scholarly journals Outcome analysis of solitary osteochondromas of femur managed surgically: a series of 32 patients

2020 ◽  
Vol 7 (1) ◽  
pp. 82
Author(s):  
Sanjeev Gupta ◽  
Abdul Ghani ◽  
Bias Dev ◽  
Rahul Mahajan ◽  
John Mohd ◽  
...  
Keyword(s):  
Surgical Excision ◽  
Long Bone ◽  
Outcome Analysis ◽  
Safe Procedure ◽  
Joint Movement ◽  
Indication For Surgery ◽  
Femoral Metaphysis ◽  
Distal Femoral Metaphysis ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Osteochondroma is the commonest benign bone tumor in humans. This tumor may either be solitary or present as multiple lesions. Solitary osteochondromas are much more common. Femur is the single most common long bone involved followed by tibia and humerus. Osteochondromas may be either asymptomatic or may present as pain, pressure symptoms or functional impairment. Most of the symptomatic lesions need surgical excision.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study which included 32 patients with solitary osteochondromas of femur, who were managed with surgical excision. Only the symptomatic cases were operated. Minimum follow-up period was 18 months after surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> This study involved 23 males (71.87%) and nine females (28.12%). 30 osteochondromas (93.75%) were located in the distal femoral metaphysis while as only two cases (6.25%) of proximal metaphyseal involvement were seen. The commonest indication for surgery was pain. Other indications included cosmetic causes, restricted joint movement, fracture of osteochondroma and paresthesia or numbness. The complications included post-operative hematoma formation which was seen in 2 patients (6.25%), infection which was seen in one patient (3.12%), post-operative hypoaesthesia in 2 patients (6.25%) and recurrence of the tumor occurred in one patient (3.12%).</p><p><strong>Conclusions:</strong> Surgical excision of the solitary symptomatic femoral osteochondromas is a rewarding and safe procedure with minimal complications. </p>

Endoscopic third ventriculostomy: outcome analysis in 368 procedures

2010 ◽  
Vol 5 (1) ◽  
pp. 68-74 ◽  
Author(s):  
Oumar Sacko ◽  
Sergio Boetto ◽  
Valérie Lauwers-Cances ◽  
Martin Dupuy ◽  
Franck-Emmanuel Roux
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Hospital Admissions ◽  
Outcome Analysis ◽  
Morbidity Rate ◽  
Third Ventriculostomy ◽  
Safe Procedure ◽  
Chronic Hydrocephalus ◽  
Risk Of Failure ◽  
Increased Risk

Object Although endoscopic third ventriculostomy (ETV) has been accepted as a procedure of choice for the treatment of obstructive hydrocephalus, the outcome of this treatment remains controversial with regard to age, cause, and long-term follow-up results. The goal of this study was to assess the risk of failure associated with these factors in a retrospective cohort study. Methods Between 1999 and 2007, 368 ETVs were performed in 350 patients (165 patients < 18 years of age) with hydrocephalus at the University Hospital of Toulouse. Failure of ETV was defined as cases requiring any subsequent surgical procedure for CSF diversion or death related to hydrocephalus management. Results Tumors (53%), primary aqueductal stenosis (18%), and intracranial hemorrhage (13%) were the most common causes of hydrocephalus. The median follow-up period was 47 months (range 6–106 months), and the overall success rate was 68.5% (252 of the 368 procedures). Patients < 6 months of age had a 5-fold increased risk of ETV failure than older patients (adjusted hazard ratio [HRa] 5.0; 95% CI 2.4–10.4; p < 0.001). Hemorrhage-related (HRa 4.0; 95% CI 1.9–8.5; p < 0.001) and idiopathic chronic hydrocephalus (HRa 6.3, 95% CI 2.5–15.0, p < 0.001) had a higher risk of failure than other causes. Most failures (97%) occurred within 2 months of the initial procedure. The overall morbidity rate was 10%, although most complications were minor. Finally, the introduction of ETV in the authors' department reduced the number of shunt insertions and hospital admissions for shunt failures by half and was a source of cost savings. Conclusions Endoscopic third ventriculostomy is a safe procedure and an effective treatment option for hydrocephalus. Factors indicating potential poor ETV outcome seem to be very young children and hemorrhage-related and chronic hydrocephalus in adults.

