Background: Different treatment options for aneurysmal bone cysts (ABCs), which have a high risk of recurrence, are discussed. The choice of the treatment approach for patients with ABCs is based on the likelihood of recurrence and any potential side effects. Objective: This study aims to evaluate the outcome of extended curettage alone as a method of treatment for patients with ABCs of the upper extremity. Patients and Methods: From April 2013 to June 2021, 15 primary ABCs in the upper extremity (15 patients) were diagnosed and managed at the Orthopedic Oncology Unit, Zagazig University Hospital. The patients were 9 males and 6 females. The mean age was 13.2 ± 1.6 years (range, 7 years 5 months to 18 years 2 months). ABCs were present in the proximal humerus in 7 cases, distal humerus in 3 cases, radius in 3 cases, glenoid in one case, and distal phalanx of the thumb in one case. All patients were managed by extended curettage and followed up for at least one year. Results: All lesions healed after a mean period of 16 weeks (range 10-21 weeks). The time to healing was related to the age of patients, size, and behavior of the lesion. Superficial infection was seen in one patient and was managed conservatively. Recurrence developed in one patient at 9 months postoperatively and was managed by repeated extended curettage. There was only one patient who developed a shortening of the humerus of about 1.5 cm due to premature fusion of the proximal humeral epiphysis but without angular deformity. Conclusion: Extended curettage with high-speed burr is considered an effective technique in the management of ABCs in the upper extremity.
Background: Acetabular fixation is a dysplastic hip challenge, and many approaches for primary total hip arthroplasty (THA) have been shown. Even though each surgical procedure was discussed, combining bulk graft with impaction of morselized graft is promising. To confirm long-term outcomes, additional research into the clinical outcomes of a combined set of procedures may be necessary. Objective : The aim of the current study is to report the midterm results of using structural and/or morselized autografts for acetabular reconstruction in a series of patients with developmental dysplasia of the hip (DDH). Patients and methods: A total of 44 patients with 44 hips were included in the study. They were followed prospectively for an average period of 2-3 years. Preoperative planning was done including laboratory and radiological investigations. Harris Hip Score (HHS) was applied pre-and post-operatively. Results: HHS was raised from 41.24 before surgery to 83.4 at the latest follow-up. The limb-length was restored to within 0.5 cm in 38 cases (86.4%). Only 4 patients (9.09%) had radiological signs of structural graft resorption. Two (4.5%) patients developed complete radiolucent lines and were revised for loosening. Infection complicated the postoperative course of 3 (6.8%) patients in this study. Conclusion:The technique of biological acetabular reconstruction using structural and/or morselized bone graft in primary THA for cases of acetabular dysplasia is reliable, and it not only simplifies the attainment of initial stability, but also strengthens the mid-term to long-term stability during THA in DDH.
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