scholarly journals Femoral bone growth after extendible endoprosthetic replacement of the proximal tibia in skeletally immature patients

2021 ◽  
Vol 87 (3) ◽  
pp. 443-448
Author(s):  
Oluwaseyi Kayode Idowu ◽  
Oladimeji Ranti Babalola ◽  
Adesegun Tibramiyu Abudu
Keyword(s):  
Bone Growth ◽  
Proximal Tibia ◽  
Malignant Tumors ◽  
Lower Limbs ◽  
Skeletally Immature ◽  
Femoral Bone ◽  
Endoprosthetic Replacement ◽  
Femoral Length ◽  
The Mean

There is increasing preference for limb salvage techniques in the management of pediatric musculo- skeletal tumors. This study was aimed at evaluating femoral growth following proximal tibia resection (PTR) and placement of an extendible endoprosthesis with sliding stem. This was a retrospective study. The demographic and clinical data were collected. All the patients with malignant tumors were fully staged and commenced on appropriate chemotherapy. An expected discrepancy of > 3cm was considered sub- stantial enough to warrant extendible prosthesis. Twelve patients who had follow up full length scanogram of the lower limbs were included for the evaluation of femoral growth. The last available scanograms were used for growth comparison of the femur. The age at resection for all twelve patients ranged from 4-13 years. The commonest histological diagnosis was Osteosarcoma. In the twelve patients assessed for the growth of femur, the mean femoral length was 96% [89%-102%] of the unaffected femur. Distal femoral physeal growth continued after im- plantation of a sliding extendible prosthesis after resection of proximal tibia tumors.

scholarly journals Malignant Eyelid Tumors in India: A Study of 536 Asian Indian Patients

2018 ◽  
Vol 5 (3) ◽  
pp. 210-219 ◽  
Author(s):  
Swathi Kaliki ◽  
Nandini Bothra ◽  
Kavya Madhuri  Bejjanki ◽  
Arpita Nayak ◽  
George Ramappa ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Asian Indian ◽  
Malignant Tumors ◽  
Tumor Location ◽  
Sebaceous Gland Carcinoma ◽  
Gland Carcinoma ◽  
The Mean ◽  
Asian Indian Population ◽  
Tumor Extent

Purpose: To study the proportion of eyelid malignant tumors in an Asian Indian population and to review their clinical features and outcomes. Methods: This is a retrospective study of 536 patients. Results: The mean age at presentation with eyelid malignancy was 58 years. Histopathology-proven diagnoses of these patients included sebaceous gland carcinoma (SGC) (n = 285, 53%), basal cell carcinoma (BCC) (n = 128, 24%), squamous cell carcinoma (SCC) (n = 99, 18%), and miscellaneous tumors (n = 24, 4%). The statistically significant differences between eyelid malignant tumors included age at presentation, tumor location, and tumor extent. The clinicopathological correlation of SGC, BCC, SCC, and miscellaneous tumors was 91, 86, 46, and 38% (p = 0.001), respectively. Comparing SGC with BCC, SCC, and miscellaneous tumors, SGC was more commonly associated with tumor recurrence (21 vs. 3, 8, and 13%; p = 0.001), systemic metastasis (13 vs. 0, 4, and 13%; p = 0.001), and death (9 vs. 0, 4, and 0%; p = 0.004). Compared to SGC, BCC, and SCC, locoregional lymph node metastasis was more common with miscellaneous tumors (26 vs. 16, < 1, and 8%; p = 0.001) over a mean follow-up period of 19 months. Conclusion: In Asian Indians, SGC is twice as common as BCC and 3 times more common than SCC. SGC is associated with poorer prognosis compared to other eyelid malignant tumors.

