ABSTRACT
Fibrous dysplasia is a rare disorder of the bone. It is seen in two main forms ofpresentation: monostotic and the polyostotic. A case of monostotic fibrous dysplasia of the maxillary and palatine bones in a 22-year old man who received prosthetic reconstruction is presented with a review of the literature.
La displasia fibrosa es un trastorno raro del hueso. Se le ve en dos formas principales: la monostótica y la poliostótica. Junto con la correspondiente revisión de la literatura, se presenta un caso de displasia fibrosa monostótica de los huesos maxilar y palatino en un hombre de 22 anos que recibió una reconstrucción prostética.
Subject(s)
Adult , Humans , Male , Young Adult , Fibrous Dysplasia, Monostotic/surgery , Maxilla/surgery , Palate, Hard/surgery , Prostheses and Implants , Plastic Surgery Procedures , Plastic Surgery Procedures/methodsABSTRACT
PURPOSE: This study was designed to verify intermediate-term functional and radiological results of limb salvage operation using endoprosthetic replacement system (MUTARS(R)) used in patients with a malignant bone tumor. MATERIALS AND METHODS: Thirty one cases which used MUTARS(R) tumor prosthesis were reviewed. The mean age of the patients was 49.2 years and the mean follow up was 39.8 months. We retrospectively reviewed complications, and evaluated functionally and radiologically by Enneking functional score, ISOLS radiological implants evaluation system at last follow-up. RESULTS: 3 patients had died of disease, distant metastasis was seen in 4 patients and local recurrence was seen in 1 patients. Complications were developed in 12 patients. (infection 6, leg length discrepancy 2, aseptic loosening 2, periprosthetic femoral fracture 1, screw loosening 1) Mean value of total functional scores were 81.2% in proximal femur, 77.4% in distal femur, 78.1% in proximal tibia, and 80.2% in proximal humerus. The overall radiological result was relatively satisfactory. CONCLUSION: Our results suggest limb salvage with the MUTARS(R) endoprosthesis is successful with good functional and radiological results. But we should be careful with complications such as infection.
Subject(s)
Humans , Extremities , Femoral Fractures , Femur , Follow-Up Studies , Humerus , Leg , Limb Salvage , Neoplasm Metastasis , Prostheses and Implants , Recurrence , Retrospective Studies , TibiaABSTRACT
Introducción. El pabellón auricular es una estructura sofisticada y compleja. La presentación clínica más frecuente de deformidades es la microtia. Los métodos reconstructivos tienen como objetivo reproducir los relieves naturales de la oreja, con resultados estéticos variables. Material y métodos. Pacientes con microtia que acudieron a consulta externa en el período del año 2002 al 2004. Se diseñó la prótesis auricular tomando el modelo de la oreja normal; en caso de microtia bilateral, de un familiar. Se realizó colocación de implantes osteointegrados. Posterior a 6 meses, se colocaron los tornillos de cicatrización para fijación de la prótesis. Resultados. Se incluyeron 34 pacientes con microtia, 20 masculinos y 14 femeninos; edad promedio: 9.5 años. La presentación clínica más frecuente fue microtia unilateral (n =31). Tiempo quirúrgico promedio: 35 min. Se observó adecuada integración de implantes en los pacientes. El resultado estético fue muy satisfactorio. En el seguimiento (1.5 años) se encontró un paciente con cicatrización hipertrófica, ninguna complicación asociada al uso de prótesis ni necesidad de recambio protésico. Conclusiones. La utilización de prótesis auriculares externas e implantes osteointegrados es un método reconstructivo eficiente, con poca morbilidad y excelente resultado estético.
Introduction. The external ear is a sophisticated and complex structure. The most frequent congenital ear deformity is microtia. The different reconstructive methods are focused in reproducing the natural reliefs of the ear, with different aesthetics results. Material and methods. Microtia patients who were seen between 2002 to 2004. The external prosthetic device was designed taking the pattern of the normal ear. In patients with bilateral microtia the ear pattern of a family member was used. Placements of the osseointegrated implants was carried out, and after 6 months of integration the scarring screws were placed in order fix de prosthesis Results. Thirty four microtia patients were included, 20 were males, the median age was 9.5 years. The most frequent clinical presentation was unilateral microtia (n =31). The surgical time for the procedure averaged: 35 min. All patients had appropriate integration of the implant. The aesthetic result of the prosthetic reconstruction was very satisfactory. In the follow-up period (1.5 years) we found an hypertrophic scar in 1 patient, no complications were associated to the use of prosthetic reconstruction and no patient required prosthetic replacement. Conclusions. The prosthetic reconstruction with osseointegrated implants is an efficient reconstructive method, with little morbidity and excellent aesthetic result.
ABSTRACT
PURPOSE: We performed this study in order to analyze the surgical and oncological results of prosthetic reconstruction of the distal tibial or fibular tumors and estimate the effectiveness of this kind of reconstruction in that region. MATERIALS AND METHODS: The data of six patients who underwent prosthetic reconstruction for the distal tibial or fibular tumors were reviewed. Diagnoses were osteosarcoma in four patients, parosteal osteosarcoma in one and recurrent giant cell tumor in one. Five tumors occurred at the distal tibia and one at the distal fibula. The age was 26 years (11-46 years). We performed resection and reconstruction using custom made tumor prosthesis. The mean follow-up duration was 5.8 years. RESULTS: Average functional score by ISOLS evaluation system was 24.2 (80.5%). All of the patients were continuously disease free at the final follow up. The complications were one wound infection and one collapse of talar component. CONCLUSION: The results of prosthetic reconstruction in the ankle regions demonstrated acceptable medium term results. It may be considered an option for malignant tumors of the distal tibia or the distal fibula in selected patients.
Subject(s)
Humans , Ankle , Diagnosis , Fibula , Follow-Up Studies , Giant Cell Tumors , Osteosarcoma , Prostheses and Implants , Tibia , Wound InfectionABSTRACT
The purpose of the prosthetic reconstruction of vertebral body after excision of malignant spine tumors is to provide the immediate and long term stability. The authors have experienced eight cases of prosthetic replacement with a titanium mesh cylinder and additional instrumentation in malignant spine tumors with neurologic deficit. There were three cervical, three thoracic and two lumbar lesions. Among them, five cases were instrumented by combined anterior and posterior procedures at one stage. Postoperatively, all cases showed excellent immediate stability. Ambulation was started within one week with minimal or no external support. Neurologic deficit observed in 7 cases were improved in all but one complete paraplegia. Major complications such as loss of fixation, recurrence or progression of deformity, and neurologic deterioration were not observed. Five patients could return to their previous occupation. Five patients with autogenous bone graft in the cylinder showed solid incorporation of prosthesis into the host bone. It is concluded that a titanium mesh cylinder replacement of vertebral defect after excision of the malignant spine tumors provides adequate immediate as well as long term stability when combined with bone graft.