Treatment of Enchondromas of the Hand with Bone Substitute

1997 ◽  
Vol 22 (4) ◽  
pp. 476-478 ◽  
Author(s):  
P. JACOULET ◽  
P. FAURE
Keyword(s):  
Bone Substitute ◽  
Operative Time ◽  
Operative Procedure ◽  
Full Range ◽  
Donor Site ◽  
Infectious Complications ◽  
Normal Function ◽  
X Ray ◽  
Allogenic Bone

We report five patients with enchondromas of long bones in the hand. They were successfully treated by curettage and implantation of a biodegradable bone substitute (calcium phosphate). Bone regained normal X-ray appearance by 9 months. The full range of motion and normal function of the hand were restored. There were no complications and no recurrence at follow-up visits 28 months after operation. There are several advantages to this technique. The operative procedure may be performed under local anaesthesia on an out-patient basis and the operative time is shortened. Complications of a cancellous bone donor site are avoided, as are the potential infectious complications of allogenic bone implantation.

scholarly journals Anterior cervical discectomy and fusion with polyetheretherketone cages in the management of single and double level cervical spondylotic myelopathy-our experiences of 80 cases

KYAMC Journal ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 32-34
Author(s):  
Md Anowarul Islam ◽  
Mohd Alamgir Hossain ◽  
Ahmed Asif Iqbal ◽  
Md Qumruzzaman Parvez ◽  
Md Ahsanuzzaman ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Donor Site ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
X Ray ◽  
Arm Pain ◽  
Operative Complications ◽  
Medical University

Background: Anterior cervical discectomy with fusion (ACDF) is challenging with respect to both patient selection and choice of surgical procedure.Objectives: The aim of this study was to evaluate the clinical outcome of anterior cervical discectomy and fusion with an artificial cage made of polyetheretherketoneMaterials & Methods: From January 2012 to January 2017, 80 consecutive patients referred to the Department of spine surgery, Bangabandhu Shekh Mujib Medical University were recruited for the study. Postoperative Clinical outcome assessed with Nurick scale for myelopathy, Odom's criteria for functional outcome and Visual Analogue Scale (VAS) for both neck and arm pain. Radiological fusion was assessed by X-ray. Operative complications were reported.Results: 36 patients were operated for one level discectomy and fusion with PEEK cages and 44 patients for two levels. There were 48 (60%) males and 32 (40%) females. The age of the patients ranged from 30-72 years, a mean ± SD 45 ± 8.34. At the 2 years clinical follow-up, there were significant post operative improvements of Nurick scale, and VAS comparative to preoperative record. According to Odom's criteria, 72/80 patients (90%) were graded excellent-good.Conclusion: Anterior cervical discectomy and fusion with polyetheretherketone (PEEK) cage is an effective treatment of cervical myelopathy having higher fusion rate and lack of donor site morbidity.KYAMC Journal Vol. 9, No.-1, April 2018, Page 32-34

Endoscopic Transnasal Pituitary Surgery: Report on 180 Cases

2001 ◽  
Vol 15 (4) ◽  
pp. 281-287 ◽  
Author(s):  
Shawn S. Nasseri ◽  
Jan L. Kasperbauer ◽  
Scott E. Strome ◽  
Thomas V. McCaffrey ◽  
John L. Atkinson ◽  
...  
Keyword(s):  
Operative Time ◽  
Operative Procedure ◽  
Full Range ◽  
Sella Turcica ◽  
Length Of Hospital Stay ◽  
Pituitary Surgery ◽  
Transsphenoidal Approach ◽  
Transnasal Approach ◽  
Endoscopic Transnasal Approach ◽  
Revision Operations