The 3-in-1 Procedure for Recurrent Dislocation of the Patella in Skeletally Immature Children and Adolescents

2009 ◽  
Vol 37 (9) ◽  
pp. 1814-1820 ◽  
Author(s):  
Francesco Oliva ◽  
Mario Ronga ◽  
Umile Giuseppe Longo ◽  
Vittorino Testa ◽  
Giovanni Capasso ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Patellar Dislocation ◽  
Case Series ◽  
Skeletal Maturation ◽  
Isokinetic Strength ◽  
Skeletally Immature ◽  
Recurrent Patellar Dislocation ◽  
Level Of Evidence ◽  
The Mean

Background Recurrent patellar dislocations are common injuries in children and adolescents. The subjective and functional results of soft tissue surgical management in a population that was skeletally immature at the time of surgery have not been reported. Hypothesis The 3-in-1 procedure is an effective treatment for recurrent patellar dislocation in skeletally immature patients. Study Design Case series; Level of evidence, 4. Methods Twenty-five skeletally immature patients (age at operation, 13.5 ± 3.8 years) who were practicing sports and suffering from recurrent unilateral patellar dislocation were included in the study and followed until skeletal maturation. Clinical evaluation included the modified Cincinnati rating system and the Kujala score, anthropometry, plain radiography, and isokinetic dynamometry. Results The average follow-up was 3.8 years (range, 2.5-6 years). The mean modified Cincinnati score increased from 51.7 ± 12.6 preoperatively to 94.3 ± 10.8 (P < .02), while the mean Kujala scores increased from 52.4 ± 12.7 preoperatively to 93.8 ± 14.2 (P < .02). The Insall-Salvati index remained essentially unchanged, being 1.04 ± 0.2 preoperatively and 1.02 ± 0.3 at latest follow-up. Significant differences were found between the operated and the contralateral limb in the various isokinetic strength variables at all angular velocities measured at the latest follow-up (.05 < P < .0042). Conclusion The 3-in-1 procedure is a safe, reliable management option for recurrent patellar dislocation in skeletally immature patients. Side-to-side differences in isokinetic strength and in anthropometric indices persist despite subjective success of the procedure.

The Mayo Conservative hip: Experience from a District General Hospital

2009 ◽  
Vol 19 (3) ◽  
pp. 211-214 ◽  
Author(s):  
Rob E. Gilbert ◽  
Seema Salehi-Bird ◽  
Peter D. Gallacher ◽  
Phillip Shaylor
Keyword(s):  
Femoral Component ◽  
Hip Replacement ◽  
District General Hospital ◽  
Fracture Rate ◽  
Bone Stock ◽  
Femoral Prosthesis ◽  
Femoral Bone ◽  
Short Term ◽  
The Mean

The Mayo Conservative Hip femoral prosthesis has been designed to optimise proximal femoral loading as well as preserving proximal femoral bone stock. Between October 2003 and May 2006, 42 patients (49 hips) underwent total hip replacement (THR) using the Mayo Conservative Hip femoral component. The mean age at operation was 57.8 years (range 44 to 74) and the mean clinical follow up was 3.1 years (range 2.3 to 4.7 years). The aim of our study was to review the short term results of this unorthodox femoral component. We found that 18%° of stems were malaligned ≥ 5° and the prevalence of intra-operative femoral fracture was 4%. We feel this prosthesis is difficult to implant and has an unacceptable fracture rate.

scholarly journals Regression Equation and Multiplication Factor for the Reconstruction of Stature by Femur Length

2020 ◽  
Vol 8 (02) ◽  
pp. 25-30
Author(s):  
Raj Kumar Karki ◽  
Pankaj Kumar Singh ◽  
Abdul Sami Khan ◽  
Sudeep Regmi
Keyword(s):  
Statistical Analysis ◽  
Direct Relationship ◽  
Regression Equation ◽  
Lower Limbs ◽  
Measuring Instruments ◽  
Multiplication Factor ◽  
Femur Length ◽  
Femoral Length ◽  
Standard Position ◽  
The Mean

