1/109. Hemophiliacs bone pseudotumors.Four cases of proved hemophiliac pseudotumors caused by intraosseous bleeding are reported. Five lesions were found at the uncommon locations involving the cranial vault, mandible, phalanx, distal femur and distal tibia. The conventional radiographic and computed tomographic findings are expansile osteolytic destruction, cortical thinning, partial breaking cortex or pathological fracture, and sometimes associated soft tissue mass. Ultrasonographic feature of one case at the phalanx shows cortical expansion and thinning contained mixed echogenicity in the medullary canal with soft tissue extension. T99m DTPA of one case at the distal femur shows increased vascular flow and uptake at right distal tibia and left distal femur.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/109. Clinical picture and management of subperiosteal hematoma of the orbit.A subperiosteal hematoma was seen in a 14-year-old boy following a blow to his head during a car accident. The involved orbit exhibited exophthalmus and inability of the eye to move above the horizontal. x-rays revealed a hairline fracture of the skull and a hemotympanum was found on the injured side. A subperiosteal hematoma of the orbital roof was suspected. Needle aspiration of the blood from the orbital hematoma resulted in an almost immediate cure of all orbital and occular problems.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
3/109. Two sibs with an unusual pattern of skeletal malformations resembling osteogenesis imperfecta: a new type of skeletal dysplasia?We report a 6 year old boy with multiple fractures owing to bilateral, peculiar, wave-like defects of the tibial corticalis with alternative hyperostosis and thinning. Furthermore, he had Wormian bones of the skull, dentinogenesis imperfecta, and a distinct facial phenotype with hypertelorism and periorbital fullness. collagen studies showed normal results. His sister, aged 2 years, showed the same facial phenotype and dental abnormalities as well as Wormian bones, but no radiographical abnormalities of the tubular bones so far. The mother also had dentine abnormalities but no skeletal abnormalities on x ray. This entity is probably the same as that described in a sporadic case by Suarez and Stickler in 1974. In spite of the considerable overlap with osteogenesis imperfecta (bone fragility, Wormian bones, and dentinogenesis imperfecta), we believe this disorder to be a different entity, in particular because of the unique cortical defects, missing osteopenia, and normal results of collagen studies.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
4/109. Treatment of giant aortic aneurysm with tracheal compression and sternal erosion without circulatory arrest.Treatment of huge aneurysms involving the ascending aorta and the aortic arch with compression of the surrounding structures represents a surgical challenge. The case of a patient affected by respiratory insufficiency and sternal erosion caused by chronic giant aortic aneurysm is reported. The use of a stepwise approach and selective cerebral arterial perfusion ensured successful operative management, avoiding circulatory arrest and enabling an expeditious postoperative recovery.- - - - - - - - - - ranking = 0.32147952668198keywords = compression (Clic here for more details about this article) |
5/109. fluorine-18 fluorodeoxyglucose PET in infectious bone diseases: results of histologically confirmed cases.The aim of this study was to evaluate the clinical use of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in acute and chronic osteomyelitis and inflammatory spondylitis. The study population comprised 21 patients suspected of having acute or chronic osteomyelitis or inflammatory spondylitis. Fifteen of these patients subsequently underwent surgery. FDG-PET results were correlated with histopathological findings. The remaining six patients, who underwent conservative therapy, were excluded from any further evaluation due to the lack of histopathological data. The histopathological findings revealed osteomyelitis or inflammatory spondylitis in all 15 patients: seven patients had acute osteomyelitis and eight patients had chronic osteomyelitis or inflammatory spondylitis. FDG-PET yielded 15 true-positive results. The tracer uptake correlated with the histopathological findings in each case. Bone scintigraphy performed in 11 patients yielded ten true-positive results and one false-negative result. Follow-up carried out on two patients revealed normal or clearly reduced tracer uptake, which correlated with a normalisation of clinical data. In early postoperative follow-up it was impossible to differentiate between postsurgical reactive changes and further infection using FDG-PET. It is concluded that acute and chronic osteomyelitis of the peripheral as well as the central skeleton can be detected using FDG-PET. osteomyelitis can be differentiated from soft tissue infection surrounding the bone. Unlike computed tomography and magnetic resonance imaging, FDG-PET is not affected by metal implants used for fixing fractures. FDG-PET demonstrated promising initial results with respect to treatment monitoring. Nevertheless, in the early postoperative phase FDG-PET seems to be of limited value owing to unspecific tracer uptake.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
