RESUMO
The detection of metastatic deposits at the site of previous osteosynthesis is difficult. Bone imaging and scanning with technectium 99m are unhelpful in differentiating between osteomyelitis, Paget's disease and a bone metastasis. The authors present details of a patient who had undergone osteosynthesis for a fracture of the left tibia in 1983. In October 1989 signs of inflammatory change appeared at the site of the previous fracture. It was initially treated as if it were osteomyelitis, with curettage and insertion of gentamycin beads, although no organisms were grown. Eventually the patient was transferred to the author's hospital and further investigation revealed a carcinoma of the prostate. Histological examination of biopsy specimens from the left tibia confirmed the presence of a metastasis from this growth.
Assuntos
Adenocarcinoma/etiologia , Adenocarcinoma/secundário , Neoplasias Ósseas/etiologia , Neoplasias Ósseas/secundário , Fixação Intramedular de Fraturas/efeitos adversos , Neoplasias da Próstata/patologia , Tíbia , Fraturas da Tíbia/complicações , Fraturas da Tíbia/cirurgia , Adenocarcinoma/diagnóstico , Adenocarcinoma/terapia , Idoso , Biópsia , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/terapia , Diagnóstico Diferencial , Evolução Fatal , Humanos , Masculino , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/cirurgiaRESUMO
The different techniques for the revision of the acetabular loosening are reviewed. In our department, we use the acetabular flanged shell fixed with screws. Three cases illustrate this promising process.