterogeneous group of tumors. Biopsy of musculoskeletal (MSK) tumors is sometimes a challenging procedure. Although the open biopsy is still considered the gold standard for the biopsy of MSK lesions, core needle biopsy can replace it in most cases, with similar accuracy and a low complication rate. The biopsy should be performed in a tertiary sarcoma center where the multidisciplinary team consists of at minimum a tumor surgeon, an MSK pathologist, and an MSK radiologist who can assess all steps of the procedure. Several factors can influence the success of the biopsy including the lesion characteristics, the equipment, and the method used for the procedure. This review highlights some of the important aspects regarding the biopsy of the MSK tumors, with special attention to imaging a guided core needle biopsy and highlighting some of the recent advancements and controversies in the field.

Download Full-text