The endoscopic transnasal approach is an evolving technique for treating lesions in the sella turcica. Since this method was introduced at our institution 4 years ago, the majority of transsphenoidal procedures are performed with it. The records of all patients having endoscopic transnasal hypophysectomy at the Mayo Clinic during the last 4 years were reviewed retrospectively. The criteria analyzed were safety, functional and cosmetic outcome, and complications. During the 4-year period, the operative procedure was modified to improve operative exposure and safety. The results of our review showed a significant decrease in length of hospital stay, reduced operative time, reduced need for nasal packing, and elimination of a sublabial incision. The complication rate was equivalent to that reported for the traditional transseptal transsphenoidal approach. As the neurosurgeons at our institution gained experience with this approach, an increasing number of pituitary microadenomas were resected safely and successfully. In addition, because of the limited septal dissection, this approach is particularly helpful for revision operations. This approach also can be used for the full range of pituitary lesions and in conjunction with adjunctive techniques, including frontal craniotomy and -knife irradiation. Currently, the endoscopic transsphenoidal approach is the method preferred for surgically treating pituitary lesions in adults at our institution.

scholarly journals Laparoscopic antegrade cholecystectomy: a standard procedure?

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 429-432 ◽  
Author(s):  
Nicola Tartaglia ◽  
Pasquale Cianci ◽  
Alessandra Di Lascia ◽  
Alberto Fersini ◽  
Antonio Ambrosi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Standard Procedure ◽  
Operative Procedure ◽  
Retrograde Approach ◽  
Calot’S Triangle ◽  
Bile Duct Injuries ◽  
Visceral Peritoneum ◽  
Average Operative Time

AbstractRetrograde approach (“fundus first”) is often used in open surgery, while in laparoscopic cholecystectomy (LC) is less frequent. LC, with antegrade access, is done by putting in traction the infundibulum and going up to the fundus before to clip the cystic. Our study analyzes a number of surgical procedures performed by experienced surgeons in laparoscopy.From 2002 to 2015, 1740 laparoscopic cholecystectomies were performed at our Institution. The operative procedure performed since 2002 consists of the incision of the visceral peritoneum from the infundibulum away from Calot’s triangle along the gallbladder bed up to the fundus. Then it continues from the fundus up to the infundibulum.Results: There were no bile duct injuries. Average operative time was 40 min. 22 conversions to an open procedure (1.3%) occurred, in cases of acute cholecystitis and cirrhotic patient. Postoperative stay was mean 2 days with no delayed sequelae on follow up.Conclusions: gallbladder antegrade dissection for laparoscopic cholecystectomy can reduce the time of surgery and is an easier technique to perform. Therefore, it can be proposed as the standard procedure and not only be used for difficult cholecystectomies.

Proximal Fractures of the Fifth Metacarpal: A Retrospective Analysis of 25 Operated Cases

2000 ◽  
Vol 25 (3) ◽  
pp. 253-257 ◽  
Author(s):  
M. Y. PAPALOIZOS ◽  
PH. LE MOINE ◽  
V. PRUES-LATOUR ◽  
N. BORISCH ◽  
D. R. DELLA SANTA
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Retrospective Analysis ◽  
Full Range ◽  
Degenerative Changes ◽  
Degenerative Arthritis ◽  
X Ray

The clinical and radiological outcomes of 25 surgically treated fractures of the proximal third of the fifth metacarpal were retrospectively analysed. Many different methods of osteosynthesis were used. At follow-up after a mean of 3.3 years, 15 of 25 patients had no pain. Most patients regained a nearly full range of motion in the adjacent joints and more than 90% of the contralateral grip strength. X-ray signs of degenerative arthritis in the metacarpohamate joint were observed in 10 of 25 patients. Pain was found to be directly correlated with the presence of degenerative changes.

