ABSTRACT
Between June 1989 and December 1994, a total of 19 patients (20 shoulders) underwent open repair of Bankart lesions using suture anchors. Subscapularis muscle and anterior capsule were cut as one layer and sutured end to end without overlap. Coracoid osteotomy was not necessary. Average follow-up was 53.6 months (range: 24-90 months). Clinical evaluation using the Rowe functional grading system showed 15 shoulders had excellent results, 3 shoulders had good results, and 1 patient was lost to follow-up. There were no complications and no failures with recurrence of dislocation.
Subject(s)
Shoulder Dislocation/surgery , Suture Techniques , Adult , Biomechanical Phenomena , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Orthopedic Procedures/methods , RecurrenceABSTRACT
We reviewed 20 patients after forequarter amputation performed for high-grade malignant tumours of the shoulder girdle (Enneking grades IIB to III). The operations were classified as palliative or curative according to the resection margins and the presence of disseminated disease at the time of the surgery. There were five palliative and 15 curative procedures. Two patients died from unrelated causes, septicaemia and suicide. Eight died in the first two years, four of whom had had a palliative operation. Four died between two and five years after surgery, one after a palliative operation. Five patients are alive, at a mean of 89.4 months after surgery, four of whom are free from disease. The median survival after a palliative amputation was 20.6 months. Our overall five-year survival (palliative and curative cases) was 21.2%, for curative cases it was 30.2%. None of the patients use an artificial prosthesis. Despite the disfigurement which results from this operation, it still has a useful role to play in the management of high-grade malignant tumours of the upper limb.
Subject(s)
Amputation, Surgical , Arm/surgery , Bone Neoplasms/surgery , Muscle Neoplasms/surgery , Shoulder Joint/surgery , Shoulder/surgery , Adolescent , Adult , Aged , Amputation, Surgical/classification , Artificial Limbs , Cause of Death , Disease-Free Survival , Female , Follow-Up Studies , Humans , Humerus/pathology , Male , Middle Aged , Necrosis , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Palliative Care , Scapula/pathology , Sepsis/etiology , Soft Tissue Neoplasms/surgery , Suicide , Surgical Wound Infection/etiology , Survival RateABSTRACT
The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, as it determines the level of bone resection. Radiographs, isotope bone and MR imaging scans have been considered as reliable in detecting skeletal metastasis and skip lesions. We report a case of osteosarcoma of the distal femur with a large skip lesion proximally which was not visualized by either routine radiography or bone scintigraphy, and was not included within the scan field on the initial MR imaging scan. The implications on patient management and possible reasons for failure of imaging to reveal the skip metastasis are discussed.
Subject(s)
Femoral Neoplasms/diagnostic imaging , Femoral Neoplasms/secondary , Osteosarcoma/diagnostic imaging , Osteosarcoma/secondary , Adolescent , False Negative Reactions , Female , Femoral Neoplasms/diagnosis , Humans , Magnetic Resonance Imaging , Osteosarcoma/diagnosis , Radionuclide ImagingABSTRACT
This report describes a rare case of Ewing's sarcoma presenting as a cystic lesion in the proximal humeral metaphysis. The clinical, pathological and radiological findings are described and discussed, with emphasis on the radiological appearances.
