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1.
J Biol Regul Homeost Agents ; 29(2): 501-7, 2015.
Article in English | MEDLINE | ID: mdl-26122243

ABSTRACT

Pathological fractures have a high incidence in musculo-skeletal oncology, and localization in long bone causes severe pain, disability and poor quality of life. The aim of this retrospective case series is to evaluate the clinical results, in particular regarding the quality of life, in patients affected by lower long bone pathological fractures surgically treated. We analyzed 93 patients with pathological fractures of tibia and femur surgically treated in our Orthopaedic Department and followed up for at least 3 years or until their death. Intramedullary nailing or endoprosthetic reconstruction for pathologic fractures located in the metadiaphyseal and diaphyseal or proximal regions in advanced-stage cancer patients are suitable methods for a stable fixation or reconstruction. These approaches guarantee a good mechanical stability, a faster mobilization, a better control of pain with an overall improvement in quality of life in all patients, confirmed also by the trend of the ECOG performance status and QOL-ACD.


Subject(s)
Bone Neoplasms/secondary , Carcinoma/secondary , Femoral Fractures/surgery , Femur/surgery , Fracture Fixation, Internal/methods , Fractures, Spontaneous/surgery , Quality of Life , Tibia/surgery , Tibial Fractures/surgery , Aged , Bone Cements , Bone Neoplasms/psychology , Bone Neoplasms/surgery , Bone Neoplasms/therapy , Carcinoma/psychology , Carcinoma/surgery , Carcinoma/therapy , Combined Modality Therapy , Curettage , Embolization, Therapeutic , Female , Femoral Fractures/etiology , Femoral Fractures/psychology , Fractures, Spontaneous/etiology , Fractures, Spontaneous/psychology , Humans , Internal Fixators , Male , Middle Aged , Multiple Myeloma/complications , Pain/etiology , Pain/psychology , Recovery of Function , Retrospective Studies , Severity of Illness Index , Tibial Fractures/etiology , Tibial Fractures/psychology
2.
Orthop Traumatol Surg Res ; 101(3): 375-9, 2015 May.
Article in English | MEDLINE | ID: mdl-25817904

ABSTRACT

BACKGROUND: Aim of the study was to evaluate degenerative lumbar facet-joints changes after percutaneous pedicle screw fixation (PPSF) in the treatment of lumbar fractures. MATERIALS AND METHODS: Thirty patients underwent short PPSF without fusion. CT-scan was performed in the pre- and post-operative time at four, eight and 12 months. The six zygapophyseal joints adjacent the fracture's level were evaluated. RESULTS: At four months patients showed no differences between pre- and post-operative joint radiographic aspect. At eight and 12 months, CT-scan demonstrated a progressive degeneration only in the middle joints respectively in 21.42% and in 76.92% of the cases. All 10 disrupted facet joints showed progressive degenerative changes at eight and 12 months. CONCLUSION: Lumbar percutaneous fixation without fusion induces little degenerations essentially collocated in the middle joints close to fracture level at eight and 12 months. In the proximal and distal joints adjacent the screws degenerative changes can be seen only when associated to pedicle-screw encroachment.


Subject(s)
Fracture Fixation, Internal , Lumbar Vertebrae/surgery , Pedicle Screws , Spinal Fractures/surgery , Zygapophyseal Joint/diagnostic imaging , Adult , Aged , Female , Follow-Up Studies , Humans , Hypertrophy , Lumbar Vertebrae/injuries , Male , Middle Aged , Osteophyte/diagnostic imaging , Retrospective Studies , Tomography, X-Ray Computed , Young Adult , Zygapophyseal Joint/pathology
4.
Eur Spine J ; 23 Suppl 6: 628-33, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25212449

ABSTRACT

INTRODUCTION: Aim of the study was to evaluate the effectiveness of facet joints injections in lumbar facet syndrome correlating clinical results to the sagittal contour of the spine. METHODS: Facet joints degree degeneration was evaluated using MRI according to Fujiwara classification. Sagittal contour of the spine was evaluated according to Roussouly classification. The clinical results were evaluated with visual analog scale (VAS) at regular intervals. RESULTS: Twenty-eight (70 %) of the 40 patients had clinical symptoms improvement, 12 (30 %) showed no benefit. There was a statistical significant correlation between postoperative VAS value improvement and Roussouly spine type 1 and 3 (p = 0.003). The benefit was more durable in patients with grade 2 or 3 degeneration. CONCLUSIONS: Facet joints injections have a more effective diagnostic than therapeutic value. The procedure could, however, give a temporary pain relief in cases with an overload of the facet joints due to lumbar hyperlordosis.


