Cases reported "Chondroblastoma"

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1/8. Use of polymethylmethacrylate in large osseous defects in the foot and ankle following tumor excision.

    foot and ankle surgeons are occasionally confronted with having to fill large defects following excision of osseous lesions. This can prove to be quite challenging to the surgeon in regards to the requirement of large amounts of autogenous, allographic, or synthetic bone graft material. The amount of time spent nonweightbearing postoperatively can be quite prolonged, and the evaluation for tumor recurrence at the graft--host interface is difficult to ascertain. Polymethylmethacrylate has been used extensively in orthopedic surgery for many years in a safe manner for total joint replacement. It has also been used to fill large defects following tumor excision (i.e., giant cell tumor) and as an alternative to bone graft. This article briefly reviews the concepts of using polymethylmethacrylate in this manner and presents the use of polymethylmethacrylate in the treatment of foot and ankle lesions with three case presentations. The authors' purpose for this paper is to simply expand on the current medical literature available regarding the use of polymethylmethacrylate in the foot and ankle and to increase the awareness of foot and ankle surgeons regarding its use as a treatment alternative. A follow-up to this article is planned to present a larger patient population, longer term follow-up, and outcomes data.
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2/8. chondroblastoma of the talus: a case report.

    chondroblastoma of bone is an uncommon condition that has a predilection for secondary ossification centers, particularly of the humerus, tibia, and femur. Treatment usually involves surgical curettage and autogenous bone graft. This article reports the case of a chondroblastoma affecting the talus of a young man and a minimally invasive surgical approach for the treatment of this lesion. The patient presented with an 18-month history of right ankle pain and swelling. The lesion involved most of the talar body, with 2.5-cm cortical erosion inferiorly at the posterior talocalcaneal facet. A lateral approach was made to the talus and a window was fashioned at the distal end of the sinus tarsi under fluoroscopic guidance to allow access to the lesion. This was curetted and the defect was filled with autogenous bone graft taken from the ipsilateral iliac crest. The patient underwent an uneventful recovery, and was asymptomatic at follow-up 24 months postsurgery. He had 75% movement at the subtalar joint, when compared with the contralateral foot.
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3/8. chondroblastoma of the distal femur. A case report.

    The authors report a case of chondroblastoma which was localised in the distal femoral epiphysis in a 16-year-old boy. The lesion was large, rapidly expanding and extended into the knee joint. After diagnostic evaluation including tru-cut biopsy, the lesion was treated surgically with curettage and grafting with coralline hydroxyapatite. Four months after surgery the patient had no pain and had nearly full range of motion of the left knee. He was followed up for thirty-five months with routine radiographs and physical examination. He had no recurrence, no pain, and regained full range of motion of his knee. Most chondroblastomas involve the medullary cavity; they may rarely involve the cortex but to the best of our knowledge, no cases with soft tissue involvement have been reported in the literature.
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4/8. chondroblastoma of the temporal bone involving the temporomandibular joint, mandibular condyle, and middle cranial fossa: case report and review of the literature.

    chondroblastoma is a highly destructive tumor, derived from immature cartilage cells, typically occurring in epiphyses of the long bones of adolescents and young adults. Those occurring in the temporal bone and TMJ area are likely to mimic TMJ symptoms. This report describes a unique case in which a chondroblastoma resulted in extensive destruction of the temporal bone, temporomandibular joint, mandibular condyle, and cranial base, including gross intracranial and extracranial involvement. With appropriate surgical management, the outcome for patients with chondroblastoma of the temporomandibular region is quite favorable. This case brings the total reported chondroblastomas to 59 in the temporal bone and eight in the mandibular condyle as of the date of submission of this article for publication.
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5/8. chondroblastoma of the upper end of the tibia, invading the attachment of the posterior cruciate ligament.

    A case of chondroblastoma with invasion of the joint via the attachment of the posterior cruciate ligament is reported. The importance of careful interpretation of early radiological signs and the usefulness of conventional tomographic and computerized axial tomographic examination is demonstrated, and a method for reconstruction of the defect using an AO buttress plate and bone chips is presented. There was no sign of recurrence two and a half years postoperatively.
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6/8. Extraarticular endoscopic excision of femoral head chondroblastoma.

    Three femoral head chondroblastomas (one associated with aneurysmal bone cyst) were excised, using a technique of percutaneous extraarticular curettage. Whereas a standard approach to the femoral head lesion requires hip arthrotomy plus a cortical window in the femoral head or neck, the extraarticular technique enters the tumor cavity via a tunnel drilled from the lateral femoral cortex through the medullary canal of the femoral neck. The videoarthroscope assists with visualization during curettage of the cartilage tumor. Bone graft material may be packed into the tumor cavity without fear of subsequent leakage into the joint space. At an average follow-up of 25 months, all three femoral head tumors have healed without recurrence and with no complications related to the approach. The extraarticular endoscopic approach could be used to treat selected benign femoral head or neck lesions other than chondroblastomas.
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7/8. Arthroscopic resection of a chondroblastoma in the knee.

    A 13-year-old boy with the diagnosis of osteochondritis dissecans underwent arthroscopic examination of his knee joint. At surgery a cartilaginous mass in the medial femoral condyle was identified. biopsy samples confirmed the diagnosis of chondroblastoma, which was removed completely through the arthroscope. A second arthroscopic examination of the knee was conducted at 6 months, and showed no residual disease. Clinical and radiographic follow-up of the affected joint 5 years after surgery was satisfactory. Arthroscopic removal of an intra-articular tumor is an attractive treatment alternative, provided the lesion is accessible and there is no suggestion of a malignancy.
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8/8. CT evaluation of primary epiphyseal bone abscesses.

    We reviewed the clinical, radiographic, and computed tomographic (CT) findings in eight children with a histologically proven diagnosis of epiphyseal or apophyseal osteomyelitis. In all cases the femur was involved: in five the osteomyelitis was localized in the femoral condyle, in two it was in the greater trochanter, and in one it was in the femoral head epiphysis. In four of the six cases of epiphyseal involvement there was associated joint effusion or septic arthritis. CT examination may demonstrate a serpentine tract, a sequestrum, cortical destruction or adjacent soft tissue swelling and can differentiate osteomyelitis from other epiphyseal lucent lesions, particularly chondroblastoma and osteoid osteoma. CT yielded important new diagnostic information in seven of the eight patients, failing to do so in only one. In one case, CT showed a wooden splinter in an abscess cavity, which had been mistaken for a sequestrum. When combined with accurate clinical and laboratory information and good quality plain radiographs, CT can lead to an early diagnosis of epiphyseal infection. early diagnosis helps avoid delays in initiating antibiotic or surgical treatment caused by the unusual (epiphyseal or apophyseal) location of the bone abscess.
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