Experience in Total Ankle Replacement at Russian Scientific-Research Institute of Traumatology and Orthopaedics Named After R.R. Vreden

2009 ◽  
Vol 16 (3) ◽  
pp. 56-60 ◽  
Author(s):  
R M Tikhilov ◽  
Nikolay Aleksandrovich Koryshkov ◽  
V G Emel'yanov ◽  
A V Stoyanov ◽  
A V Zhuravlev ◽  
...  
Keyword(s):  
Infectious Complications ◽  
Early Complications ◽  
Long Term Outcomes ◽  
Joint Replacements ◽  
X Ray ◽  
Russian Scientific ◽  
Ankle Replacement ◽  
Russian Scientific Research Institute

Results of 45 ankle joint replacements performed during the period from 1998 to 2008 have been analyzed. Cementless original implants were applied in 6 (13.3%), «Link S.T.A.R.» implants - in 26 (57.8%) and «DePuy Mobility TM» implants - in 13 (28.9%) cases. Mean follow-up made up 3 years (from several months to 10 years). For the evaluation of long-term outcomes the data from patients questionnaires (prior to, 6 months after operation and at the time of last examination) and X-ray results were used. Early complications, i.e. fracture of lateral malleolus, was noted in 4 patients. Long-term complications, i.e. dislocation of tibial component, were observed in 2 patients. In 2 patients the development of infectious complications required implant removal followed by arthrodesis. In 91% of cases the results were assessed as satisfactory and good by Kitaoka scale.

Surgical Treatment With Nonunion Of The Lateral Humeral Condyle Of Humerus With Cubitus Valgus In Children Using Apparat Ilizarov

2010 ◽  
Vol 1 ◽  
Author(s):  
Ilkhom Khujanazarov ◽  
Iskandar Khodjanov
Keyword(s):  
Surgical Treatment ◽  
Operative Procedure ◽  
Lateral Condyle ◽  
Cubitus Valgus ◽  
X Ray ◽  
Loss Of Correction ◽  
The Mean ◽  
Humeral Condyle ◽  
Degrees Of Severity

Background. Nonunion of the lateral humeral condyle  are of the complex pathology of the elbow joint, occurring relatively often and resulting in disability of children.The treatment of nonunion of the lateral humeral condyle of humerus with cubitus valgus remains controversial. Purpose of this report was improvement of the results of surgical treatment of the nonunion of the lateral humeral condyle of humerus with cubitus valgus of the lateral humeral condyle of humerus with cubitus valgus with use of differential approach to the surgical strategy.Material and methods. We were observing 28 children (17 boys and 11 girls) with nonunion and long-standing nonunion of lateral condyle of humerus, with various degrees of severity. There were used MRI and X-ray investigations for differential study of the patients divided into 3 groups in relation to stability and non-stability of the nonunion of the lateral humeral condyle of humerus with cubitus valgus of the lateral humeral condyle of humerus with cubitus valgus.Results. All 28 patients lateral humeral condyle nonunions with cubitus valgus achieved union within sixty five days after operative procedure using Ilisarov’s technique. The mean postoperative humerus-ulna angle was 6,0 degrees of cubitus valgus. All of reverse T-osteothomies healed uneventfully, and there was no loss of correction postoperatively.  The mean duration of follow-up was 7 years. The overall results were excellent in 15(53,5%) patients,  good in 11(39,3%) patients, and fair in 2(7,2%) patients. All 28 patients lateral humeral condyle nonunions with cubitus valgus achieved union within sixty five days after operative procedure using Ilisarov’s technique. The mean postoperative humerus-ulna angle was 6,0 degrees of cubitus valgus. All of reverse T-osteothomies healed uneventfully, and there was no loss of correction postoperatively.  The mean duration of follow-up was 7 years. The overall results were excellent in 15(53,5%) patients,  good in 11(39,3%) patients, and fair in 2(7,2%) patients.

scholarly journals Comparison of the modified direct closure method and skin grafting for wounds at the anterolateral thigh flap donor site

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092537
Author(s):  
Song Gu ◽  
Yuxuan Zhang ◽  
Yinjun Huang ◽  
Huichao Fu ◽  
Guheng Wang ◽  
...  
Keyword(s):  
Operative Time ◽  
Donor Site ◽  
Skin Grafting ◽  
Anterolateral Thigh Flap ◽  
Direct Closure ◽  
Anterolateral Thigh ◽  
Closure Method ◽  
Alt Flap ◽  
Scar Score