INTRODUCTION Stature is the important parameter along with age, sex and race while identifying bodies. Stature has direct relationship with the skeletal dimensions most importantly with lower limbs. This study attempts to derive regression equation (RE) and multiplication factor (MF) from femur length (FL) which could be used for stature reconstruction. MATERIAL AND METHODS The study was conducted amongst the 160 students and staff of Dhulikhel Hospital, Nepal for the period of six months from February 2020 to July 2020. The sample was composed of 95 males and 65 females between the age of 18 - 40 years. The femoral length and height was measured in standard position using standard measuring instruments. Statistical analysis was done using SPSS 25.   RESULTS The mean height and femur length of overall sample was 162.33 ±7.62 cm and 40.14 ±2.132 cm respectively, male surpassing the female dimensions. There was a strong correlation between femur length and stature (r = 0.723, 0.869 and 0.791 for males, females, and overall participants respectively). MF was derived as 4.084 ±0.139, 3.99 ±0.11, 4.047 ±0.135 and RE was derived as y = 75.51 + 2.13*FL ±4.06, y = 55.238 + 2.581*FL ±2.999, y = 48.791 + 2.829*FL ±4.672 for males, females and overall participants. Both methods were checked for accuracy and could successfully interpret the height (p>0.05). CONCLUSION The femoral length was found to be a reliable estimator of stature of an individual by using both RE and MF.

scholarly journals Treatment of atrophic nonunion via autogenous ilium grafting assisted by vertical fixation of double plates: A case series of patients

2019 ◽  
Vol 47 (5) ◽  
pp. 1998-2010 ◽  
Author(s):  
Liang Sun ◽  
Zhong Li ◽  
Teng Ma ◽  
Han-Zhong Xue ◽  
Qian Wang ◽  
...  
Keyword(s):  
Bone Healing ◽  
Case Series ◽  
Lower Limbs ◽  
Structural Environment ◽  
Tibial Nonunion ◽  
The Mean ◽  
And Function ◽  
Atrophic Nonunion ◽  
Humeral Nonunion

Objective To investigate the efficacy of the treatment of atrophic nonunion using structural autogenous ilium bone grafting in combination with vertical fixation of double plates. Methods This retrospective study analysed the clinical data from consecutive patients with atrophic nonunion who underwent autogenous ilium grafting in combination with double-plate vertical fixation. The injury type and the bone affected by nonunion, the duration of nonunion and the outcomes following surgery were recorded for all patients. Results The study enrolled 43 patients with atrophic nonunion of the upper and lower limbs: 17 patients with tibial nonunion, 21 with femoral nonunion, four with humeral nonunion and one with radial shaft nonunion. The mean duration of postoperative follow-up was 14.5 months (range, 8–28 months). A total of 43 of 43 patients (100%) achieved a healed nonunion fracture without the occurrence of complications such as infection, fracture of internal fixation or pain in the harvesting site. Comprehensive postoperative assessments of bone healing and function were observed to be good and/or excellent in all 43 patients. Conclusion Structural autogenous ilium grafting used in combination with double-plate vertical fixation can provide a stable structural environment for near optimal bone healing in patients with atrophic nonunion.

Change in Posterior Tibial Slope in Skeletally Immature Patients With Anterior Cruciate Ligament Injury: A Case Series With a Mean 9 Years’ Follow-up

2021 ◽  
pp. 036354652199709
Author(s):  
R. Kyle Martin ◽  
Guri R. Ekås ◽  
JūratėŠaltytė Benth ◽  
Nicholas Kennedy ◽  
Gilbert Moatshe ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Case Series ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Skeletally Immature ◽  
Posterior Tibial ◽  
Lateral Posterior ◽  
The Mean ◽  
Injured Knee

