Cases reported "Bone Resorption"

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11/24. Resorption of the zygomatic arch after elevation of a depressed fracture and subsequent osteomyelitis: report of case.

    A case of osteomyelitis of the zygomatic arch with complete resorption has been presented. The cause of osteomyelitis of the facial bones was discussed. infection of the soft tissue after intraoral elevation of fractured zygomas does occur, but rarely leads to osteomyelitis and subsequent bony resorption of the underlying bone. Antibiotics have reduced the incidence of osteomyelitic infections in the past 20 years; however, a vigorous regimen of preoperative and postoperative attention to aseptic technique, proper antibiotics, and close follow-up is required to control these problems.
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12/24. Intentional replantation of periodontally involved and endodontically mistreated tooth.

    This article presents a case in which a tooth was intentionally replanted after it was endodontically mistreated; there was also a severe periodontal involvement. The unusually long period of time that the tooth survived might be attributed to a different approach to the replantation technique, such as occlusion adjustment prior to replantation, preoperative reduction of oral cavity bacteria and of the harmful aerosols commonly found in the dental operatory, placement of a noneugenol periodontal packing under the acrylic splint to prevent residual liquid monomer from seeping into the periodontal space, use of the patient's own blood and no other material to moisten the root while it was out of the socket, a short extraoral period, loose splinting, complete isolation of the operative site in the oral cavity, and completion of periodontal therapy before intentional replantation.
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13/24. Vascularized skull bone grafts in craniofacial surgery.

    Vascularized skull bone grafts based on a pedicle of temporalis muscle have been used in 30 zygomatic arch and malar reconstructions, 1 mandible reconstruction, and 1 palate reconstruction. The surgical technique, complications, and postoperative results are reviewed. technetium bone scans obtained within one week of operation confirm blood supply to the transferred bone. After a mean follow-up of 13 months, there is no evidence of bone graft resorption. We have used a team approach and careful surgical technique, and no serious complications have been encountered.
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14/24. Observations of tarsal disintegration in the cases operated for foot-drop.

    Fifty cases operated for foot-drop during the years 1971-82 were called for follow-up. Out of fifty, twenty cases were reported to the hospital. Three cases among the twenty were found to have changes of tarsal disintegration. The changes were found more confined to the talo-navicular junction. X-ray changes both in non-weight and weight bearing were studied. Their line drawings (tracings from actual radiograph) are presented. It is concluded that due attention should be given to the pre-operative evaluation, operative procedure used and post-operative management particularly the weight-bearing and proper footwear.
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15/24. hajdu-cheney syndrome: rehabilitation after decompression of cervical spinal cord compromise.

    Cervical spinal cord compromise can be caused by many pathologic conditions. In this case report, a patient with hajdu-cheney syndrome, an exceedingly rare disorder of bony elements which led to basilar skull invagination and subsequent cervical cord compression, is described. Postoperatively, the patient continued to have difficulty with self-care and ambulation and required an extensive rehabilitation program which included mat activities, progressive resistive exercises, activities of daily living, and gait training. She was able to become independent in transfers, ambulation, and activities of daily living. The patient's rehabilitation course after cervical spinal cord decompression is presented, along with a brief description of the clinical features of this unusual disease process.
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16/24. Surgical advancement of the retrognathic mandible in growing children.

    Orthodontists and surgeons may occasionally decide that there are compelling reasons for correcting a retrognathic mandible surgically before facial growth is completed. The literature implies that there will be no untoward effects. This study on twenty-two growing children demonstrated that there are severe growth disturbances after surgery. The response varied with the amount of surgical correction: Type A cases (those advanced more than 10 mm.) showed either resorption of the condyle, bizarre bony outgrowths in the posterior symphysis, or both. Relapse may continue in these cases for several years. Once condylar resorption occurred, there was no recovery. Type B cases (those advanced less than 9 mm.) had a milder response. Even in Type B cases, however, there was no clinically significant increase in mandibular length subsequent to surgery. There is a one-year recovery period, after which further growth and remodeling of the condyle are directed (if our hypothesis is correct) towards achieving an equilibrium of forces and a return to the preoperative growth pattern. We found that movement of the Y point (intersection of the posterior surface of the symphysis with the inferior border of the mandible) reflected a stable growth pattern prior to surgery and returned to the same pattern, usually within 2 years after surgery.
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17/24. Healing of osteitis fibrosa cystica after partial parathyroidectomy despite persistent parathyroid hyperfunction: a case report.

