ABSTRACT
This study examined the effects of vascular bundle implantation into a bone graft. Vascularized and nonvascularized autografts, allografts, and xenografts were placed inside defects in the proximal tibia in rabbits. Evaluation using radiographs, magnetic resonance imaging, bone scintigraphy, and microscopy showed autografts fused more rapidly than allografts and xenografts, and the majority of the vascularized grafts were incorporated completely. Autografts emerged as the gold standard. These findings indicate vessel implantation enhances and accelerates vascularization, new bone formation, and incorporation in autografts, allografts, and xenografts.
Subject(s)
Bone Transplantation/methods , Disease Models, Animal , Tibia/blood supply , Tibia/transplantation , Tibial Fractures/surgery , Tissue and Organ Harvesting/methods , Transplantation, Autologous/methods , Transplantation, Heterologous/methods , Animals , Bone Transplantation/instrumentation , Cryopreservation , Female , Humans , Rabbits , Tibial Fractures/diagnosis , Treatment OutcomeABSTRACT
This case report presents a 66-year-old woman with multiple vertebral hemangiomas causing spinal cord compression at different levels with a long symptom-free interval between episodes of compression. She presented with back pain and progressive weakness and numbness in her lower limbs for 3 months. Ten years earlier, she had had a symptomatic T4 vertebral hemangioma operated successfully, and had made a full recovery. Magnetic resonance imaging (MRI) of the thoracic and lumbar spine revealed multiple thoracic and lumbar vertebral hemangiomas. Extraosseous extension of a hemangioma at T9 was causing spinal cord compression. Selective embolization was performed preoperatively, and cord decompression was achieved via anterior T9 corpectomy. The patient's neurological status improved rapidly after surgery. After a course of radiotherapy, she was neurologically intact and could walk independently. One year later, MRI showed complete resolution of the cord edema at T9, and showed regression of the high signal intensity that had been observed at unoperated levels. These findings indicated diminished vascularity and reduced aggression of the tumor.
Subject(s)
Hemangioma/complications , Neoplasms, Multiple Primary/complications , Spinal Cord Compression/etiology , Spinal Neoplasms/complications , Aged , Embolization, Therapeutic , Female , Hemangioma/pathology , Hemangioma/therapy , Humans , Magnetic Resonance Imaging , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/therapy , Recurrence , Spinal Cord Compression/pathology , Spinal Cord Compression/therapy , Spinal Neoplasms/pathology , Spinal Neoplasms/therapy , Time FactorsABSTRACT
Most of the sports-related lower limb injuries in children and adolescents involve the knee. Due to the physiological characteristics of the growing skeleton, fractures are more common than ligamentous injuries in this age group. The most frequent type of injury is distal femoral physeal fractures followed by proximal tibial physeal injuries. Tibial tubercle avulsions are rare. Reduction should be gently performed and fixation methods should ensure that no further damage to the physeal plate occurs. Even after proper treatment, there is a significant risk for subsequent leg length discrepancies and/or angular deformities, requiring that children be followed closely for at least two years. Arthroscopic techniques have become popular in recent years in the treatment of displaced tibial eminence fractures. Residual anterior laxity remains an important problem after the healing of these fractures.
