Acute atraumatic compartment syndrome in the leg.

The compartment syndrome is well recognised as occurring after trauma, but atraumatic acute compartment syndrome is less widely known. We report 3 cases in whom an acute compartment syndrome developed without major injury. Early diagnosis and prompt treatment by decompressive fasciotomy is of vital importance if limb function is to be preserved and complications avoided.

[Transplantation in orthopedic surgery and traumatology]. / Los trasplantes en cirugía ortopédica y traumatología.

Clinical applications of the musculoskeletal system tissue bank are currently enlarging in areas such as tumour surgery, spine surgery and arthrodesis, reconstructive procedures of the hip joint and ligament repair. We report our experience about the use of more than 1,000 grafts utilize from 1987 to 1992. We concluded that a bone bank or a musculoskeletal system tissue bank has a great usefulness in different reconstructive surgery technics and arthrodesis. They are used more frequently in orthopaedic and traumatology surgery improving the development of this surgery.

Intercalary bone allografts. 23 tumor cases followed for 3 years.

From 1987 to 1991, 26 patients with malignant bone tumors (osteosarcoma, Ewing's sarcoma, chondrosarcoma and malignant fibrous histiocytoma) in the diaphysis or metaphysis of long bones have been treated by chemotherapy, radiotherapy and intercalary bone allograft replacement after resection. The mean follow-up was 3 years in 23 patients, 2 died from tumors, and 1 had an amputation because of local recurrence. Allograft incorporation in 11 metaphyseal anastomoses was excellent in all cases. In the 23 diaphyseal anastomoses there were 6 non-unions. Other complications were deep infection in 3 cases, leg length discrepancy in 2 and allograft fracture in 2. Function became satisfactory in 14 cases.

Limb salvage for malignant bone tumors in young children.

From March 1984 to April 1991, the Orthopaedics Department of the Clínica Universitaria de Navarra treated 47 cases of malignant bone tumors in young children by limb-salvage surgery. Mean follow-up time was 4.4 years. The histologic diagnoses were osteosarcoma (33 cases) and Ewing's sarcoma (14 cases). All patients were treated following the Cancer Protocol of the Clínica Universitaria de Navarra. We used allograft reconstruction in 26 patients, autograft reconstruction in seven, and nonbiologic material in seven other patients. Thirty-six of these patients are alive currently; 11 have died. The overall survival rate was 76.6%. Three patients suffered local recurrences, and seven developed metastatic disease. The most significant complications were infection in four cases, and osteosynthesis anchorage detachment in eight cases. We believe that with recent medical, surgical, and rehabilitative advances, limb-salvage surgery has surpassed amputation as the primary treatment for malignant bone tumors in young children.

Removal of metaphyseal bone tumours with preservation of the epiphysis. Physeal distraction before excision.

In immature long bones, radical excision of malignant tumours of the metaphysis may necessitate sacrifice of the adjacent epiphysis. To preserve the adjacent joint while allowing a safe margin of excision, we used physeal distraction before removing the tumour. From July 1984 to August 1992, we operated on 20 patients by this method. After a mean follow-up of 54 months there was no local recurrence in the epiphyseal region. Three patients had developed pulmonary metastases.

Iliac allograft used for sternal reconstruction after resection of a chondrosarcoma.

We report the case of a man, aged 48 years, with a primary chondrosarcoma of the sternum which was treated by radical resection and reconstruction with an iliac allograft and musculocutaneous flaps. No complications were seen at follow up after two years.

[Knee resection prosthesis in tumor reconstructive surgery: comparative study between the use of cryopreserved bone allografts and non-biologic material]. / La prótesis de resección de rodilla en la cirugía reconstructiva tumoral: estudio comparativo entre el uso de aloinjertos óseos crioconservados y material no biológico.

From july 1983 to december 1990, 34 patients with aggressive or malignant bone tumors in the knee have been treated by radical resection and endoprosthesis replacement with or without allograft. The follow up was three years. We have a comparative study between allograft and plastic spacer. The functional character is better with endoprosthesis with non biologic material (75% excellent and good versus 66.6%). The complications were similar in both.

[Tissue bank for the musculoskeletal system. Clinical applications]. / Banco de tejidos del sistema musculoesquelético. Aplicaciones clínicas.

From June 1987 to June 1990, the musculoskeletal system tissues bank of the Orthopaedics and Traumatology Department of the University Clinic of Navarra has used 310 allografts. Of this, 219 has been used in our Department, 142 of cancellous bone and 42 of cortical bone. 24 of patellar tendon and 11 of fascia lata. The other 91 grafts have been sent to other hospitals in the country. In the present work we make a retrospective study that included the patients who were operate with allograft. We observe the differences between several types of allografts comparing them with conventional surgery technics. Within the complications we distinguished a 10.52% of infection in cortical bone allografts used in patients with neoplastic treatment. In the other type of allograft we didn't present this complication. We concluded that a bone bank or a musculoskeletal system tissues bank has a great usefulness in different reconstructive surgery technics and arthrodesis. They are used more frequent in orthopaedics and traumatology surgery improving the development of this surgery.