ABSTRACT
Percutaneous osteoplasty has been used for pathologic fractures of long bones as an adjunct to orthopedic surgery. The present report describes a case of percutaneous osteoplasty with a cement-filled catheter and cement augmentation as the principal therapy to unite a painful pathologic fracture of the humerus. After the procedure, the patient experienced immediate pain relief and improved limb mobility. Percutaneous osteoplasty with this method holds promise as a treatment for pathologic fractures of the humerus that are not amenable to surgical repair.
Subject(s)
Bone Cements/therapeutic use , Bone Neoplasms/complications , Carcinoma, Hepatocellular/pathology , Catheterization/methods , Fractures, Spontaneous/therapy , Humeral Fractures/therapy , Humerus , Liver Neoplasms/pathology , Aged , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Fractures, Spontaneous/complications , Fractures, Spontaneous/diagnostic imaging , Fractures, Spontaneous/etiology , Humans , Humeral Fractures/complications , Humeral Fractures/diagnostic imaging , Humeral Fractures/etiology , Humerus/diagnostic imaging , Male , Pain/etiology , Pain Management , Pain Measurement , Radiography, Interventional , Treatment OutcomeABSTRACT
BACKGROUND: The purpose of this study was to compare a very-high-flow injection-rate method (group A) and a conventional injection-rate method (group B) for visualization of upper abdominal arteries by multidetector helical computed tomography (MDHCT). METHODS: The subjects were 240 patients suspected to have abdominal lesions. They were randomly assigned to group A (120 patients) and group B (120 patients). In group A, the bilateral medial cubital veins were punctured, and contrast medium was infused at a rate of 8.6-9.6 ml/s. In group B, the unilateral medial cubital vein was punctured, and contrast medium was infused at a rate of 2.0-3.0 ml/s. The quality of vascular visualization was graded as poor, good, or excellent by three radiologists. RESULTS: All visualizations of the celiac trunk (CE) and superior mesenteric artery (SMA) were graded as excellent in both group A and group B. Visualization grades of the subsegmental branches of the hepatic artery (HA), right gastric artery (RGA), cystic artery, dorsal pancreatic artery (DPA), and superior pancreaticoduodenal artery (SPDA) were good or excellent, in 75% (paging method)/53.3% (three-dimensional method), 85%/30%, 77.7%/18.3%, 76.7%/28.3%, and 88.3%/42.5%, respectively, in group A, and 33.3%/11.7%, 46.7%/3.4%, 41.6%/5%, 55%/4.2%, and 72.5%/14.2%, respectively, in group B. The appearance rate of intrahepatic portal branches was 28.3% in group A and 66.7% in group B in the arterial dominant phase. CONCLUSION: Group A showed better visualization results than Group B in upper abdominal arteries according to MDHCT.