Subject(s)
Intervertebral Disc Degeneration/drug therapy , Low Back Pain/drug therapy , Spine/pathology , Zygapophyseal Joint , Aged , Aged, 80 and over , Anesthetics, Local/administration & dosage , Anesthetics, Local/therapeutic use , Bupivacaine/administration & dosage , Bupivacaine/therapeutic use , Drug Combinations , Female , Glucocorticoids/administration & dosage , Glucocorticoids/therapeutic use , Humans , Injections, Intra-Articular , Intervertebral Disc Degeneration/complications , Intervertebral Disc Degeneration/diagnosis , Low Back Pain/diagnosis , Low Back Pain/etiology , Lumbosacral Region , Magnetic Resonance Imaging , Male , Middle Aged , Pain Measurement/methods , Treatment Outcome , Triamcinolone Acetonide/administration & dosage , Triamcinolone Acetonide/therapeutic use
5.
Orthop Traumatol Surg Res ; 100(5): 455-60, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25108675

ABSTRACT

BACKGROUND: Treatment of A3 thoraco-lumbar and lumbar spinal fractures nowadays remains a controversial issue. Percutaneous techniques are becoming very popular in the last few years to reduce the approach-related morbidity associated with conventional techniques. HYPOTHESIS: Purpose of the study was to analyze the clinical and radiological outcome of patients who underwent percutaneous posterior fixation without fusion for the treatment of thoraco-lumbar and lumbar A3 fractures. MATERIALS AND METHODS: Sixty-three patients, having sustained a single-level thoraco-lumbar fracture, underwent short segment percutaneous instrumentation and were retrospectively analyzed. sagittal index (SI) was calculated in all patients. Clinical and functional outcome were evaluated by Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and Short Form General Health Status (SF-36). RESULTS: Average operative blood loss was 82 mL (50-320). Mean pre-operative SI in the thoraco-lumbar segment was 13.3° decreased to 5.8° in the immediate postoperative with a mean deformity correction of 7.5. Mean pre-operative SI in the lumbar segment was 16.5° decreased to 11.3° in the immediate postoperative with a mean deformity correction of 5.2. Not statistically significant correction loss was registered at 1-year minimum follow-up. Constant clinical conditions improvement in the examined patients was observed. CONCLUSION: Percutaneous pedicle screw fixation for A3 thoraco-lumbar and lumbar spinal fractures is a reliable and safe procedure. LEVEL OF EVIDENCE: Level IV. Retrospective study.


Subject(s)
Fracture Fixation, Internal , Lumbar Vertebrae/surgery , Spinal Fractures/surgery , Thoracic Vertebrae/surgery , Adult , Aged , Female , Fracture Fixation, Internal/instrumentation , Humans , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/injuries , Male , Middle Aged , Pedicle Screws , Radiography , Retrospective Studies , Spinal Fractures/diagnostic imaging , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/injuries , Visual Analog Scale , Young Adult
6.
Eur Spine J ; 22 Suppl 6: S905-9, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24072338

ABSTRACT

PURPOSE: Purpose of the study was to analyze in a retrospective way the clinical and radiographic outcome of three different surgical techniques in patients who underwent anterior cervical fusion. METHODS: Eighty-six patients affected by symptomatic cervical disc herniation or spondylosis underwent cervical anterior fusion. Patients were divided in three groups considering the surgical technique. Clinical outcomes were evaluated by Visual Analog Scale, Odom's criteria, Neck Disability Index. Radiographic evaluation included standard and functional X-rays. RESULTS: At 7 years mean follow-up, a comparable improvement in clinical symptoms was observed in all groups. Radiographic findings showed a solid fusion in all patients but seven cases in group 2 showed a subsidence of the cage. CONCLUSIONS: As shown by the obtained clinical and radiographic results, the anterior interbody fusion with stand-alone peek cage containing ß-tricalcium phosphate could be considered an effective and reliable procedure.