Background: Increased lateral posterior tibial slope (LPTS) is associated with increased rates of anterior cruciate ligament (ACL) injury and failure of ACL reconstruction. It is unknown if ACL deficiency influences the developing proximal tibial physis and slope in skeletally immature patients through anterior tibial subluxation and abnormal force transmission. Purpose: To assess the natural history of LPTS in skeletally immature patients with an ACL-injured knee. Study Design: Case series; Level of evidence, 4. Methods: A total of 38 participants from a previous study on nonoperative management of ACL injury in skeletally immature patients were included. During the initial study, bilateral knee magnetic resonance imaging (MRI) was performed within 1 year of enrollment and again at final follow-up. All patients were younger than 13 years at the time of enrollment, and final follow-up occurred a mean 10 years after the injury. MRI scans were retrospectively reviewed by 2 reviewers to determine bilateral LPTS for each patient and each time point. Linear mixed models were used to assess LPTS differences between knees, change over time, and association with operational status. Subgroup analyses were performed for patients who remained nonoperated throughout the study. Results: A total of 22 patients had ACL reconstruction before final follow-up and 16 remained nonoperated. In the entire study population, the mean LPTS was higher in the injured knee than in the contralateral knee at final follow-up by 2.0° ( P < .001; 95% CI, 1.3°–2.6°). The mean LPTS increased significantly in the injured knee by 0.9° ( P = .042; 95% CI, 0.03°–1.7°), while the mean LPTS decreased in the contralateral knee by 0.4° ( P = .363; 95% CI, –0.8° to 0.4°). A significant difference in LPTS was also observed in the nonoperated subgroup. No significant association was observed between LPTS and operational status. Conclusion: Lateral posterior tibial slope increased more in the ACL-injured knee than in the contralateral uninjured knee in a group of skeletally immature patients. Lateral posterior tibial slope at baseline was not associated with the need for surgical reconstruction over the study period.

Endoscopic Management of Sinonasal Tumors: A Preliminary Report

2005 ◽  
Vol 19 (3) ◽  
pp. 307-315 ◽  
Author(s):  
David M. Poetker ◽  
Robert J. Toohill ◽  
Todd A. Loehrl ◽  
Timothy L. Smith
Keyword(s):  
Recurrence Rate ◽  
Chart Review ◽  
Malignant Tumors ◽  
Surgical Excision ◽  
Tumor Location ◽  
Therapeutic Modality ◽  
Endoscopic Management ◽  
Benign Tumors ◽  
The Mean

Background The increased experience with the endoscopic approach to sinonasal inflammatory disease has resulted in the increased use of endoscopes to manage many different sinonasal pathologies. Methods A chart review of patients with sinonasal tumors treated with primary endoscopic management, from January, 1993 to November, 2003 was performed. Results Forty patients were identified (26 men and 14 women). The mean age was 53.2 years, and the mean follow-up was 31.1 months. For benign tumors, 24 patients were identified with a mean age of 50.7 years, a mean follow-up of 17.5 months, and a recurrence rate of 4.2%. For malignant tumors, 16 patients were identified, with a mean age of 57.3 years, a mean follow-up of 51.5 months, and a recurrence rate of 31.3%. The overall survival rate was 87.5%. Conclusion Endoscopic surgical excision of selective sinonasal tumors may be an effective therapeutic modality. In some cases, adjuvant external procedures may be required based on tumor location.

Physeal-preserving endoprosthetic replacement with short segment fixation in children with bone sarcomas

2019 ◽  
Vol 101-B (9) ◽  
pp. 1144-1150 ◽  
Author(s):  
Y. Tsuda ◽  
T. Fujiwara ◽  
D. Sree ◽  
J. D. Stevenson ◽  
S. Evans ◽  
...  
Keyword(s):  
Survival Rate ◽  
Proximal Humerus ◽  
Joint Function ◽  
Endoprosthetic Replacement ◽  
Custom Made ◽  
Effective Option ◽  
Bone Sarcomas ◽  
The Mean ◽  
Short Segment Fixation

Aims The aim of this study was to report the results of custom-made endoprostheses with extracortical plates plus or minus a short, intramedullary stem aimed at preserving the physis after resection of bone sarcomas in children. Patients and Methods Between 2007 and 2017, 18 children aged less than 16 years old who underwent resection of bone sarcomas, leaving ≤ 5 cm of bone from the physis, and reconstruction with a custom-made endoprosthesis were reviewed. Median follow-up was 67 months (interquartile range 45 to 91). The tumours were located in the femur in 11 patients, proximal humerus in six, and proximal tibia in one. Results The five-year overall survival rate was 78%. No patient developed local recurrence. The five-year implant survival rate was 79%. In all, 11 patients (61%) developed a complication. Seven patients (39%) required further surgery to treat the complications. Implant failures occurred in three patients (17%) including one patient with aseptic loosening and two patients with implant or periprosthetic fracture. The preserved physis continued to grow at mean 3.3 cm (0 to 14). The mean Musculoskeletal Society score was 88% (67% to 97%). Conclusion Custom-made endoprostheses that aim to preserve the physis are a safe and effective option for preserving physeal growth, limb length, and joint function with an acceptable rate of complications. Cite this article: Bone Joint J 2019;101-B:1144–1150