    The diagnosis of primary hyperparathyroidism was made in a 55-year-old female with marked hypercalcemia (15 mg/100 ml) and hypercalciuria and skeletal x-rays showing typical lesions of subperiosteal resorption and numerous cystic areas. At surgery a left lower parathyroid adenoma presumably was totally excised. serum calcium returned to normal levels immediately postoperatively, but 4 months after surgery hypercalcemia (11.5 mg/100 ml) was again found. During the following 18 months the patient was free of symptoms, and radiologic studies revealed complete healing of the subperiosteal resorption and repair of the bone cysts. Cortical bone mineral content also increased. However, elevated levels of serum parathyroid hormone (PTH) and calcium clearly indicated the persistence of primary hyperparathyroidism. Thus, a decrease in the degree of PTH hypersecretion permitted the repair of the skeletal lesions caused by a more severe level of parathyroid hyperfunction.
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18/24. hypercalcemia with ovarian carcinoma: evidence of a pathogenetic role for prostaglandins.

    A 70-year-old white woman had a lower abdominal mass and hypercalcemia. Physical and radiologic evidence was found for the presence of nonmetastatic pelvic tumor. Biochemical tests confirmed the presence of hypercalcemia with evidence of active bone resorption. plasma parathyroid hormone (PTH) and the nephrogenic urinary cyclic amp excretion were low; levels of plasma prostaglandins were elevated. Bone biopsy revealed histologic evidence of extensive osteoclastic bone resorption. At operation, a papillary serous cystadenocarcinoma of the ovary was removed. Postoperatively, the serum calcium fell to normal, and plasma prostaglandins became undetectable. Short-term incubation of ovarian tumor fragments demonstrated the production by tumor tissue of a substance causing bone resorption in an in vitro bioassay. The production of this substance was blocked by indomethacin. radioimmunoassay of the incubation medium revealed significant amounts of prostaglandins of the E F series. parathyroid hormone was not detected in the medium. These data implicate tumor-produced prostaglandins as mediators of the hypercalcemia in this patient.
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keywords = operative
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19/24. Intradiploic cerebrospinal fluid fistula. Report of two cases.

    Two patients with asymptomatic osteolytic skull lesions were found to have cerebrospinal fluid diploic fistulas. The radiographic and operative findings have not been reported previously.
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20/24. Costochondral graft construction/reconstruction of the ramus/condyle unit: long-term follow-up.

    This is a retrospective study of 26 patients (seven growing and 19 non-growing) who received costochondral grafts (n = 33) for construction or reconstruction of the ramus/condyle unit (RCU). Facial appearance, jaw motion, occlusion, contour, and linear growth changes were documented preoperatively, immediately postoperatively, and long-term (> 1 year). Average follow-up was 48.6 months for growing and 46.4 months for nongrowing patients. facial asymmetry and malocclusion were successfully corrected in all patients except for those with hemifacial microsomia, where partial correction was most common. For the growing patients mean change in RCU length (n = 8) during the observation period was 3.1 mm on the constructed/reconstructed side and 3.2 mm on the unoperated side. For nongrowing patients, mean change in the RCU length (n = 25) was -5.7 mm for the reconstructed side. Three patients developed lateral contour overgrowth of the articulating surface; no patients developed clinically significant linear overgrowth with malocclusion. The results of this study indicate that a costochondral graft may be used successfully to construct/reconstruct the RCU and that linear overgrowth of the graft does not appear to be a clinical problem with the method described in this paper.
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