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Percutaneous Injection of Calcium Phosphate Composite in Pediatric Unicameral Bone Cysts: a Minimum 5-Year Follow-Up Study
Sport Sciences for Health (2019) 15:207–213 https://doi.org/10.1007/s11332-018-0513-7 ORIGINAL ARTICLE Percutaneous injection of calcium phosphate composite in pediatric unicameral bone cysts: a minimum 5-year follow-up study Marco Turati1,2 · Marco Bigoni2,3 · Lilia Brahim1 · Emeline Bourgeois1 · Giovanni Zatti2,3 · Ahmad Eid1 · Jacques Griffet1 · Aurélien Courvoisier1 Received: 4 September 2018 / Accepted: 9 November 2018 / Published online: 24 November 2018 © Springer-Verlag Italia S.r.l., part of Springer Nature 2018 Abstract Background Unicameral bone cyst (UBC) is a common lesion in skeletally immature patients. Multiple treatments are pro- posed as curettage and autologous bone graft, percutaneous local corticoids injections, decompression with internal fixation, and injection of bioresorbable cement. Decompression, curettage, and percutaneous bioresorbable cement injection showed interesting results, but until now, no long-term follow-up was reported in pediatric patients with UBC. Methods We retrospectively evaluated 13 pediatric patients with UBC treated with curettage, decompression, and injection of a calcium phosphate composite (CPC) at a single institution with an average F-U of 5.46 years (range 5–7 years). Func- tional outcomes were evaluated according to the Musculoskeletal Tumour Society (MSTS) Score. Radiographic healing was assessed with the modified Neer Outcome Rating System. Complications were recorded. Results The mean MSTS score was 29.61 (range 28–30). No joint limitation or any pain was recorded. All patients returned to their previous level of activity. Complete healed cysts were observed in 76.9% of patients (10 of 13) and partially healed in 23.1% (3 of 13). Three fractures of the humerus occurred without any further consequence. -
Benign Fibro-Osseous Lesions Plus…
“Vision is the art of seeing things invisible.” Jonathan Swift 1667 - 1745 Benign Fibro-osseous Lesions Plus… Steven R. Singer, DDS [email protected] 212.305.5674 Benign Fibro-osseous Lesions Fibrous Dysplasia A group of lesions in which normal bone is Localized change in bone metabolism replaced initially by fibrous connective tissue Normal cancellous bone is replaced by Over time, the lesion is infiltrated by osteoid fibrous connective tissue and cementoid tissue The connective tissue contains varying amounts of abnormal bone with irregular This is a benign and idiopathic process trabeculae Trabeculae are randomly oriented. (Remember that normal trabeculae are aligned to respond to stress) Fibrous Dysplasia Fibrous Dysplasia Lesions may be solitary (monostotic) or Fibrous dysplasia is non-hereditary involve more than one bone (polyostotic) Caused by a mutation in a somatic cell. Monostotic form accounts for 70% of all Extent of lesions depends on the timing of cases the mutation. Polyostotic form is more common in the first If the mutation occurs earlier, the disease decade will be more widespread throughout the M=F except in McCune-Albright syndrome, body. An example is McCune-Albright which is almost exclusively found in females Syndrome 1 Fibrous Dysplasia Fibrous Dysplasia McCune-Albright Syndrome • Monostotic and polyostotic forms usually -Almost exclusively begins in the second decade of life females -Polyostotic fibrous • Slow, painless expansion of the jaws dysplasia • Patients may complain of swelling or have -
Bone Grafting in Brodie's Absc Rafting in Brodie's Abscess
Case Report Bone Grafting in Brodie’s Abscess Athar Ahemad Department of Orthopaedics, Indian Institute of Medical Sciences and Research, Warudi, Tq. Badnapur, Jalna, Maharashtra, INDIA. Email: [email protected] Abstract Brodie’s abscess is a localized infection of the bone manifesting on radiographs as an osteolytic lesion limited by sclerotic bone. It was first described by Sir Benjamin Brodie 1in the year 1832 as a localized abscess in the tibia seen in an amputation stump. It is most commonly seen in proximal tibia follo wed by femur and then in humerus. Various treatments have been described in the literature ranging from antibiotics alone to debridement alone to curettage and filling of defect by bone graft or cement 2,3,4. Here, we