Subject(s)
Bone Neoplasms/diagnosis , Bone Neoplasms/surgery , Chondrosarcoma/diagnosis , Chondrosarcoma/surgery , Toes , Adult , Biopsy , Bone Neoplasms/classification , Bone Neoplasms/complications , Chondrosarcoma/classification , Chondrosarcoma/complications , Disease-Free Survival , Female , Humans , Magnetic Resonance Imaging , Neoplasm Staging , Pain/etiology , Treatment OutcomeABSTRACT
INTRODUCTION: Osteoarthritis of the carpometacarpal joint of the thumb is a common pathology. Several surgical methods exist, including trapeziectomy, arthrodesis, cemented or cementless prosthesis. Therefore, one must question the legitimacy of non prosthetic surgery. The authors have tried to answer this question. METHOD: Surgery consisted in trapeziectomy and ligament reconstruction with tendon interposition arthroplasty (LRTI). Authors reviewed 47 cases with five years follow-up. Patients were evaluated using a functional score, including pain, professional and domestic activities, and leisure involving the hand. Objective data were also assessed: thumb opposition, radiographic scaphometacarpal mobility, key and tip pinch, grasp strength. RESULTS: Functional results ranged from good to excellent in 42 cases. Opposition was satisfactory in 46 cases. Scapho-metacarpal range of motion was 16 degrees. Pinch strength was 4.2 kg and grasp strength was 23 kg. There were no complications. Loss of pinch strength was 1 to 2 kg as compared to our reference group. Such a loss does not impair patients' daily life. Age and operated side do not influence results. Scores do not decrease with time. Radiographic staging seems to be linked with scoring. Reducing the trapezial space does not influence results. We had none of the complications described in other techniques: synovitis, ossifications, loosening and reflex sympathetic dystrophy. DISCUSSION: This study, as well as literature, confirms that trapeziectomy and ligament reconstruction with tendon interposition arthroplasty gives satisfactory functional results which are stable with time and without complication. For all these reasons, the authors prefer this technique in degenerative osteoarthritis.
Subject(s)
Arthroplasty/methods , Carpal Bones/surgery , Joints/surgery , Ligaments, Articular/surgery , Metacarpus , Osteoarthritis/surgery , Tendon Transfer/methods , Thumb , Activities of Daily Living , Aged , Aged, 80 and over , Female , Follow-Up Studies , Hand Strength , Humans , Male , Middle Aged , Osteoarthritis/physiopathology , Pain, Postoperative/etiology , Range of Motion, Articular , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
A case of alveolar rhabdomyosarcoma of the hand in a 21-year-old patient is reported. In the light of this case, the authors review the literature and analyse the therapeutic implications.
Subject(s)
Hand , Rhabdomyosarcoma, Alveolar/surgery , Adult , Biopsy , Diagnosis, Differential , Humans , Lymph Node Excision , Lymphatic Metastasis , Magnetic Resonance Imaging , Male , Rhabdomyosarcoma, Alveolar/diagnosis , Rhabdomyosarcoma, Alveolar/pathologyABSTRACT
Multiple osteosarcoma is a rare tumour which usually has a poor prognosis. We report the case of a 14-year old girl who developed successively, at 2 1/2 years' interval, one osteosarcoma of the right radius bone, then one of the left radius bone. The tumours were strictly symmetrical. Each time, the patient was treated with chemotherapy of the Rosen type and underwent conservative surgery. At present, 5 years after the first treatment, she is in good health. This case is remarkable on several scores: chemotherapy was feasible and well tolerated, the multiple osteosarcoma had a favourable outcome, and conservative surgery of both radius bones gave satisfactory functional results.
Subject(s)
Bone Neoplasms/pathology , Neoplasms, Multiple Primary/pathology , Osteosarcoma/pathology , Radius , Adolescent , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Bleomycin/administration & dosage , Bone Neoplasms/drug therapy , Bone Neoplasms/surgery , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Dactinomycin/administration & dosage , Doxorubicin/administration & dosage , Female , Follow-Up Studies , Humans , Methotrexate/administration & dosage , Neoplasms, Multiple Primary/drug therapy , Neoplasms, Multiple Primary/surgery , Osteosarcoma/drug therapy , Osteosarcoma/surgery , PrognosisSubject(s)
Bone Neoplasms/therapy , Femoral Neoplasms/therapy , Humerus , Osteosarcoma/therapy , Radius , Tibia , Adolescent , Adult , Amputation, Surgical , Bone Neoplasms/drug therapy , Bone Neoplasms/surgery , Child , Cisplatin/administration & dosage , Combined Modality Therapy , Female , Femoral Neoplasms/drug therapy , Femoral Neoplasms/surgery , Humans , Male , Methotrexate/administration & dosage , Osteosarcoma/drug therapy , Osteosarcoma/surgerySubject(s)
Leg Injuries/surgery , Surgical Flaps , Adult , Humans , Leg Injuries/complications , Male , Microsurgery , Middle Aged , Surgery, PlasticABSTRACT
First described by Kapandji, the double closed "basket-like" pinning is a new and quite attractive treatment of the Colles' fracture. With or without XR TV, following closed reduction the epiphysis is fixed steady with two Kirschner wires, sliding along its lateral and its posterior aspects, entering the radius at the fracture site and transfixing the bone cortex above. Plaster cast is unnecessary, and wrist reeducation begins on the first day post-op. Technical "know-how" is specified, and seventy-two patients followed up. Present findings indicate that the complication rate is very low, excellent and good results are 83%. Rehabilitation is quicker, socio-economically gratifying. We believe that the method significantly improves the conservative treatment of Colles' fracture and decide to use it extensively from now on.