Objective This study was performed to compare the modified direct closure method and traditional skin grafting for wounds at the anterolateral thigh (ALT) flap donor site. Methods Among 29 consecutive patients with wounds at the ALT flap donor site, 14 underwent the modified direct closure method (MDC group) and 15 underwent traditional skin grafting (SG group). The operative time, follow-up time, complications, Vancouver Scar Scale (VSS) score, and Scar Cosmesis Assessment and Rating (SCAR) score of the two groups were statistically analyzed. Results The mean follow-up times in the MDC and SG group were 16.1 and 16.7 months, respectively. Two patients showed partial skin necrosis after skin grafting, but the remaining patients’ wounds healed uneventfully. The operative time in the MDC group was an average of about 64 minutes shorter than that in the SG group. The average VSS and SCAR scores in the MDC group were 2.1 and 3.0 points lower, respectively, than those in the SG group. Conclusions Compared with traditional skin grafting, the modified direct closure method is more efficient for repair of wounds at the ALT flap donor site because of its shorter operative time, better postoperative appearance of the donor site, and higher patient satisfaction.

TricOsTM and Fibrin Sealant Combined for Bone Defect Filling: from Pre-Clinical Tests to Prospective Clinical Study. Preliminary Human Data

2007 ◽  
Vol 361-363 ◽  
pp. 1335-1338 ◽  
Author(s):  
Marlene Durand ◽  
Dominique Chauveaux ◽  
Maryse Moinard ◽  
Thierry Fabre ◽  
Jean Louis Rouvillain ◽  
...  
Keyword(s):  
Clinical Study ◽  
Ct Scan ◽  
Fibrin Sealant ◽  
Bone Substitute ◽  
Material Removal ◽  
Bone Defects ◽  
Tibial Osteotomy ◽  
Clinical Tests ◽  
X Ray

The association of TricOsTM (Macroporous Biphasic Ceramic Phosphate MBCP granules) and the fibrin sealant FS VH S/D 4, has been developed to answer a challenging request of orthopaedic surgeons: a biocompatible, osteogenic, mouldable, and self-hardening bone substitute able to fill randomly shaped bone defects. The aims of this study was the evaluation of the performance and safety of the bioactive bone substitute TricOs™ associated with a fibrin sealant in regeneration of functional bone. The pre-clinical tests were conducted to optimize MBCP granules size and ratio MBCP–FS VH S/D 4 (sheep maxillary sinus grafting, femoral epiphysis defect in rabbits, long bone defects in sheep). A clinical study design was set up as an exploratory prospective French multicentric phase II study sponsored by INSERM (Institut National de la Santé et de la Recherche Médicale). The application was the TOV (Tibial Osteotomy of Valgisation) using osteosynthesis and bone substitute: TricOs™ mixed with the fibrin sealant (FS VH S/D 4) for filling the space created. The follow up is 13 months with safety checks, clinical assessments, highsensitivity X-ray, and CT-scan imaging. A bone sample will be collected from the reconstructed area at 12 months, during the osteosynthesis material removal surgery. The principal criterion is CT-scan imaging performed 12 months after TOV surgery, before material removal, to assess qualitative and quantitative bone reconstruction. Animals’ studies demonstrate that the biomaterial is safe to use and shows osteoconductive properties, granules resorption and bone ingrowth at the expenses of the implants. As for clinical trial, 7 patients are today included in the study: This paper present the first results obtained from X-ray imaging during follow up.

scholarly journals Cementless calcar-replacement stem with integrated greater trochanter plate for unstable intertrochanteric fracture in very elderly patients

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668474 ◽  
Author(s):  
Keizo Wada ◽  
Hiroshi Mikami ◽  
Koichi Oba ◽  
Hiroshi Yonezu ◽  
Koichi Sairyo
Keyword(s):  
Elderly Patients ◽  
Operative Time ◽  
Intertrochanteric Fracture ◽  
Bony Union ◽  
Very Elderly ◽  
Greater Trochanter ◽  
X Ray ◽  
Unstable Intertrochanteric Fracture ◽  
The Mean

