Archives of orthopaedic and trauma surgery
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Chondromyxoid fibroma is a benign, although potentially aggressive tumor, with a cartilage-like matrix, accounting for approximately 1% of all bone tumors. It usually affects the metaphyseal region of long bones of patients in their first or second decade of life. An additional peak of incidence has been observed between 50 and 70 years of age. ⋯ Preferred treatment is complete local excision with tumor-free margins. Intralesional curettage with or without local adjuvants shows a local recurrence rate of approximately 25%. Radiation therapy may be useful in nonresectable cases but bears the well documented risk of radiation-induced malignancies.
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Arch Orthop Trauma Surg · Jan 2000
Scintigraphic evaluation of impaction grafting for total hip arthroplasty revision.
To determine the fate of an impacted allograft after a minimum follow-up of 1 year, we examined 9 of 40 patients who underwent revision arthroplasty with the impaction grafting technique. The allograft used in this study was morselized cancellous freeze-dried allograft. We examined these 9 patients with technetium-99 m methylene diphosphonate bone scintigraphy at an average of 14 (range 12-20) months after surgery. ⋯ Scintigraphic examination demonstrated that the area corresponding to the allograft had a remarkable radioactivity accumulation suggesting new bone formation. The allograft in total hip revision using the impaction grafting technique undergoes a significant neovascularization and new bone formation. This study suggests than when vigorous impaction is used, freeze-dried cancellous allograft can be used for impaction grafting.
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Arch Orthop Trauma Surg · Jan 2000
Value of myofibrillar protein catabolic rate in Duchenne muscular dystrophy. A study after lower limb surgery.
Previous studies have shown a decreased progression of the course in Duchenne muscular dystrophy (DMD) patients treated by lower limb surgery in early childhood. The use of 3-methylhistidine (3-MH) excretion and 3-MH/creatinine excretion ratio as an appropriate indicator for the myofibrillar protein catabolic rate (MPCR) in muscle disorders is discussed controversially. ⋯ However, the formula for the calculation of the MPCR contains quantities which are not precisely known in DMD or assumed to be constant over the progressive course of DMD. Summarizing MPCR cannot be recommended for the assessment of therapeutic efficacy in DMD.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsTotal knee arthroplasty in patients with inherited dwarfism--a report of five knee replacements in two patients with Morquio's disease type A and one with spondylo-epiphyseal dysplasia.
In Morquio's disease and in hereditary spondylo-epiphyseal dysplasia of longer duration, malalignment, instability and unfavourable anatomy are generally the main surgical problems, but as these patients nowadays do not have a reduced life expectancy, it is worthwhile giving them a functional replacement for their severely deformed and painful knees. We report three patients with inherited dwarfism, in whom a replacement of the knee was performed.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyLimb reconstruction with the callus distraction method after bone tumor resection.
The callus distraction method was applied to nine patients who were referred to us because of a bone tumor. Their mean age was 17 years and 3 months (range 7-37 years). Three were female, and 6 were male. ⋯ All of the complications were successfully treated. Functional evaluation gave excellent results in four patients, good in three, and fair in two. This method can be used without any need for massive autogenous bone graft in repairing defects of any length and diameter produced after excision of the lesion and thus can be considered as an alternative to other techniques.