Chondroblastoma of bone: management and results of surgical treatment in ten patients

Ten patients with chondroblastoma were treated in our hospital during the past three years, five males and five females, with an age range of 12-40 years [average 20 years]. Chondroblastoma was located in the distal femur [3 patients], the greater trochanter and talus [2 patients each], and the proximal tibia, proximal humerus, lesser trochanter [one patient each]. All patients presented with pain, followed by knee swelling and stiffness in tumors around the knee, while patients with tumors in the proximal femur had pain and limp. All tumors were studied with plain radiographs, with CT and MRI scans used if needed. Treatment was planned according to the site, size, activity [as determined from the radiographic appearance], and histopathological findings [the presence of secondary aneurysmal bone cyst]. Surgical procedures included curettage [4 cases], curettage and packing with iliac graft [4 cases], curettage and packing with methylmethacrylate in one case of the greater trochanter, and marginal excision in chondroblastoma of the lesser trochanter. Curettage was performed by the arthroscope in one case of chondroblastoma of the knee. Follow-up averaged 19 months. Complication included knee stiffness in two cases, which were treated by arthroscopic arthrolysis. There was no recurrence after treatment, and all patients retained normal function. A protocol of management of chondroblastoma is proposed based on review of the literature and on our observations and experience

Condylar buttress plating for distal femoral fractures: indications and outcome

Fourteen patients with distal femoral fractures had been treated by condylar buttress plating [CBP] between May 1997 and February 2001 at Assiut University Hospital. There were eight males and six females with an average age of 45 years. Eleven fractures were closed and three were open. The indications for CBP were fractures with articular comminution and fractures with coronal plane element in addition to the sagittal plane element [AO-type C3], fractures extending to less than 3 cm from the joint line with short distal fragment for angled blade-plate fixation, and the presence of comminution of the site of entry for condylar plate. The surgical technique had respected the biological principles in all cases with modification of the approach to be transarticular-minimally invasive in four cases. No bone graft was done in any case even in the presence of medial comminution. All cases united with time to union ranging from 12 to 24 weeks [average 16 weeks]. According to Neer's score, the results were excellent in seven cases, satisfactory in five cases and unsatisfactory in two cases