Management of Giant Cell Tumors in Hand and Foot.

The aim of this study is to determine the treatment modalities and clinical characteristics of 12 patients diagnosed with giant cell tumor (GCT) of the hand and foot. The clinical findings, treatment modalities, and treatment failures of 12 patients with giant cell tumors of the hand and foot bones between 2007 and 2018 years were evaluated retrospectively. The average age at diagnosis was 29.2 ± 14.9 std. (between 16 and 62 years old), 8 males (66.6%) and 4 females (33.3%). Tumor was more frequently located in the talus, metacarpal, and metatarsal bones. The mean tumor size was 3.1 ± 1.1 cm (between 2.2 and 5.3 cm). The mean post-operative follow-up period was 76.3 ± 42.5 (between 12 and 139 months). The most of patients' (58.3%) common complaints were pain. The most commonly used surgical method was curettage + autografting (91.7%). Infection was seen in one patient after relapse surgery. Recurrence occurred in 33.3% of the patients in the first year. Only one patient was detected to have knee and lung metastases. Swelling and pain in the hand and foot should be examined for tumor lesions. When a bone lesion is detected, the giant cell tumor of the bone should be included in the differential diagnosis. Patients with giant cell tumors should be followed closely for recurrence and metastasis after treatment.

Management and retrospective analysis of tumors and tumor-like lesions localized in the talus.

OBJECTIVES: This study aims to investigate the characterization and follow-up results of tumors and tumor-like lesions in the talus. PATIENTS AND METHODS: Twenty-one patients (15 males, 6 females; mean age: 31.6±17 years; range, 4 to 67 years) with benign and malignant tumors or tumor-like lesions in the talus region treated and followed in our clinic between January 2007 and January 2019 were evaluated retrospectively. Radiological, pathological, surgical, and demographic features were scanned from the database. RESULTS: Patients were followed for mean 80±45.1 (range, 25 to 156) months. The most common complaint was pain and antalgic gait. Benign bone tumors were found in 15 (71%) of 21 patients, while tumor-like lesions (two intraosseous ganglia, osteomyelitis, and bone infarction) were found in four patients. The remaining two were patients with lung and bladder cancer metastasis. Lesion size was mean 2.1±0.5 (range, 1.1 to 3.3) cm. Recurrence developed in 14.3% (n=3) of the patients during follow-up. CONCLUSION: The talus is a rare location for tumors; however, benign and malignant tumors and tumor-like lesions may be localized in the talus.

Management and retrospective analysis of pelvic ramus tumors and tumor-like lesions: Evaluation with 31 cases.

OBJECTIVES: This study aims to investigate the characterization, treatment approaches, and follow-up results of tumors and tumor-like lesions located in the pelvic ramus. PATIENTS AND METHODS: Thirty-one patients (9 males, 22 females; mean age 48.9 years; range, 7 to 79 years) with benign and malignant tumors or tumor-like lesions in the pelvic ramus region treated and followed-up in our clinic between January 2005 and January 2019 were evaluated retrospectively. Surgical procedures were performed with anterior approach or inner-thigh approach. Twelve patients were diagnosed with malignant tumors, 12 patients with benign tumors, and seven patients with tumor-like lesions. RESULTS: Seventeen patients who underwent surgical treatment were followed-up for a mean period of 61.7 months. The diameters of benign and malignant tumors were similar (p=0.425). Of all lesions, 64.5% were located in the pubis. Ischium location was significantly higher in patients with malignant lesions than tumor-like lesions. The most common complication was diffuse subcutaneous edema in the inguinal region and thigh (8.3%). CONCLUSION: There are many different tumoral lesions in the pelvic ramus. Pelvic ramus tumors tend to settle more frequently in pubic ramus, whereas ramus ischium tumors are more likely to be malignant. In addition, the diagnosis of insufficiency fracture should be considered primarily in pathologic fractures of pubic ramus in females over 50 years of age. In the postoperative follow-up of pelvic ramus tumors, diffuse edema may occur even if there is no intraoperative vascular damage.

Comparison of mini-open versus all-arthroscopic rotator cuff repair: retrospective analysis of a single center.

