BACKGROUND Giant cell tumour is a primary bone tumour. It is benign but locally aggressive neoplasm with a tendency for local recurrence. The aim of treatment is to remove the tumour completely and to preserve the joint. Local recurrence is a well-documented problem. Treatment of recurrent lesions is the same as for primary lesions. This study is aimed at analysing the treatment of the recurrent GCT and aggressive GCT with pathological fracture by adequate curettage using adjuvant like H2O2, liquid nitrogen followed by filling the curetted cavity with bone grafts, bone substitutes and bone cement, thereby preventing the recurrence and to provide structural stability in aggressive GCT with pathological fracture. MATERIALS AND METHODS This is a prospective study of management of 32 cases of Giant Cell Tumour during 2003 to 2007 in Government Kilpauk Medical College, Chennai. Out of the 32 cases, 17 cases were Aggressive GCT with pathological fracture and 15 cases were Recurrent GCT. RESULTS For recurrent GCT, removal of previously applied bone cement, extended curettage with adjuvant Hydrogen Peroxide and reconstruction with bone cement/bone graft/amputation were the treatment methods employed. For Aggressive GCT with pathological fracture, extended curettage with adjuvant H2O2/liquid nitrogen and reconstruction with fibular strut graft/cancellous bone graft, bone substitute and bone cement were the treatment methods employed. CONCLUSION GCT is a locally aggressive benign tumour occurring in young individuals with a normal life expectancy. If inadequately or inappropriately treated, it results in considerable morbidity and recurrence. Careful attention to soft tissue protection while using cryosurgery significantly decreased the previously published reports of high rates of infection and wound healing problem. Hydrogen peroxide is an ideal adjuvant, which gives a comparable rate of recurrence and least local or systemic complications. Free fibular strut graft along with PMMA incorporates in the bone early and the joints can be salvaged with useful function. En bloc resection must also be followed by adjuvant to prevent recurrence due to local tissue contamination.
The incidence of musculoskeletal tuberculosis (TB) is on the rise due to the current Acquired Immunodeficiency Syndrome (AIDS) pandemic. Spine is the most common osseous site, followed by other joints. TB identified in the elbow accounts for 2%–5% of skeletal TB cases, which are secondary to pulmonary TB. Primary elbow TB is rare. We report a case of primary TB of the elbow which had a negative synovial biopsy. A 46-year-old right-hand dominant female patient with chronic pain and disability of the right elbow was diagnosed with chronic non-specific arthritis based on an arthroscopic synovial biopsy. The case was diagnosed retrospectively as active TB from bone cuts post total elbow arthroplasty (TEA). Anti-tuberculosis treatment (ATT) was given postoperatively for 12 months. The patient reported good functional outcomes at 3 years of follow-up. Such atypical presentations of osteoarticular TB are challenging to diagnose. Therefore, particularly in endemic areas, clinicians should be careful before excluding such a diagnosis even after a negative biopsy. Further research should investigate whether active TB of small joints such as the elbow can be treated with ATT, and early arthroplasty should be a focus of this research.
Background: The treatment for acromioclavicular joint injuries (ACJI) ranges from a conservative approach to extensive surgical reconstruction, and the decision on how to manage these injuries depends on the grade of acromioclavicular (AC) joint separation, resources, and skill availability. After a thorough review of the literature, the researchers adopted a simple cost-effective technique of AC joint reconstruction for acute ACJI requiring surgery.Methods: This was a prospective single-center study conducted between April 2017 and April 2018. For patients with acute ACJI more than Rockwood grade 3, the researchers performed open corococlavicular ligament reconstruction using synthetic sutures along with an Endobutton and a figure of 8 button plate. This was followed by AC ligament repair augmenting it with temporary percutaneous AC K-wires. Clinical outcomes were evaluated using the Constant Murley shoulder score. Results: Seventeen patients underwent surgery. The immediate postoperative radiograph showed an anatomical reduction of the AC joint dislocation in all patients. During follow-up, one patient developed subluxation but was asymptomatic. The mean follow-up period was 30 months (range, 24–35 months). The mean Constant score at 24 months was 95. No AC joint degeneration was noted in follow-up X-rays. The follow-up X-rays showed significant infra-clavicular calcification in 11 of the 17 patients, which was an evidence of a healed coracoclavicular ligament post-surgeryConclusions: This study presents a simple cost-effective technique with a short learning curve for anatomic reconstruction of acute ACJI. The preliminary results have been very encouraging.
INTRODUCTIONThe anatomy of the temporal bone is intricate, complex and highly variable. 1 It is important for an ear surgeon to study the three dimensional anatomy of this bone. Understanding the interrelationships of the structures contained within the temporal bone is an intellectually demanding task. This is important for the otologist in order to operate safely and effectively to achieve good results in ear surgery.2 Various important neurovascular structures run within or adjacent to the temporal bone. Of these, the facial nerve is the most important. The course and depth of the facial nerve in the mastoid is subject to variation and hence liable for iatrogenic injury during tympanomastoid surgery. Iatrogenic injury resulting in facial paralysis is a difficult complication for the surgeon, patient and for people who interact with the affected patient. A poll in the early 1990s' in the United States revealed a high level of discomfort for both patients and their attendants.3 Very few studies have been performed regarding the depth of the facial nerve from fixed reference points in the temporal bone. Hence this study attempts to determine the mean depth of the facial nerve in the mastoid and hence address these deficiencies. METHODSThis cadaveric anatomical study was conducted at the Department of ENT, Mysore Medical College and Research Institute, Mysore, between 1/12/2017 to 31/01/2018. Institutional Ethical Committee Clearance was obtained for this study.Twenty adult wet temporal bones from both sides were harvested for this study. The temporal bone was mounted on a temporal bone holder in the surgical position. Using a drill, the first bone cut was made along the linea temporalis. The second cut was made along the posterosuperior canal wall upto the mastoid tip. These two cuts were joined together forming a triangle of attack. Cortical ABSTRACT Background:The hallmark of the temporal bone is variation. Various important structures like the facial nerve run in the temporal bone at various depths which can be injured during mastoidectomy. Methods: Twenty wet cadaveric temporal bones were dissected. A cortical mastoidectomy was performed followed by a canal wall down mastoidectomy and the depth of the vertical segment of the facial nerve in the mastoid was determined. Results:The mean depth of the second genu was 13.82 mm. The mean depth of the stylomastoid foramen was 12.75 mm and the mean distance from the annulus at 6'0 clock to the stylomastoid foramen was 10.22 mm. Conclusions:There is significant variation in the average depth of the facial nerve in the mastoid.
Objective: To estimate the mean of morphometric values of the human aortic valve in the population of western Maharashtra. The morphometric variables include mean area and the circumference of the human aortic valve of both genders. Materials and Methods: The present study was carried out on 30 adult cadaveric hearts in the department of Anatomy at a tertiary care hospital in western Maharashtra. Heart and aortic arch were dissected according to standard dissection techniques. The aortic orifice and valves were exposed; pictures were taken keeping a plastic ruler alongside the periphery of the valve. The pictures were analyzed using Image J software to calculate circumference and area of the aortic valve. Results: The mean circumference of the aortic valve was 8.827 cm in males and 8.179 cm in females. The mean area of the male aortic valve was 5.365cm² and the female aortic valve is 4.641cm². The circumference results were found to be significant whereas the area results were not significant. Conclusion: The size of the aortic valve in the western Maharashtra region was found to be more as compared to other studies. The present study might help the cardiothoracic surgeons as well as the prosthetic valve manufacturing companies for the rough estimation of the aortic valve size. Keywords: Aortic valve, valve area, valve circumference
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.