6/109. Fibrogenesis imperfecta ossium (Baker's disease): a case studied at autopsy.A man aged 40 years showed radiographic changes in the form of generalized increased bone density and patchy rarefaction. Urinary calcium was increased and serum alkaline phosphatase was elevated; serum calcium and phosphate levels were normal. Multiple fractures developed. At autopsy, all parts of the skeleton showed partial replacement of bone and bone marrow by a tissue deficient in collagen fibers. Much of this tissue was unmineralized, but lesions in cortical bone showed hypermineralization on microradiographic examination. Electron microscopy showed replacement of collagen fibers by amorphous material in the affected areas. Electron probe analysis showed a normal Ca:P ratio for bone mineral in the hypermineralized areas.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
7/109. Primary hyperparathyroidism: what every orthopedic surgeon should know.The diagnosis of hyperparathyroidism should rarely by missed by the orthopedic surgeon. When a patient presents with a pathologic fracture, routine serum calcium should be obtained. If there is evidence of elevated serum calcium or any of the pathognomonic findings of primary hyperparathyroidism on plain radiographs, total and ionized calcium and an intact parathyroid hormone levels should be obtained to make the diagnosis (Figure 5). When patients require surgical treatment for an orthopedic condition and also need surgery for hyperparathyroidism, the procedures can be safely performed simultaneously. Simultaneous parathyroidectomy corrects the underlying endocrinopathy, thereby improving the outcome of the orthopedic procedure. In addition, these procedures can easily be performed simultaneously under one anesthetic and thereby minimize cost and length of hospitalization.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
8/109. Widespread bone disease in acute myeloid leukaemia.We describe a 11-year-old boy with acute myeloid leukaemia who presented with widespread bone disease. spine x-rays revealed multiple crush fractures and there were multiple hot spots on the bone scan. The bone-mineral density was markedly reduced but there was no hypercalcaemia or hypercalcuria. bone marrow aspirate revealed 98% blast cells and a balanced translocation between chromosomes 10 and 17 in seven of nine metaphases. plasma interleukin-6 level before chemotherapy was high at 53 pg/ml. We postulate that the mechanism for bony destruction in this case was similar to that in the adult disease myeloma.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
9/109. Epidural hematoma from a cranial eosinophilic granuloma.The formation of an epidural hematoma from an eosinophilic granuloma of the skull is an exceptional occurrence. A 9-year-old boy presented with severe headache, somnolence and vomiting following a minor head injury. Cranial computerized tomography scan showed a seemingly depressed skull fracture together with an epidural hematoma in evolution. A neoplasm and an epidural hematoma were removed at operation. Histopathological study of the excised mass confirmed the diagnosis of eosinophilic granuloma.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
10/109. Autosomal dominant craniometaphyseal dysplasia with atypical features.Craniometaphyseal dysplasia (CMD) is a rare genetic disorder of bone modelling characterised by hyperostosis and sclerosis of the craniofacial bones, and abnormal modelling of the metaphyses. Clinically, autosomal dominant (AD) CMD is characterised by facial distortion and cranial-nerve compression. The goals of surgical treatment for AD CMD are cosmetic recontouring of the sclerotic craniofacial bones, correction of nasal obstruction and correction or prevention of neurological manifestations. We describe the successful correction of AD CMD craniofacial manifestations in an individual with atypical findings, and outline an approach for correcting the craniofacial deformities associated with this rare disorder.- - - - - - - - - - ranking = 0.064295905336396keywords = compression (Clic here for more details about this article) |
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