report 2 cases of Brodie’s abscess tre ated successfully by surgical debridement and bone grafting. Address for Correspondence Dr. Athar Ahemad, Department of Orthopaedics, Indian Institute of Medical Sciences and Research, Warudi, Tq. Badnapur, Jalna, Maharashtra, INDIA. Email: [email protected] Received Date: 13/09/2014 Accepted Date: 17 /0 9/2014 hydrogen peroxide. The cavity was debrided till there was Access this article online bleeding bone all around. Since the bone defect was large (5x3x3cm), fresh cancellous autograft from ipsilateral Quick Response Code: Website: iliac crest was used to fill the defect. Muscle flap st itched www.medpulse.in over the window as a local flap. A long knee brace was given to prevent pathological fracture. DOI: 18 September 2014 INTRODUCTION Case 1 A 24 year old male manual laborer presented to us with complaints of throbbing pain in the upper part of leg on Photo 1: Cavity of the abscess being debrided with a curette which and off since last 4 years especially at night. -
Orthopedic-Conditions-Treated.Pdf
Orthopedic and Orthopedic Surgery Conditions Treated Accessory navicular bone Achondroplasia ACL injury Acromioclavicular (AC) joint Acromioclavicular (AC) joint Adamantinoma arthritis sprain Aneurysmal bone cyst Angiosarcoma Ankle arthritis Apophysitis Arthrogryposis Aseptic necrosis Askin tumor Avascular necrosis Benign bone tumor Biceps tear Biceps tendinitis Blount’s disease Bone cancer Bone metastasis Bowlegged deformity Brachial plexus injury Brittle bone disease Broken ankle/broken foot Broken arm Broken collarbone Broken leg Broken wrist/broken hand Bunions Carpal tunnel syndrome Cavovarus foot deformity Cavus foot Cerebral palsy Cervical myelopathy Cervical radiculopathy Charcot-Marie-Tooth disease Chondrosarcoma Chordoma Chronic regional multifocal osteomyelitis Clubfoot Congenital hand deformities Congenital myasthenic syndromes Congenital pseudoarthrosis Contractures Desmoid tumors Discoid meniscus Dislocated elbow Dislocated shoulder Dislocation Dislocation – hip Dislocation – knee Dupuytren's contracture Early-onset scoliosis Ehlers-Danlos syndrome Elbow fracture Elbow impingement Elbow instability Elbow loose body Eosinophilic granuloma Epiphyseal dysplasia Ewing sarcoma Extra finger/toes Failed total hip replacement Failed total knee replacement Femoral nonunion Fibrosarcoma Fibrous dysplasia Fibular hemimelia Flatfeet Foot deformities Foot injuries Ganglion cyst Genu valgum Genu varum Giant cell tumor Golfer's elbow Gorham’s disease Growth plate arrest Growth plate fractures Hammertoe and mallet toe Heel cord contracture -
(Xgeva®) Related Osteonecrosis of the Jaw: a Retrospective Study
Journal of Clinical Medicine Article A Comparison of the Clinical and Radiological Extent of Denosumab (Xgeva®) Related Osteonecrosis of the Jaw: A Retrospective Study Zineb Assili 1, Gilles Dolivet 2, Julia Salleron 3 , Claire Griffaton-Tallandier 4, Claire Egloff-Juras 1 and Bérengère Phulpin 1,2,* 1 Faculty of Odontology, Lorraine University, 7 Avenue de la Forêt de Haye, 54505 Vandoeuvre les Nancy, France; [email protected] (Z.A.); [email protected] (C.E.-J.) 2 Department of Head and Neck and Dental Surgery, Institut de Cancérologie de Lorraine, 54519 Vadoeuvre-lès-Nancy, France; [email protected] 3 Cellule Data-Biostatistiques, Institut de Cancérologie de Lorraine, 54519 Vandoeuvre-lès-Nancy, France; [email protected] 4 Cabinet de Radiologie RX125, 125 Rue Saint-Dizier, 54000 Nancy, France; [email protected] * Correspondence: [email protected]; Tel.: +33-3-83-59-84-46 Abstract: Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of antiresorptive medication. The aim of this study was to evaluate the incidence of denosumab-related osteonecrosis of the jaw and to compare the clinical and radiological extent of osteonecrosis. A retrospective study of patients who received Xgeva® at the Institut de Cancérologie de Lorraine (ICL) was performed. Patients for whom clinical and radiological (CBCT) data were available were divided into two groups: Citation: Assili, Z.; Dolivet, G.; “exposed” for patients with bone exposure and “fistula” when only a fistula through which the bone Salleron, J.; Griffaton-Tallandier, C.; could be probed was observed. The difference between clinical and radiological extent was assessed. -
