Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2009
Case ReportsOncogenic osteomalacia: two case reports with surprisingly different outcomes.
Oncogenic osteomalacia is a rare paraneoplastic syndrome of acquired hypophosphatemic osteomalacia, resulting from a deficit in renal tubular phosphate reabsorption, in which fibroblast growth factor 23 (FGF23) seems to be implicated. This condition is usually associated with a phosphaturic mesenchymal tumor of mixed connective tissue located in the bone or soft tissue. The clinical and the radiologic findings are the same as those seen in osteomalacia, and the biochemical features include renal phosphate loss, low serum phosphate and 1,25-(OH)(2) vitD(3) levels, increased alkaline phosphatase, and normal calcium, PTH, calcitonin, 25-OH-vitD(3) and 25,25-(OH)(2) vitD(3). ⋯ This disease usually remits with complete tumor resection. Nevertheless, if this is not possible, oral treatment with phosphate, calcium and calcitriol can improve the symptoms. If scintigraphy of the tumor shows octreotide receptors, patients may respond partially to therapy with somatostatin analogs, with stabilization of the lesion.
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Arch Orthop Trauma Surg · Apr 2009
Case ReportsHip and knee dislocation during femoral lengthening in congenital short femur: a rare case report.
Congenital short femur is a rare and complex deformity that is often associated with other anomalies. There are few reports of either hip or knee dislocations during femoral lengthening in congenital short femur predisposed by associated anomaly. ⋯ We have this case of congenital short femur, where both hip and knee dislocation occurs during femoral lengthening. We reviewed different article to understand the cause and avoid such unwanted complications in future.
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Arch Orthop Trauma Surg · Apr 2009
The use of structural periacetabular allografts in acetabular revision surgery: 2.5-5 years follow-up.
"Acetabular bone loss" presents a major reconstructive challenge in total hip arthroplasty. Loss of acetabular bone stock is a consequence of removal of bone during the original procedure, subsequent prosthetic failure and osteolysis resulting from wear particles of cement and polyethylene. In case of severe bone loss treatment options are rather limited, as fixation requires either biological (cancellous allograft with cage or structural allograft) or non-biological (trabecular metal, triflange implant, etc.) scaffolds. ⋯ The bicortical allograft without protective device seems to function as a passive biocompatible dead scaffold, which has a less intrinsic strength at intermediate term follow-up, compared to the by ring or cage protected structural allografts.
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Bone transport is based on the principle of distraction osteogenesis described by Ilizarov and is a consecrated method for the treatment of segmental bone defects. One of its most problematic and, paradoxically, least studied aspects is the consolidation of the docking site. We studied histologically the ossification of the docking site and regenerate to determine any difference between them. ⋯ The experimental bone transport model proposed in the present study permits us to conclude that there is a clear difference between the ossification of the docking site and of the regenerate.
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Arch Orthop Trauma Surg · Apr 2009
Technetium-99 m-MDP scintigraphy and long-term follow-up of musculo-skeletal sarcoma reconstructed with pasteurized autologous bone graft.
Local bone tumor excision followed by pasteurization and reimplantation is a unique technique of reconstruction for sarcoma patients. The long-term scintigraphic findings of pasteurized bone grafts in relation to clinical patients' data were reviewed retrospectively. ⋯ The method of pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors.