Extraskeletal mesenchymal chondrosarcomas (EMCs) are relatively uncommon, and a location in the upper extremity, especially in the shoulder or axillary region, is rare. Furthermore, the radiographic findings of EMCs do not show any features that distinguish them from other neoplasms, and therefore, definitive diagnoses are made based on histological features. EMC is an aggressive tumor with a poor prognosis, and requires wide surgical excision. However, its treatment may involve peculiarities such as a difficulty in obtaining a proper surgical margin in the axillary region or shoulder. In this report, the authors present two rare cases of EMCs in the axillary region.
Supplementary transverse Kirschner wire fixation is not recommended for proximal metatarsal chevron osteotomy since two axial Kirschner wires provided sufficient stability.
To evaluate short-term clinical and radiographical results of fixed bearing unicondylar knee arthroplasty (UKA) comparing results between over-corrected group and under-corrected group. Materials and Methods: Clinical and radiographical outcomes of 47 Miller-Galante ® UKAs with a minimum of 4-year follow-up were evaluated. We also compared both clinical and radiographical results between over and under corrected groups, which were divided by 2 o varus of mechanical axis postoperatively. Results: HSS and WOMAC scores improved from 75.4 and 57.7 preoperatively to respectively, 95.2 and 12.1 at the last follow up. Radiographically, the mechanical axis changed from 7.2 o varus preoperatively to 2.8 o varus at the last follow-up. A partial radiolucent line on the medial side of the tibia was observed in 23% of the 47 cases. Degenerative changes in the lateral compartment and the patellofemoral joint were observed, respectively, in 23% and 26%. There were no significant differences between the two groups in clinical and radiographical results (p>0.05). In the undercorrected group, three cases converted to total knee arthroplasty because of medial tibial collapse. Conclusion: Miller-Galante ® UKA showed good outcomes in short-term follow-up with the exception of three failures. There were no significant differences between more than 2 o varus corrected and under 2 o varus corrected groups in clinical and radiographical results. However, all 3 conversions to total knee arthroplasties occurred in the undercorrected group.
Purpose: We evaluated results of arthroscopically assisted volar and dorsal scapholunate(SL) ligament reconstruction using flexor carpi radialis(FCR). Methods: We reviewed 31 cases who had been operated from August 2015 to June 2018. Two cases were excluded and 4 cases lost contact. Twenty five wrists were included. The average follow-up duration was 25.3months. Diagnostic arthroscopy was performed to evaluate EWAS stage of SL instability and the reparability of SL ligament. The SL reconstruction was performed for the cases which showed EWAS stage IIIC, IV having gap over 3mm and irreparable SL ligament. The interval between the diagnosis and operation was 5.9 days in average. We modified the arthroscopic Corella technique by repairing the graft tendon to FCR. Results: All SL joints were stabilized to EWAS stage I arthroscopically after reconstruction. DASH score changed from 32.7 to 9.7. Grip power changed from 74.1% to 93.3%. Modified Mayo Wrist score was 83.8. Preoperative SL angle was 53.8。, postoperative 49.6。 and the last was 51.2。. The improvement between preoperative and last follow-up SL angle was statistically significant(p<0.05). The SL angle from operation to last follow-up has increased by 1.67。(39.8%, p<0.01). Twelve cases showed SL gap over 2mm in clenched fist view before operation, but no case at follow-up. Conclusions: Volar and dorsal SL reconstruction using FCR should provide more stability and strength than only dorsal SL reconstruction. Arthroscopic technique has the merit that it causes minimal damage to extrinsic carpal ligaments and posterior interosseous nerve and can provide rapid recovery.
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