INTRODUCTION: the aim of this study was to compare the impacts of all-arthroscopic repair and mini-open repair for rotator cuff tendon tear on post-operative pain, shoulder joint range of motion and physical function. METHODS: the study was a retrospective comparative analysis of rotator cuff repair between January 2013 and January 2018. The patients included in the study were enrolled into all-arthroscopic surgery or mini-open surgery groups. Patients were assessed with a 10mm visual analog scale for pain in the 7th day post-operatively. The physical function was assessed with Quick Disabilities Arm Shoulder and Hand (DASH) questionnaire at 12th month. The flexion and abduction ROM of the involved site were measured preoperatively and 12 months after the surgery. RESULTS: a total of 40 patients were included in the study. The mean age of the all-arthroscopic surgery group was significantly lower than the open surgery group (46.9±6.9 vs. 52.45±4.0 years). While no complication was seen in the arthroscopic group, 5 patients had superficial infection in the open surgery group. The patients in the all-arthroscopic surgery group experienced significantly less pain in the 7th day of the surgery. Improvement in Quick Dash score and shoulder flexion after surgery were significantly higher in the all-arthroscopic surgery group. None of the patients needed revision surgery in both groups. CONCLUSION: according to the results of this study, arthroscopically operated patients with rotator cuff tear had less pain in the first week after surgery. Patients in this group had better shoulder flexion and function in long-term follow-up with no post-operative complication.

The role of magnetic resonance imaging and clinical assessments in predicting meniscal tear surgery.

OBJECTIVES: This study aims to investigate the role of physical examination and magnetic resonance imaging (MRI) findings in predicting meniscal tear surgery. PATIENTS AND METHODS: Medical records of a total of 997 patients (563 females, 434 males; mean age 40.53 years; range 18 to 66 years) who were recommended surgery for meniscal tear in an external center, but continued follow-up in our hospital between January 2012 and March 2018 were retrospectively analyzed. Data of the patients including demographic and clinical characteristics, physical examination findings, and MRI results were recorded. The visual analog scales (VAS) scores and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were evaluated. RESULTS: Of all the patients evaluated by MRI, 62.4% were recommended surgical treatment in private hospitals and 37.6% were recommended surgical intervention in state hospitals. Only 282 of them (28.3%) were treated surgically for meniscal tear after MRI evaluation and physical examination in our clinic. The median pre-treatment VAS score was 7.0 (range, 4 to 10) and 6.0 (range, 3 to 8) in the patients undergoing surgery and undergoing conservative treatment, respectively. The VAS and KOOS scores were similar between the groups at the postoperative sixth month and first year (p=0.940, p=0.203; p=116, p=0.057, respectively). Pain scores significantly decreased, while the KOOS scores significantly increased after the treatment in both groups (for all p=0.001). CONCLUSION: Decision for surgery should be solely based on physical examination and radiological findings in meniscal tears.

Delayed diagnosis of acute leukemia in a patient with bone pain and fracture.

In childhood acute lymphoblastic leukemia (ALL), non-hematological manifestations involving the musculoskeletal system can also be encountered. These manifestations may cause a delay in the diagnosis of leukemia. The presented case in this report is a six-year-old boy who developed bone pain and long bone fracture and was diagnosed as ALL after a considerable delay. This case is presented to draw attention to the fact that leukemia must be considered in pediatric patients who present with bone manifestations.

Hair-thread tourniquet syndrome. A case report.

The authors report the case of a 3-month-old boy with hair-thread tourniquet syndrome, seen just distal to the MP joint on the right fourth toe. The patient was brought to the hospital with a history of irritability and weeping. On examination there was swelling, ecchymosis and a hair fibre was found wrapped around his right fourth toe. After the hair fibre was removed there was a fast healing period and no signs of tissue necrosis were seen.

Coccygectomy in the treatment of coccygodynia.

Fourteen patients, all female, who underwent coccygectomy for coccygodynia resistant to conservative treatment, were reviewed after a mean follow-up period of 30 months; 5 had a very good result and 7 had a good result. No re-operations were performed. Coccygodynia can be a real problem in women and total coccygectomy is an acceptable operation for coccygodynia not responding to conservative treatment.