Der Unfallchirurg
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Benign bone tumors are relatively seldom compared to degenerative and inflammatory skeletal diseases. There are usually diagnostic difficulties because of their markedly high differential diagnostic potential. This leads to problems regarding the further procedure. ⋯ The diagnostics of primary and secondary benign (and malignant) bone tumors requires a specialized osteoradiological expertise because of their rarity and the differential diagnostic and differential therapeutic potential. Radiology and pathology are the basis of diagnosing bone tumors and tumor-like lesions. Benign bone tumors and tumor-like lesions can often be diagnosed radiologically; therefore, the choice between a conservative (surveillance) or interventional (surgery) procedure will be correct in most cases.
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Benign bone tumors and tumor-like lesions are much more frequent than malignant bone tumors among the total number of tumors of the skeleton. ⋯ The treatment of benign bone tumors depends on the histological type and the biological activity. Most benign bone tumors are diagnosed incidentally and do not necessitate any treatment.
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In posttraumatic dystrophy the resorption of cancellous bone remains an unsolved phenomenon. ⋯ Intraosseous av anastomoses with acidosis and hypoxia of the tissues are probably responsible for the excessive activity of osteoclasts in acute posttraumatic dystrophy. Even enhancements in the late static phase of the three phase bone scan (TPBS) are in agreement with this hypothesis. In cancellous bone these enhancements are induced by the bone seeking tracers. The nomenclature for these tracer molecules is in line with the recommendations of International Union of Pure and Applied Chemistry (IUPAC) as methylene bisphosphonate and hydroxymethylene bisphosphonate. From this, therapeutic recommendations for posttraumatic dystrophy can be derived. The term diphosphonates should be changed to bisphosphonates.
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Giant cell bone tumors (GCT) are benign but partially locally aggressive osteolytic tumors which typically occur around the knee joint in the epiphysis and metaphysis of long bones after maturation of the skeleton is completed. Due to the locally aggressive growth behavior with destruction of the bone structure, the rare possibility of pulmonary metastases in recurrent cases and a very rare possibility of malignancy, GCTs were previously also described as semimalignant bone tumors. ⋯ After unsatisfactory attempts at surgical treatment of GCT patients, the new treatment option with denosumab is a promising alternative due to its effect as a monoclonal RANKL inhibitor.
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The number of injuries caused by accidents while springing on a trampoline has increased significantly. This study therefore focused on the incidence, morbidity and circumstances of the accidents in pediatric patients. ⋯ Pediatric accidents on a trampoline result in severe injuries in 28% of cases. There is no difference in the severity of the injury regarding trampolines with or without special safety measures. Safety nets do not reduce the risk of severe injury.