Metachronous multicentric giant-cell tumour: a case report.

Giant-cell Tumours (GCT) of bone are not uncommon but a primary multicentric giant-cell tumour is very rare. This reported case represents a true multicentric giant-cell tumour with four lesions. These lesions had only curettage with no recurrence.

Retained portion of latex glove during femoral nailing. Case report.

A case of retained glove during Kuntscher intramedullary nailing is described. An abscess around the glove could have lead to osteomyelitis. One need to be cautious feeling the top end of the nail while femoral nailing to avoid such a complication.

Malignancy in chronic osteomyelitis sinus. Report of three cases.

Three cases of squamous cell carcinoma in a chronic osteomyelitis sinus is reported. These tumours are usually managed by amputation alone. One of our patient had a histologically invasive and keratinising tumour who died after amputation. The other two cases are still surviving, one even without any treatment. We believe that in patients with histologically undifferentiated and invasive tumours aggressive mode of treatment should be carried out by way of amputation, regional lymph node clearance and a short course of chemotherapy/radiotherapy.

Manage of acute osteomyelitis in children--should it be conservative?

73 children with acute osteomyelitis seen at King Fahd University Hospital, Al-Khobar, Saudi Arabia were reviewed. Majority of patients were between the 6-10 year age group and male children predominated. All patients had incision and drainage and antibiotic therapy for a minimum of 6 weeks. Metaphysis of the tibia was the commonest site of infection and the staphylococcal species was cultured in 77% of children. Ampiclox was the most sensitive antibiotic. The average follow up was 4.9 years and the incidence of chronic osteomyelitis was 1.75%. In conclusion this study confirms that clinically it is not possible to detect a subperiosteal abscess within the first 48 hours. As blood culture is not 100% reliable in isolating the ineffective organism and incision and drainage plays a double role, firstly in the identification of the offending organism and secondly in the evacuation of pus. A six-week antibiotic therapy is essential to prevent any relapses. The correct management of acute osteomyelitis in children is surgical drainage of the affected site combined with antibiotic therapy.

Arteriovenous fistula for hemodialysis. A report of 112 consecutive cases.

Arterio-venous fistula of Brescia was created in 112 consecutive patients during a five year period from May 1983 at King Fahd University Hospital of King Faisal University, Al-Khobar, Saudi Arabia. These fistulae were created for hemodialysis in patients with chronic renal failure. There were 67 males and 45 females. The youngest patient was 13 years and the oldest 75 years. Complications were negligible (0.85%), even-though 31% were diabetics and 24% had sickle cell hemoglobinopathy. The arteriovenous fistula failed in 6 patients and the patency rate was 94.6%. The minimum follow up was three months and the maximum fifty-two months. The end-to-side anastomosis gave better results. For long term dialysis arterio-venous fistula of Brescia should remain as the first choice.

Malignant bone tumours in pregnancy (a report of two cases and review of literature).

Two cases of malignant bone tumours in pregnancy are reported. The optimum management is not clearly defined due to the rarity of the condition and limited individual experience. Our patients delivered healthy babies without any signs of maternal malignant disease. Cancer chemotherapy was instituted during the postmortem period. Pregnancy did not appear to exacerbate the tumour growth nor in any way affect the ultimate outcome of the patients.