Outcomes of Prophylactic Intramedullary Fixation for Benign Bone Lesions
Orginal Article 364 Outcomes of prophylactic intramedullary fixation for benign bone lesions İyi huylu kemik lezyonlarında profilaktik intramedüller fiksasyon sonuçları Çağrı Neyişci, Yusuf Erdem, Ahmet Burak Bilekli Gülhane Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey Dergiye Ulaşma Tarihi: 26.09.2019 Dergiye Kabul Tarihi: 29.09.2019 Doi: 10.5505/aot.2019.64325 ÖZET Amaç: Bu çalışmada benign kemik lezyonu sebebiyle profilaktik intramedüller tespit ameliyatı yaptığımız hastaların sonuçlarını sunmayı amaçladık. Gereç ve Yöntem: Bu çalışmaya 2008-2017 yılları arasında benign kemik lezyonu nedeni ile küretaj, greftleme ve profilaktik intramedüller tespit ameliyatı yaptığımız 22 hasta dâhil edilmiştir. Lezyonlar preoperatif dönemde Mirels sınıflamasına göre incelenerek patolojik kırık riski belirlenmiştir. Tüm hastaların tedavisinde küretaj, greftleme ve intramedüller tespit yöntemi kullanılmıştır. Kontrol muayenelerinde hastalar; eklem hareket açıklıklarına, ağrı durumuna, lezyonun ve implantın radyolojik görüntüsüne göre değerlendirilmiştir. Bulgular: Hastaların yaş ortalaması 24,8 (aralık, 7-38) yıldı. Hastalar ortalama 35,8 (aralık, 13-80) ay takip edildi. Çalışmaya dâhil edilen 21 hastanın ilk başvuru nedeni ağrı olup 2 hastada ağrı fonksiyon kaybına neden olmaktaydı. Patolojik humerus kırığı olan bir hasta akut ağrı ve fonksiyon kaybı ile başvurdu, iki ay konservatif olarak takip edildi ve ardından profilaktik cerrahi yapıldı. Hastaların ortalama Mirels skoru 9,3 (aralık, 9-10)’tü. Takiplerde tüm hastaların ekstremite fonksiyonları tamdı. Ameliyat sonrası ortalama VAS 8,09'dan 2,54'e gerilemiştir. Sonuç:9 veya daha fazla Mirels skoruna sahip olan iyi huylu kemik lezyonları için profilaktik fiksasyonun, olası patolojik kırık riskini azalttığı, VAS skorlarını azalttığı, ayrıca fonksiyon kaybını önlediği ve daha erken normal aktivitesine geri dönüşe olanak sağladığı sonucuna vardık. -
Chronic Osteomyelitis of Jaw
Chronic Osteomyelitis of Jaw Dr. Dhawal Goyal, 1 Dr. Nilima Malik, 2 Dr. Neha Gupta, 3 Dr. Manoj Agarwal, 4 Dr. Rajani Kalla, 5 Dr. Sanyam Agarwal 6 1. Dr. Dhawal Goyal MDS, Oral Private Practitioner 2. Dr. Nilima Malik MDS Oral and Maxillofacial Surgery 3. Dr. Neha Gupta Assistant Professor, Dept. of Prosthodontics, RUHS College of Dental Sciences, Jaipur 4. Dr. Manoj Agarwal Assistant Professor, Dept. of Conservative Dentistry & Endodontics, RUHS College of Dental Sciences, Jaipur 5. Dr. Rajani Kalla Assistant Professor, Dept. of Prosthodontics, RUHS College of Dental Sciences, Jaipur 6. Dr. Sanyam Agarwal Medical Officer, Dept. of Conservative Dentistry & Endodontics, RUHS College of Dental Sciences, Jaipur The prevalence of osteomyelitis of jaws in third Cultures, bone biopsy, conventional radiography, world country is still at a higher rate despite newer scintigraphy, CT scan are used to diagnose chronic and powerful antibiotics and advances in dental osteomyelitis of jaws. Computed Tomograph helps care. This may be due to low socio-economical in determination of cortex and medullary status, unavailability of primary health care involvement of diseased bone better as compared to services, and poor nutritional status in the rural conventional radiograph. areas. Therapy for osteomyelitis of jaws requires a Osteomyelitis may be defined as an inflammatory multidisciplinary approach. A precise condition of the bone that usually begins as an microbiologic diagnosis and adequate debridement infection of the medullary cavity, rapidly involves of necrotic tissue are essential. Acute the Haversian system and quickly extends to hematogenous osteomyelitis usually responds to periosteum of the affected area. The infection then antimicrobial therapy. -
The Role of Imaging in Tibia Stress Injury