Natural History of Adult-Onset Laryngeal Papillomatosis following Multiple Cidofovir Injections

2006 ◽  
Vol 115 (3) ◽  
pp. 175-181 ◽  
Author(s):  
Ana Nusa Naiman ◽  
Darius Abedipour ◽  
Sonia Ayari ◽  
Elizabeth Fresnel ◽  
Bruno Coulombeau ◽  
...  
Keyword(s):  
Complete Remission ◽  
Surgical Excision ◽  
Intralesional Injection ◽  
Adult Onset ◽  
Laryngeal Papillomatosis ◽  
Long Term Follow Up ◽  
History Of ◽  
A Prospective Study

Objectives: A prospective study was performed to assess the intermediate and long-term efficacy of intralesional cidofovir therapy associated with surgical excision in laryngeal papillomatosis in adults. Methods: Endoscopy with intralesional injection of cidofovir 5 mg/mL was performed 3 times at 4-week intervals. The concentration was later increased to 7.5 mg/mL and the interval between injections shortened to 2 weeks. Further treatment was performed at 3 or 6 months, depending on the evolution of the papillomas. After complete remission, the treatment was stopped and the patients were reviewed every 6 months. Results: Nineteen patients completed the protocol, with a mean of 4.5 injections each. Complete remission was obtained in 17 cases (89%) after a mean of 3.8 procedures. Remission was stable after a mean follow-up of 24 months (range, 8 to 57 months). With higher cidofovir concentrations at shorter intervals, patients needed fewer injections to achieve remission (mean, 2.1 versus 4.7 injections). Conclusions: The effectiveness of intralesional cidofovir therapy in adult-onset recurrent respiratory papillomatosis was impressive. Once obtained, complete remission was stable on intermediate or long-term follow-up. The concentration and the interval between injections seemed to influence the number of injections necessary to achieve remission.

Surgical and Endovascular Management of Arteriovenous Malformation: Case Series from a Single Center

Vascular ◽  
2007 ◽  
Vol 15 (3) ◽  
pp. 134-140 ◽  
Author(s):  
Mohamed A. Elsharawy ◽  
Khaled M. Moghazy
Keyword(s):  
Arteriovenous Malformation ◽  
Case Series ◽  
Surgical Excision ◽  
Preoperative Embolization ◽  
Conventional Angiography ◽  
Ethanol Sclerotherapy ◽  
Superselective Embolization ◽  
Endovascular Approach ◽  
A Prospective Study

Management of arteriovenous malformation (AVM) remains a major challenge to vascular surgeons. A multidisciplinary approach was introduced in our hospital to manage these cases from October 2003 to date. This is a report of our experience in their management. A prospective study was done on all patients with symptomatic AVM admitted to our unit between October 2003 and May 2006. All patients had preoperative duplex scanning and magnetic resonance imaging with or without conventional angiography. A multidisciplinary team assessed and treated these cases according to the type of malformation. Thirty-two cases were included in this study, with a mean follow-up of 18.3 months. Of these, 20 cases were predominantly venous and treated with surgical excision ( n = 14) or ethanol sclerotherapy ( n = 6). Twelve cases were predominantly arterial or arteriovenous shunting; 10 were treated with preoperative embolization followed by surgical excision and the remaining 2 with superselective embolization alone. The overall complication rate was high (31%). However, all were minor and settled down conservatively. No recurrence was observed in the early follow-up period. Management of AVM by a surgical and endovascular approach can deliver excellent results, with acceptable morbidity and no recurrence in the early follow-up period.

scholarly journals Outcome analysis of patients after ligament-sparing microdiscectomy for lumbar disc herniation

2002 ◽  
Vol 13 (2) ◽  
pp. 1-4 ◽  
Author(s):  
Youn-Kwan Park ◽  
Joo-Han Kim ◽  
Heung-Seob Chung
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Successful Outcome ◽  
Outcome Analysis ◽  
Safe Procedure ◽  
Repeated Surgery ◽  
Independent Assessment

Object The authors describe a microsurgical technique for the preservation of the ligamentum flavum and the long-term surgery-related results, including an independent assessment of outcome. Methods Three hundred seventy-seven patients underwent ligament-sparing microsurgical discectomy for a previously untreated single-level lumbar disc herniation and were followed for more than 2 years. A successful outcome at 6 months was demonstrated in 93.9% of the patients. At a median follow-up period of 30 months, successful patient-assessed outcome was 84.1%. During the mean follow-up period of 4.2 years (range 2–6.5 years), recurrent disc herniation was detected in 18 patients (4.8%). These patients all underwent repeated surgery. The overall surgery-related rate of complications was 1.3%. Conclusions The authors conclude that ligament-sparing microdiscectomy is a safe procedure, with a favorable success rate and minimal morbidity. Reoperation is safer and easier when using this technique compared with traditional ones.