Subject(s)
Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/surgery , Intervertebral Disc Displacement/diagnostic imaging , Intervertebral Disc Displacement/surgery , Spinal Fusion/methods , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Radiography , Spinal Fusion/adverse effects , Spinal Fusion/instrumentation , Treatment Outcome
7.
Eur Spine J ; 22 Suppl 6: S933-8, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24043339

ABSTRACT

PURPOSE: The clinical outcome of polytrauma patients underwent spine fixation was analyzed and correlated both to surgical time (early versus delayed) and to fixation type (open versus percutaneous). METHODS: Twenty-four polytrauma patients were retrospectively evaluated. Patients were evaluated according to age, accident dynamic, mechanical ventilation need, blood transfusion need, SAPS II score, type of vertebral injury, time of fixation (within or after 72 h) and type of fixation. RESULTS: Nine patients underwent percutaneous pedicle screw fixation and 12 open fusion. An early fixation allows better clinical outcome considering ICU stay (13.7 versus 21.71 days), H-LOS (25.8 versus 69.5 days), mechanical ventilation need (7 versus 16.2), blood transfusion need (250 versus 592 cc). CONCLUSIONS: In polytrauma patients an early spine fixation improves clinical outcome. Patients underwent percutaneous screw fixation showed a better outcome compared to open surgery group obtained despite worst clinical conditions.


Subject(s)
Multiple Trauma/surgery , Pedicle Screws , Spinal Fusion/instrumentation , Spinal Fusion/methods , Spinal Injuries/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Young Adult
8.
Injury ; 44(8): 1092-6, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23648362

ABSTRACT

Advances in adjuvant and neoadjuvant therapies have improved the prognosis of cancer patients leading to an increasing incidence of bone metastases and consequent long bone fractures. In the present study the authors consider the indications and the different surgical options of treatment of tibial pathological lesions. 13 patients (14 lesions, 6 pathological fractures), treated according to histotype and lesion localisation, were retrospectively evaluated. Using generic outcome instruments such as the Eastern Cooperative Oncology Group (ECOG) and Quality of life questionnaire of European Organization for Research and Treatment of Cancer (QLQ-C30) pain, mobility and use of analgesics were evaluated before and after surgery. In all patients, mechanical stabilisation of the osteolytic lesion was achieved. There were no pathological fractures, and no implant mechanical failure. All patients reported pain relief, with a relevant reduction in the amount of analgesics used. Surgical treatment of tibial metastases has to be decided taking into consideration the histotype, localisation of the metastases and life expectancy. The treatment has to be all-encompassing in a solitary lesion in patients with a good prognosis but less invasive in plurimetastatic patients with poor prognosis. Acquisition of good mechanical stability is crucial for a successful outcome.


Subject(s)
Bone Neoplasms/surgery , Fractures, Spontaneous/surgery , Tibia/injuries , Tibial Fractures/surgery , Aged , Bone Neoplasms/complications , Female , Fractures, Spontaneous/etiology , Humans , Male , Middle Aged , Neoadjuvant Therapy/methods , Pain Management/methods , Prognosis , Quality of Life , Radiotherapy , Retrospective Studies , Survival , Tibia/surgery , Treatment Outcome
9.
Eur Rev Med Pharmacol Sci ; 16(14): 1908-14, 2012 Dec.
Article in English | MEDLINE | ID: mdl-23242715

ABSTRACT

BACKGROUND: In lung cancer patients, metastases to soft tissues (STs), including skeletal muscle, subcutaneous tissue and skin, are rarely reported. Besides, lung cancer, primary carcinomas of the kidney and colon are the most commonly associated with ST metastases. AIM: To determine the prevalence, clinical-pathological features and treatment options of ST metastases originating from lung carcinoma. MATERIALS AND METHODS: A literature search was performed using the following terms: lung cancer, ST metastasis, skeletal muscle metastasis, cutaneous metastasis, subcutaneous metastasis. RESULTS: Autopsy series have detected STs metastases in 0.75-9% of patients who died from metastatic lung carcinoma. Pain and the presence of a palpable mass are the most frequent clinical features. The biopsy is recommended after MRI for diagnosis. Due to the rarity of ST metastases, the differential diagnosis must be posed especially with primary ST sarcomas. The type of treatment depends on the patient's clinical status and prognosis, and includes observation, radiotherapy, chemotherapy and surgery. CONCLUSIONS: In lung cancer patients, ST metastases are rare, but not exceptional. Their presence should be suspected in the presence of a palpable mass either painful or asymptomatic. Radiological and histological examinations are required for the definite diagnosis. The choice of treatment should be based on considerations related to the stage of the primary tumor and the patient's global health status.