SPORTS RADIOLOGY THE ROLE OF IMAGING IN TIBIA STRESS INJURY – Written by Keiko Patterson and Bruce Forster, Canada Stress fractures are frequently encountered immediate rehabilitation, rather than to In contrast, an insufficiency fracture occurs injuries in the discipline of sports medi- persist through the pain. when normal stress acts on an already cine, accounting for between 1 and 20% The differential diagnosis between shin abnormal, usually osteoporotic bone. Tibial of all visits to the sports medicine clinic1. splints – also known as medial tibial stress stress fractures are bilateral in 16% of cases Tibial stress fractures account for half of all syndrome (MTSS) – and a true stress fracture and typically occur at the junction of the stress fractures and are especially common is often difficult. MTSS can be thought of as a middle and distal third in adults1. Variants in athletes who are involved in repetitive less advanced version of tibial stress fracture, in tibial stress fractures include the anterior impact sports that are often of high inten- involving pain at the posterior medial border mid-diaphysis known as the ‘dreaded black sity1. Runners and younger participants in during exercise with diffuse periostitis, but line’ (transverse fracture line across entire jumping sports are particularly prone to no cortical break2. The term stress fracture shaft of the tibia) (see Figure 2) found in 5% these injuries due to repetitive submaxi- is therefore not an appropriate label for of cases, and longitudinal stress fractures mal stress on the posterior medial cortex of all stress injuries, as many do not show found usually in the mid- to distal bone1. -
WHO Manual of Diagnostic Imaging Radiographic Anatomy and Interpretation of the Musculoskeletal System
The WHO manual of diagnostic imaging Radiographic Anatomy and Interpretation of the Musculoskeletal System Editors Harald Ostensen M.D. Holger Pettersson M.D. Authors A. Mark Davies M.D. Holger Pettersson M.D. In collaboration with F. Arredondo M.D., M.R. El Meligi M.D., R. Guenther M.D., G.K. Ikundu M.D., L. Leong M.D., P. Palmer M.D., P. Scally M.D. Published by the World Health Organization in collaboration with the International Society of Radiology WHO Library Cataloguing-in-Publication Data Davies, A. Mark Radiography of the musculoskeletal system / authors : A. Mark Davies, Holger Pettersson; in collaboration with F. Arredondo . [et al.] WHO manuals of diagnostic imaging / editors : Harald Ostensen, Holger Pettersson; vol. 2 Published by the World Health Organization in collaboration with the International Society of Radiology 1.Musculoskeletal system – radiography 2.Musculoskeletal diseases – radiography 3.Musculoskeletal abnormalities – radiography 4.Manuals I.Pettersson, Holger II.Arredondo, F. III.Series editor: Ostensen, Harald ISBN 92 4 154555 0 (NLM Classification: WE 141) The World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. Applications and enquiries should be addressed to the Office of Publications, World Health Organization, CH-1211 Geneva 27, Switzerland, which will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available. © World Health Organization 2002 Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. -
Tuberculosis of the Hip Joint Region in Children
SAOJ Autumn 2013_Orthopaedics Vol3 No4 2013/03/20 3:06 PM Page 38 Page 38 SA Orthopaedic Journal Autumn 2013 | Vol 12 • No 1 Tuberculosis of the hip joint region MAFin Mohideen children MBChB(Medunsa) Registrar MN Rasool MBChB(UKZN), FC(Ortho)SA Paediatric Orthopaedics Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa Reprints requests: [email protected] Abstract Aim: To describe the clinical and radiological manifestations of tuberculosis of the hip joint and the resemblance to com- mon osteoarticular lesions in children. Methods: Thirty-six children (1 to 12 years) were reviewed retrospectively between 1990 and 2011. Clinical, laboratory and radiological features were assessed. The hips were classified and the outcome was graded as described by Shanmugasundaram. Results: Common clinical features were a limp, flexion, adduction and internal rotation contractures. Common radiologi- cal features were osteopaenia and cystic lesions in the neck and acetabulum. Permeative lesions, focal erosions, pathological fractures and sequestra were less common. Seven children had extra-articular lesions. Of the 29 with osteoarticular involvement, six had purely synovial involvement. Osteoarticular lesions mimicked benign bone and joint conditions. Follow-up was 1 to 6 years, 36% were graded as good, 36% fair and 28% had poor outcome with ankylosis. Other complications included avascular necrosis, coxa vara, coxa magna, growth arrest and flex- ion-adduction contractures. Conclusion: Tuberculosis of the hip can mimic various benign conditions. Biopsy from a bony lesion is important. The initial radiological appearance predicts the outcome, especially in the ‘normal’ type of hip. Key words: tuberculosis, hip joint, children Most of the literature on tuberculosis of the hip in children Introduction is over 40 years old.6-11 The lesions were mainly destructive. -