Multilevel oblique corpectomy without fusion in managing cervical myelopathy: long-term outcome and stability evaluation in 268 patients

2009 ◽  
Vol 10 (5) ◽  
pp. 458-465 ◽  
Author(s):  
Salvatore Chibbaro ◽  
Giuseppe Mirone ◽  
Orphée Makiese ◽  
Bernard George
Keyword(s):  
Spinal Canal ◽  
Japanese Orthopaedic Association ◽  
Spinal Stability ◽  
Safe Procedure ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Oblique Corpectomy ◽  
A Prospective Study

Object The multilevel oblique corpectomy (MOC) allows widening of the spinal canal and foramen trough via an anterolateral access to the cervical spine with control of the vertebral artery and does not require vertebral stabilization or fusion. In the present study, the authors' goal was to demonstrate the long-term efficacy and safety of MOC in the treatment of selected cases of spondylotic myelopathy. Methods The authors conducted a prospective study in a series of 268 patients who underwent MOC for cervical spondylotic myelopathy over a 14-year period. Preoperative and postoperative neurological functioning were evaluated with the modified Japanese Orthopaedic Association scale. Spinal stability was assessed in all patients on serial plain and dynamic cervical radiographs at the last follow-up. The degree of canal expansion after MOC was also measured using the spinal canal/vertebral body ratio, and directly by measuring the diameter of osseous canal on pre- and postoperative CT scans and high-resolution MR images. Results At a mean follow-up of 96 months, clinical improvement was recorded in 86.6% of patients with a global recovery rate of 87.6%, clinical stability in 8%, and worsening in 5%. Long-term spinal stability was demonstrated in 98% of patients. Conclusions Multilevel oblique corpectomy was demonstrated to be a safe procedure that provided good results in terms of improved functional status and long-term spinal stability.

scholarly journals Results of Winograd technique (wedge resection of the toenail and nail bed) in ingrown toe nail

2019 ◽  
Vol 6 (7) ◽  
pp. 2349 ◽  
Author(s):  
Aftab Ahmad Khan ◽  
Shiv Kumar
Keyword(s):  
Surgical Intervention ◽  
District Hospital ◽  
Wedge Resection ◽  
Surgical Techniques ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
Nail Bed ◽  
A Prospective Study ◽  
Late Stages

Background: Ingrown toe nail is a very common condition affecting toes which causes significant morbidity. Most common reasons are improper nail trimming or a tight show wear. Early stages can be managed conservatively by warm soaks, antibiotics and analgesics, however late stages need surgical intervention. Numerous surgical techniques have been described for this condition.Methods: A prospective study was carried out in District hospital Doda from November 2015 to November 2017. Wedge resection of the toe nail and nail bed (Winograd technique) was used. Recurrence rates, complications and patient satisfaction was noted at the end of follow up at one year.Results: We operated 29 toes in 23 patients. We had 3 (10.34%) recurrences out of 29 toes operated, 2 (6.89%) patients got secondarily infected. The overall satisfaction rate in our series was 69.56%.Conclusions: Winograd technique is an easy and safe procedure, however chances of recurrence and cosmetic disfigurement should be explained to the patient during consent. 

scholarly journals Congenital multiple giant lipomas of the back: A case report with a 24-year follow-up

2020 ◽  
pp. 36-40
Keyword(s):  
Flank Region ◽  
Surgical Excision ◽  
Young Female ◽  
Chief Complaint ◽  
Benign Tumors ◽  
Indication For Surgery ◽  
Physical Discomfort ◽  
Giant Size ◽  
Different Parts

Lipomas are the most common benign tumors of connective tissue which can be found in different parts of the human body. In rare cases, their size may be so giant which could be an indication for surgery. Here, we present a case of congenital multiple asymmetrical giant lipomas of the back in a young female. She presented with a chief complaint of physical discomfort due to the giant size and weight of the lipomas. Apart from that, she was in total health. She was born with 5 small lipomas in the back and flank region which had become giant lipomas with estimated weigh around 16 kg in total by the age of 24. The patient underwent seven operations to remove or debulk the mass over a 24-year period since the recurrence of the growths was inevitable. Considering the size of the mass and differential diagnosis, such as liposarcoma, and since no risk factor or underlying etiology was detected for the patient`s condition, surgical excision was the preferred technique for this case.

Palmar Wrist Ganglion: Does Intervention Improve Outcome A Prospective Study of the Natural History and Patient-Reported Treatment Outcomes

2003 ◽  
Vol 28 (2) ◽  
pp. 172-176 ◽  
Author(s):  
J. DIAS ◽  
K. BUCH
Keyword(s):  
Surgical Excision ◽  
Patient Evaluation ◽  
Recurrence Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Patient Reported ◽  
Evaluation Measure ◽  
A Prospective Study

A prospective cohort study was undertaken to observe the long-term outcome of different treatments for palmar wrist ganglia. One hundred and eighty-two patients agreed to participate in the study. One hundred and fifty-five patients (88%) responded at 2 or 5 years. Seventy-nine had been treated by surgical excision, 39 by aspiration and 38 by reassurance alone. At 5 years no significant differences were observed in the recurrence rates which were 42% after excision of a palmar wrist ganglion and 47% (19 of 39) after aspiration. Twenty of the 39 untreated ganglia had disappeared spontaneously. Eighty-five per cent of the patients were satisfied irrespective of treatment. Patients having surgery had a complication rate of 20% and took more time off work (14 days). Significantly more patients in the untreated group felt the persistent ganglion was unsightly. The patient evaluation measure scores were similar. At 2 and 5 year follow-up, regardless of treatment, no difference in symptoms was found, regardless of whether the palmar wrist ganglion was excised, aspirated or left alone. One in four wrists remained weak regardless of treatment or disappearance of the ganglion.