Subject(s)
Carcinoma/secondary , Lung Neoplasms/pathology , Soft Tissue Neoplasms/secondary , Biopsy , Carcinoma/mortality , Carcinoma/therapy , Humans , Lung Neoplasms/mortality , Lung Neoplasms/therapy , Magnetic Resonance Imaging , Multimodal Imaging , Positron-Emission Tomography , Predictive Value of Tests , Prevalence , Prognosis , Soft Tissue Neoplasms/mortality , Soft Tissue Neoplasms/therapy , Tomography, X-Ray Computed
10.
Orthop Traumatol Surg Res ; 98(4): 470-4, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22591784

ABSTRACT

One case of cervical myelopathy associated to ossification of transverse atlantal ligament (OTAL) and C1 posterior arch hypoplasia in a Caucasian adult female is reported. A 53-year-old female affected by cervical myelopathy was treated with C1 laminectomy and posterior arthrodesis. CT scan demonstrated that the distance between ossification of the ligament and anterior cortex of the posterior arch of atlas was 6,2mm leading to consistent space reduction for spinal cord at this level. Patient underwent spinal cord decompression and fixation with C1 poliaxial screws in lateral masses and two bilateral crossing C2 laminar screws with an improvement of neurological functions at 4-years follow-up. The association between OTAL and C1 hypoplasia was reported in very few cases. The treatment with C1 laminectomy without fusion is reported in medical literature with good clinical outcome. Our patient obtained a neurological improvement at midterm follow-up with spinal cord decompression and fusion.


Subject(s)
Ossification of Posterior Longitudinal Ligament/surgery , Arthrodesis , Decompression, Surgical , Female , Humans , Laminectomy , Middle Aged , Ossification of Posterior Longitudinal Ligament/diagnostic imaging , Tomography, X-Ray Computed
11.
J Biol Regul Homeost Agents ; 26(1): 139-44, 2012.
Article in English | MEDLINE | ID: mdl-22475106

ABSTRACT

The mucopolysaccharidoses (MPS) are a group of rare diseases characterized by deficiencies in different enzymes required for degradation of complex carbohydrates. The enzymatic deficiencies lead to lysosomal accumulation of dermatan sulphate, heparan sulphate, and keratan sulphate in different tissue resulting in multi-system complications. Six different principal types are described. Most MPS types, with the exception of MPS III, are associated with widespread skeletal abnormalities and joint disease. Authors analyzed clinical pathological and radiographical features of mucopolysaccharidoses focusing on pelvic and spine pathologies that generally limit activity and normal life so they have to be treated at the beginning of their manifestations in order to avoid major complication and improve quality of life.


Subject(s)
Bone and Bones/physiopathology , Mucopolysaccharidoses/diagnostic imaging , Mucopolysaccharidoses/physiopathology , Bone and Bones/diagnostic imaging , Humans , Mucopolysaccharidoses/classification , Radiography
12.
Eur Spine J ; 21 Suppl 1: S141-5, 2012 May.
Article in English | MEDLINE | ID: mdl-22434531

ABSTRACT

PURPOSE: The aim of the study was to report and discuss the preliminary data obtained in a homogeneous series of 50 patients affected by multiple myeloma treated with bisphosphonates. METHODS: Patients were followed for a minimum of 1 year. Main orthopaedic data were recorded. Visual Analogue Score and QLQ-C30 and MY 20 were used to assess the quality of life. RESULTS: Statistical analysis showed less lytic lesions in the group with zoledronate therapy and stable primary disease compared with a greater number of lesions in the non-treated group. Results regarding VAS score and QLQ-C30 and MY were statistically better in the first group than in the second. CONCLUSIONS: Our results confirm the efficacy of zoledronate in ensuring an acceptable quality of life restraining the aggressiveness of the myeloma on bone tissue, especially in spine although further prospective studies have to be conducted to determine its correct use in myeloma patients.


