Aneurysmal bone cyst of the cervicodorsal spine.

A 23-year-old woman with paraparesis and bladder atonia of one week's duration demonstrated lytic destruction of the anterior elements of C7, D1, and D2, with gibbus deformity at C7. The tumor was excised in August 1975 through an anterior approach and the cervical spine was reconstructed with a five-level, fibular strut bone graft. Several weeks later a posterior fusion was performed. The patient was placed in a halo jacket for three months, at which time solid fusion was achieved. The final pathologic diagnosis was aneurysmal bone cyst. The patient obtained full neurologic recovery after surgery and has had no sequelae or recurrence to date. Involvement of several adjacent cervical vertebrae by an aneurysmal bone cyst is unusual, and a comparable case is rarely reported.

Chrysosporium, a new causative agent in osteomyelitis. A case report.

A 24-year-old black man presented with a two-month history of swelling of the right ankle. Roentgenograms were initially read as negative. One month later the patient returned with increased pain and swelling, and roentgenograms demonstrated a large lucency involving the distal tibia. Bone scanning revealed extension of the lesion proximally, to 6 cm below the knee. Biopsy of a large tibial abscess demonstrated histocytic giant cells with budding yeasts and septate mycelia. Chrysosporium was isolated from cultures. Amphotericin B was used to treat the patient. Clinically, the infection healed within four months in a short-leg cast. Although Chrysosporium is usually a contaminant, its presence in cultures and histologic sections is evidence of pathogenicity.

Total hip revision: indications and surgical technique.

Specialized techniques for evaluation and treatment of failed total hip arthroplasties were developed in the management of 171 patients from 1972 through 1978, using an integrated, interdisciplinary approach. Various surgical techniques were tailored to the individual and directed at the specific etiology of failure. Intraoperative biplanar fluoroscopic monitoring of a high-speed, low-torque pneumatic drill facilitated removal of femoral acrylic and reaming of the distal shaft. Coordinated use of instrumentation for autotransfusion, cement fragmentation, bone debridement and acetabuloplasty, together with new advances in the diagnosis and management of various intraoperative complications are described.An average follow-up of 36 months was obtained in 91 cases. Good to excellent hip ratings were seen in 83%.

Geometric total knee replacement: an eight year experience at the new England baptist hospital.

Total knee arthoplasty has been accepted as a valuable adjunct in the treatment of knees severely compromised by disease or trauma. One hundred nine geometric total knee replacements were reviewed to determine the efficacy of the device in the relief of pain, the correction of deformity and instability, and the restoration of functional motion in the diseased knee.1.

Acquired os odontoideum. A case report.

A 7-year-old boy presented with os odontoideum after a 5 story fall at 19 months of age, at which time roentgenograms documented a normal odontoid. Current flexion-extension films revealed a marked altlantoaxial instability related to the acquired "os." The treatment consisted of an atlantoaxial arthrodesis. Acquired os odontoideum is a recognized, though uncommon entity in which it is hypothesized that trauma produces vascular insufficiency, with subsequent resorption of the central portion of the odontoid, resulting in the classical features of os odontoideum. It is often associated with instability, with potential danger to the spinal cord. Instability in cases of os odontoideum is a positive indication for atlantoaxial arthrodesis.