Purpose: To evaluate the clinical results of rigid fixation of the greater trochanter fragment through a consecutive hemiarthroplasty series using a cementless and modular calcar-replacement prosthesis with an integrated plate (MOD-Centaur stem) with 1-year follow-up in very elderly patients with unstable intertrochanteric fractures. Methods: We assessed 44 consecutive very elderly patients (age >85 years; 2 men, 42 women; mean age at surgery: 89.6 years) with an unstable intertrochanteric fracture who underwent bipolar hemiarthroplasty using the MOD-Centaur stem by the same surgeon. Operative time and blood loss were evaluated, and postoperative complications and mortality rate within 1 year were assessed. Bony union of the greater trochanter was evaluated using plain X-ray images at least 6 months postoperatively. Walking ability was evaluated at the time of discharge and at 1 year postoperatively. Results: The mean operative time was 95.8 min, and the mean intraoperative blood loss was 358.0 mL. Postoperative peripheral infection occurred in one patient. Four patients died within 1 year postoperatively (mortality rate: 9.1%). Bony union of the greater trochanter was achieved in all the patients who had a plain X-ray taken at least 6 months postoperatively. At 1-year follow-up, 20 patients could walk independently. Conclusion: Hemiarthroplasty using the MOD-Centaur stem for unstable intertrochanteric fracture in very elderly patients offers favorable outcomes. These findings encourage early walking without any loading limitations, despite severe osteoporosis, and emphasize the importance of greater trochanteric fixation, which reconstructs the mechanism of the gluteus medius muscle.

Use of allograft bone for posterior C1–2 fusion

2009 ◽  
Vol 11 (4) ◽  
pp. 396-401 ◽  
Author(s):  
Virany Huynh Hillard ◽  
Daniel R. Fassett ◽  
Michael A. Finn ◽  
Ronald I. Apfelbaum
Keyword(s):  
Blood Loss ◽  
Bone Grafting ◽  
Iliac Crest ◽  
Operative Time ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Estimated Blood Loss ◽  
Autograft Group ◽  
Atlantoaxial Arthrodesis

Object An iliac crest autograft is the gold standard for bone grafting in posterior atlantoaxial arthrodesis but can be associated with significant donor-site morbidity. Conversely, an allograft has historically performed suboptimally for atlantoaxial arthrodesis as an onlay graft. The authors have modified a bone grafting technique to allow placement of a bicortical iliac crest allograft in an interpositional manner, and they evaluated it as an alternative to an autograft in posterior atlantoaxial arthrodesis. Methods The records of 89 consecutive patients in whom C1–2 arthrodesis was performed between 2001 and 2005 were reviewed. Results Forty-seven patients underwent 48 atlantoaxial arthrodeses with an allograft (mean follow-up 16.1 months, range 0–49 months), and 42 patients underwent autograft bone grafting (mean follow-up 17.6 months, range 0–61.0 months). The operative time was 50 minutes shorter in the allograft (mean 184 minutes, range 106–328 minutes) than in the autograft procedure (mean 234 minutes, range 154–358 minutes), and the estimated blood loss was 50% lower in the allograft group than in the autograft group (mean 103 ml [range 30–200 ml] vs mean 206 ml [range 50–400 ml], respectively). Bone incorporation was initially slower in the allograft than in the autograft group but equalized by 12 months postprocedure. The respective fusion rates after 24 months were 96.7 and 88.9% for autografts and allografts. Complications at the donor site occurred in 16.7% of the autograft patients, including 1 pelvic fracture, 1 retained sponge, 1 infection, 2 hernias requiring repair, 2 hematomas, and persistent pain. Conclusions The authors describe a technique for interpositional bone grafting between C-1 and C-2 that allows for the use of an allograft with excellent fusion results. This technique reduced the operative time and blood loss and eliminated donor-site morbidity.

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