Subject(s)
Bone Diseases/etiology , Bone Diseases/prevention & control , Bone Resorption/drug therapy , Diphosphonates/therapeutic use , Imidazoles/therapeutic use , Multiple Myeloma/complications , Spine/physiopathology , Adult , Aged , Bone Diseases/physiopathology , Bone Resorption/pathology , Bone Resorption/physiopathology , Diphosphonates/pharmacology , Female , Follow-Up Studies , Humans , Imidazoles/pharmacology , Longitudinal Studies , Magnetic Resonance Imaging , Male , Middle Aged , Osteogenesis/drug effects , Osteogenesis/physiology , Pain Measurement , Positron-Emission Tomography , Quality of Life , Retrospective Studies , Spine/drug effects , Spine/pathology , Treatment Outcome , Zoledronic Acid
13.
Eur Spine J ; 21 Suppl 1: S128-33, 2012 May.
Article in English | MEDLINE | ID: mdl-22402843

ABSTRACT

PURPOSE: The aim of the study was to evaluate clinical and radiographic outcome of patients treated with a modified Grob technique analysing the advantages related to increased mechanical stability. METHODS: 30 patients that underwent "in situ" fusion for L5-S1 spondylolisthesis were evaluated. All patients presented a low-dysplastic developmental L5-S1 spondylolisthesis. Patients were divided into two groups: A, in which L5-S1 pedicle instrumentation associated with transsacral screw fixation was performed, and B, in which L5-S1 pedicle instrumentation associated with a posterolateral interbody fusion (PLIF) was performed. RESULTS: Patients treated with transdiscal L5-S1 fixation observed a faster resolution of the symptoms and a more rapid return to daily activities, especially at 3-6 months' follow-up. The technique is reliable in giving an optimal mechanical stability to obtain a solid fusion. CONCLUSIONS: The advantages of this technique are lower incidence of neurologic complications, speed of execution and faster return to normal life.


Subject(s)
Bone Screws , Intervertebral Disc/surgery , Lumbar Vertebrae/surgery , Sacrum/surgery , Spinal Fusion/methods , Spondylolisthesis/surgery , Adult , Aged , Female , Follow-Up Studies , Health Status Indicators , Humans , Longitudinal Studies , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/pathology , Magnetic Resonance Imaging , Male , Middle Aged , Pain Measurement , Radiography , Retrospective Studies , Sacrum/diagnostic imaging , Sacrum/pathology , Spondylolisthesis/diagnostic imaging , Spondylolisthesis/pathology , Treatment Outcome
14.
J Biol Regul Homeost Agents ; 25(3): 313-21, 2011.
Article in English | MEDLINE | ID: mdl-22023755

ABSTRACT

Osteogenesis imperfecta is one of the most commonly recognized inheritable disorders of the connective tissue leading to bone fragility. Usually it is associated to a genetic mutation inducing a reduction in collagen quality and entity production. It involves either modification in dentin formation or multiple bone fractures. The authors reviewed the clinical aspects of these disorders, focusing on oral and orthopaedic concerns, especially related to the histological features of the fracture callus, with respect to new trends in pharmacological and surgical treatments of bone fractures. Surgical treatment varies, according to the age of the patient. In children, surgical orthopaedic procedures include multiple osteotomies and the use of telescopic rods. Medical therapy has always to be associated to surgery and is designed to reduce the incidence of fractures, to increase growth velocity and to ally pain in order to improve mobility and independence. Bisphosphonates (BP) are considered potent inhibitors of bone resorption decreasing the osteoclast population and its activity and bone turn over.


Subject(s)
Bones of Lower Extremity/abnormalities , Fractures, Bone/pathology , Fractures, Bone/therapy , Osteogenesis Imperfecta/pathology , Osteogenesis Imperfecta/therapy , Tooth Abnormalities/pathology , Tooth Abnormalities/therapy , Bone Resorption/genetics , Bone Resorption/metabolism , Bone Resorption/pathology , Bone Resorption/therapy , Bones of Lower Extremity/metabolism , Bony Callus/abnormalities , Bony Callus/metabolism , Bony Callus/pathology , Child , Child, Preschool , Collagen/genetics , Collagen/metabolism , Dentin , Fractures, Bone/genetics , Fractures, Bone/metabolism , Humans , Mutation , Osteogenesis Imperfecta/genetics , Osteogenesis Imperfecta/metabolism , Tooth Abnormalities/genetics , Tooth Abnormalities/metabolism
15.
Eur Spine J ; 20 Suppl 1: S41-5, 2011 May.
Article in English | MEDLINE | ID: mdl-21445617