scholarly journals Parapharyngeal space tumors: a serial case study

2019 ◽  
Vol 47 (8) ◽  
pp. 4004-4013
Author(s):  
Kuang-Hsu Lien ◽  
Chi-Kuang Young ◽  
Shy-Chyi Chin ◽  
Chun-Ta Liao ◽  
Shiang-Fu Huang
Keyword(s):  
Parapharyngeal Space ◽  
Clinical Symptoms ◽  
Malignant Tumors ◽  
Neck Mass ◽  
Surgical Approaches ◽  
Common Symptom ◽  
Neck Tumors ◽  
The Mean

Objective Primary parapharyngeal space (PPS) tumors are one of the most challenging head and neck tumors to diagnose and treat. We analyzed our experience in patients with PPS tumors who were treated in our hospital over 13 years. Methods We retrospectively reviewed 16 patients with PPS tumors between 2006 and 2018. The study included clinical symptoms, histological types, surgical approaches, adjuvant therapies, postoperative complications, and prognosis. Results The mean age of the patients was 49.63 ± 17.03 years. A palpable neck mass (56.3%) was the most common symptom. In our series, 78.6% of the tumors were benign, and of these, schwannomas were the most common (6/14, 42.9%). Three surgical approaches were used in our patients, including transmandibular (57.1%), transcervical (21.4%) and transparotid (21.4%) approaches. Few complications were reported, including hoarseness and numbness. Adjuvant therapy was administered depending on pathological parameters of the tumors. No recurrence was observed during a mean follow-up of 60.6 months in patients with malignant tumors. Conclusions Radiological studies of PPS tumors are essential for diagnosis and surgical planning. Excision of PPS tumors using appropriate surgical approaches provides good outcomes.

Long-Term Outcome of Surgical Management in Symptomatic Pediatric Vertebral Hemangiomas Presenting With Myelopathy

Neurosurgery ◽  
2020 ◽  
Author(s):  
Pankaj K Singh ◽  
Sarat P Chandra ◽  
Mohit Agrawal ◽  
Dattaraj Sawarkar ◽  
Rajender Kumar ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Spinal Injury ◽  
Lower Limbs ◽  
Vascular Lesions ◽  
Vertebral Hemangioma ◽  
Long Term Outcome ◽  
The Mean ◽  
Vertebral Hemangiomas

Abstract BACKGROUND Vertebral hemangiomas are benign, highly vascular lesions of the vertebra, rarely seen in the pediatric age group. OBJECTIVE To analyze the long-term (&gt;3 yr) outcome of patients of pediatric vertebral hemangioma presenting with myelopathy and to describe our surgical strategy to treat such cases. METHODS All patients up to 18 yr of age with a symptomatic vertebral hemangioma treated at our hospital from May 2003 to August 2016, with at least 3-yr follow-up were included. Functional clinical outcomes were measured using American Spinal Injury Association (ASIA) score. RESULTS There were 7 male and 7 female patients. All hemangiomas were located in the thoracic spine with single-level involvement. Upper thoracic spine involvement was more common (12 cases: 85.71%) than lower thoracic spine involvement (2 cases: 14.29%). All patients had features of myelopathy. The mean age was 14.57 yr, ranging from 10 to 18 yr. The mean follow-up was 62.21 mo, ranging from 36 to 90 mo. All patients had improvement in motor strength of both lower limbs postoperatively. Local pain, which was present in 1 patient, resolved, and the bladder symptoms present in 5 patients also resolved. CONCLUSION Our experience in treating symptomatic pediatric vertebral hemangiomas, along with the long-term follow-up data, suggests that good postoperative results can be achieved with minimal complications in carefully selected patients.

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