328 Outcome Analysis of Common Peroneal Nerve Neuroplasty at Lateral Fibular Neck

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 272-272
Author(s):  
John Souter ◽  
Kevin Swong ◽  
Matthew McCoyd ◽  
Magan Nielsen ◽  
Neelam Balasubramanian ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peroneal Nerve ◽  
Medical Center ◽  
Common Peroneal Nerve ◽  
Significant Trend ◽  
Sensory Loss ◽  
Outcome Analysis ◽  
Motor Deficits ◽  
Safe Procedure

Abstract INTRODUCTION Common Peroneal Nerve (CPN) neuropathy is the most common entrapment neuropathy of the lower extremities. Patients present with sensory loss along the anterolateral leg and dorsum of the foot, or weakness of the foot dorsiflexors and evertors. METHODS This is an IRB-approved retrospective review of a prospectively maintained database of patients who underwent decompressive surgery for CPN neuropathy with a minimum of 3 months follow up at Loyola University Medical Center. Motor scores were totaled using the Oxford Scale, with an improvement defined as resolution of pain or sensory loss or improvement in motor score by at least a 1-grade. RESULTS >30 patients were analyzed. Of the 26 patients who presented with abnormal lower extremity motor scores, 24 had at least 1 grade improvement in motor scores, and 2 experienced no change. 26 patients presented with lower extremity decreased sensation, and 12 of these patients reported improved sensation, while 14 patients reported no change. Patients with an increased time to surgery (>67 weeks) had a non-significant trend towards worse outcomes (p = .06). Patients who presented with weakness had a significant trend towards improvement (p = .0006) compared to patients presenting with pain and sensory deficits. CONCLUSION Surgical decompression of the CPN at the lateral fibular neck is an effective and safe procedure. Patients presenting with pain or sensory loss did not show a significant trend towards improvement with surgery, while patients presenting with motor deficits had a significant improvement with surgery. There was a trend of worse outcomes with a symptoms-to-surgery time greater than 67 weeks.

scholarly journals Multifocal Joint Osteonecrosis in Sickle Cell Disease

2009 ◽  
Vol 3 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Charles Henri Flouzat-Lachaniete ◽  
Xavier Roussignol ◽  
Alexandre Poignard ◽  
Martin Mukisi Mukasa ◽  
Olivier Manicom ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Tibial Plateau ◽  
Femoral Condyle ◽  
Cell Disease ◽  
Femoral Metaphysis ◽  
Distal Femoral Metaphysis ◽  
Time Of Presentation ◽  
Very High

The purpose of this study was to evaluate the frequency of multifocal osteonecrosis in patients with sickle cell disease. Between 1980 and 1989, 200 patients with sickle cell disease were treated in our institution for osteonecrosis. The patient population consisted of 102 males and 88 females with a mean age of twenty-six years at the time of presentation (range, eighteen to thirty-five years) and was followed until the year 2005. This cohort of patients was follow-up during average 15 years (until the year 2005). Multifocal osteonecrosis was defined as a disease of 3 or more anatomic sites. At the time of presentation, 49 patients were identified as having multifocal osteonecrosis. At the most recent follow-up, 87 patients had multifocal osteonecrosis. So at the last follow up among these eighty-seven patients, the occurrence of osteonecrosis was 158 lesions of the proximal femur associated with 151 proximal humerus osteonecroses, thirty-three lateral femoral condyle osteonecroses, twenty-eight distal femoral metaphysis osteonecroses, twenty-seven medial femoral condyle osteonecroses, twenty-three tibial plateau osteonecroses, twenty-one upper tibial metaphysis osteonecroses and forteen ankle osteonecroses. The total number of osteonecrosis was 455 in these 87 patients. The epiphyseal lesions were more frequent than the metadiaphyseal lesions excepted in the proximal tibia (Table 3). In conclusion, in patients with sickle cell disease, the risk of multifocal osteonecrosis is very high. In patients with hip osteonecrosis, the other joints should be evaluated with radiograph and MRI if the joint is symptomatic. In patients with osteonecrosis of the knee, shoulder or ankle, the patients’ hip should be evaluated by radiographs or MRI, regardless of whether the hip is symptomatic.

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