ABSTRACT

Percutaneous techniques may be helpful to reduce approach-related morbidity of conventional open surgery. The aim of the study was to evaluate the feasibility and safety of mini-open posterior lumbar interbody fusion for instabilities and degenerative disc diseases. From May 2005 until October 2008, 20 patients affected by monosegmental instability and disc herniation underwent mini-open lumbar interbody fusion combined with percutaneous pedicle screw fixation of the lumbar spine. Clinical outcome was assessed using the Visual Analog Scale, Oswestry Disability Index, and Short Form Health Survey-36. The mean follow-up was 24 months. The mean estimated blood loss was 126 ml; the mean length of stay was 5.3 days; the mean operative time was 171 min. At 24-month follow-up, the mean VAS score was 2.1, mean ODI was 27.1%, and mean SF-36 was 85.2%. 80 screws were implanted in 20 patients. 74 screws showed very good position, 5 screws acceptable, and 1 screw unacceptable. A solid fusion was achieved in 17 patients (85%). In our opinion, mini-open TLIF is a valid and safe treatment of lumbar instability and degenerative disc diseases in order to obtain faster return to daily activities.


Subject(s)
Intervertebral Disc Displacement/surgery , Joint Instability/surgery , Lumbar Vertebrae/surgery , Minimally Invasive Surgical Procedures/methods , Spinal Fusion/methods , Adult , Bone Screws , Disability Evaluation , Female , Humans , Intervertebral Disc Displacement/diagnostic imaging , Joint Instability/diagnostic imaging , Lumbar Vertebrae/diagnostic imaging , Male , Middle Aged , Pain Measurement , Radiography , Spinal Fusion/instrumentation , Treatment Outcome
16.
J Biol Regul Homeost Agents ; 24(2): 115-21, 2010.
Article in English | MEDLINE | ID: mdl-20487624

ABSTRACT

The efficacy of bisphosphonate in controlling skeletally-related event in cancer patients without a great number of adverse events has resulted in a widespread use of these medications in oncology. Zoledronic acid and pamidronate are the most common bisphosphonates intravenously administered as a preventive treatment of bone complications encountered in multiple myeloma, as well as a palliative treatment of bone metastases in a large variety of solid tumours including breast, prostate and lung cancers. However, in recent years a relationship has been established between these drugs and a new bone injury characterised by avascular necrosis of bone that was isolated to the jaws. This paper reviews the literature concerning the discovery of this disease, its clinical, radiological and histological manifestations; its pathogenesis, with a look at the treatment and future options in preventing this complication and in treating hypercalcemia and bone lytic lesions in solid tumours.


Subject(s)
Bone Neoplasms/chemically induced , Diphosphonates/adverse effects , Jaw Diseases/chemically induced , Osteonecrosis/chemically induced , Antineoplastic Agents/therapeutic use , Bone Neoplasms/drug therapy , Breast Neoplasms/complications , Breast Neoplasms/drug therapy , Diphosphonates/therapeutic use , Female , Humans , Jaw Diseases/drug therapy , Lung Neoplasms/complications , Lung Neoplasms/drug therapy , Male , Multiple Myeloma/complications , Multiple Myeloma/drug therapy , Osteonecrosis/drug therapy , Pamidronate , Prostatic Neoplasms/complications , Prostatic Neoplasms/drug therapy
17.
J Biol Regul Homeost Agents ; 23(2): 59-63, 2009.
Article in English | MEDLINE | ID: mdl-19589285

ABSTRACT

Osteopetrosis is one cause of diffuse osteosclerosis and bone fragility due to abnormal remodelling rate and balance. It may cause some serious skeletal abnormalities, with particular respect to long bones, and oral complications such as osteomyelitis and exposed necrotic bone. Orthopaedists and dentists should be aware of patients with the disease because of its effect on osteoclast function, which results in impaired wound healing. The purpose of this paper is to review the aetiology, pathogenesis and bone remodelling of osteopetrosis leading to some guidance for orthopaedic surgeons and dentists on the management of patients with osteopetrosis, with particular attention to fractures.


Subject(s)
Bone and Bones/pathology , Osteopetrosis/pathology , Fractures, Bone/etiology , Fractures, Bone/pathology , Fractures, Bone/therapy , Humans , Maxillofacial Abnormalities/pathology , Osteopetrosis/complications , Prognosis
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