Treatment for Unicameral Bone Cysts in Long Bones: an Evidence Based
Orthopedic Reviews 2010; volume 2:e13 Treatment for unicameral bone unknown, it is estimated that approximately 75% of children present with pathological frac- Correspondence: Sandra Donaldson, cysts in long bones: ture.1 Cysts heal in less than 15% of children Orthopaedic Surgery, The Hospital for Sick an evidence based review following fracture.2 Although unicameral bone Children, S107-555 University Ave, cysts are believed to resolve with skeletal Toronto, Ontario, M5G 1X8, Canada. E-mail: [email protected] Sandra Donaldson,1 Josie Chundamala,2 maturity, without treatment these children are 3 2 Suzanne Yandow, James G. Wright at risk for pain, or recurrent fracture leading to Key words: unicameral bone cyst, pediatrics, 1Orthopaedic Surgery, The Hospital for activity restriction for many years. treatment, levels of evidence. Unicameral bone cysts may also lead to Sick Children, Toronto, Ontario, Canada; growth disturbance. Growth arrest, a relatively Contributions: SD and JC, analysis and interpreta- 2Department of Surgery, The Hospital for uncommon complication, may occur through tion of data, drafting the article, final approval of Sick Children, Toronto, Ontario, Canada; many mechanisms. The disruptive, hydrody- the version to be published; SY, analysis and inter- 3 Orthopaedic Surgery, Central Texas namic assault of cyst fluid on the physis may in pretation of data, revising article for important intellectual content, final approval of the version to Pediatric Orthopedics, Austin, Texas, itself result in growth disturbances.3 Other USA be published; JGW, conception and design; analy- rare causes for growth arrest include multiple sis and interpretation of data, revising article for fractures through the cyst that damage the important intellectual content, final approval of the physis, direct extension of the cyst through the version to be published and funding. -
Tuberculosis – the Masquerader of Bone Lesions in Children MN Rasool FCS(Orth) Department of Orthopaedics, University of Kwazulu-Natal
SAOJ Autumn 2009.qxd 2/27/09 11:11 AM Page 21 CLINICAL ARTICLE SA ORTHOPAEDIC JOURNAL Autumn 2009 / Page 21 C LINICAL A RTICLE Tuberculosis – the masquerader of bone lesions in children MN Rasool FCS(Orth) Department of Orthopaedics, University of KwaZulu-Natal Reprint requests: Dr MN Rasool Department of Orthopaedics University of KwaZulu-Natal Private Bag 7 Congella 4001 Tel: (031) 260 4297 Fax: (031) 260 4518 Email: [email protected] Abstract Fifty-three children with histologically confirmed tuberculous osteomyelitis were treated between 1989 and 2007. The age ranged from 1–12 years. There were 65 osseous lesions (excluding spinal and synovial). Seven had mul- tifocal bone involvement. Four basic types of lesions were seen: cystic (n=46), infiltrative (n=7), focal erosions (n=6) and spina ventosa (n=7). The majority of lesions were in the metaphyses (n=36); the remainder were in the diaphysis, epiphysis, short tubular bones, flat bones and small round bones. Bone lesions resembled chronic infections, simple and aneurysmal bone cysts, cartilaginous tumours, osteoid osteoma, haematological bone lesions and certain osteochondroses seen during the same period of study. Histological confirmation is man- datory to confirm the diagnosis of tuberculosis as several bone lesions can mimic tuberculous osteomyelitis. Introduction The variable radiological appearance of isolated bone Tuberculous osteomyelitis is less common than skeletal lesions in children can resemble various bone lesions tuberculosis involving the spine and joints. The destruc- including subacute and chronic osteomyelitis, simple and tive bone lesions of tuberculosis, the disseminated and the aneurysmal bone cysts, cartilaginous tumours, osteoid multifocal forms, are less common now than they were 50 osteoma, granulomatous lesions, haematological disease, 6,7,12 years ago.1-7 However, in recent series, solitary involve- and certain malignant tumours.