Does image guidance improve accuracy of core needle biopsy in diagnosis of soft tissue tumours?

The aim of this study was to compare accuracy of an image guided percutaneous core needle biopsy (PCNB), using ultrasound or computed tomography, to PCNB without image guidance in the diagnosis of palpable soft tissue tumours. One hundred forty patients with a suspected soft tissue sarcoma underwent a percutaneous core needle biopsy with or without image guidance. One hundred eleven patients had subsequent surgical excision.

Growth hormone: does it have a therapeutic role in fracture healing?

Background: The role of growth hormone (GH) in augmenting fracture healing has been postulated for over half a century. GH has been shown to play a role in bone metabolism and this can be mediated directly or indirectly through IGF-I.

Objectives: The use of GH was evaluated as a possible therapeutic agent in augmenting fracture healing.

Prostaglandin EP2 and EP4 receptor agonists in bone formation and bone healing: In vivo and in vitro evidence.

Background: Using agonists that selectively stimulate PGE2 receptors, the adverse effects that have limited the clinical utility of PGE2 can be avoided and there may be potential for their use as therapeutic agents in the treatment of bone loss in humans.

Objective: A comprehensive review of the recent literature on the effect of prostaglandins and their agonists on bone mineral density and fracture healing.

Methods: In vitro and in vivo evidence was collected using medical search engines MEDLINE (1950 to March 2008) and EMBASE (1980 to March 2008) databases.

Impaction allografting revision for B3 periprosthetic femoral fractures using a Mennen plate to contain the graft: a technical report.

We prospectively evaluated the long-term results of a technique using the Mennen plate to contain impacted allograft and support cemented Exeter stem revision fixation for the treatment of three B3 periprosthetic femoral fractures (PFFs). Three patients with a median age of 77 years were followed-up for a median of 84 months. In all cases the stem bypassed the distal fracture line by a median length of 85 mm (median ratio over femoral diameter = 2.

Intramedullary strut substitution and impaction allografting cemented revision for the treatment of a periprosthetic fracture in a severely compromised femur.

Revision for the treatment of a B3 periprosthetic femoral fracture often requires proximal femoral allograft arthroplasty in physiologically young or tumor prostheses in elderly patients. Extramedullary strut allograft augmentation can only be used when the host femur is structurally adequate for the insertion of the revision stem (periprosthetic femoral fractures type B2) and appears to be an attractive biological concept as early incorporation to the host bone results in a sound biomechanical construct. We report here the simultaneous use of whole femur intramedullary strut substitution along with an extramedullary strut graft placement, with impaction allografting revision to a long cemented femoral prosthesis, to augment the deficient metadiaphyseal bone stock (Paprosky type IV) for the treatment of a complex type B3 periprosthetic femoral fracture.

Dynamic compression plates for Vancouver type B periprosthetic femoral fractures: a 3-year follow-up of 18 cases.

Background: There is no consensus on the best surgical treatment of periprosthetic femoral fractures. We report our experience with a dynamic compression plate.

Patients And Methods: We reviewed the results of 18 periprosthetic femoral fractures treated with open reduction and internal fixation using the dynamic compression plate (DCP).

Through-the-nail technique.

Ipsilateral fractures of the neck of the femur and the femoral shaft are uncommon injuries and they present considerable challenge as the concurrent survival of the femoral head and union of the femoral shaft fracture is of paramount importance. We present a young male patient who sustained a Garden IV fracture of the neck of his right femur following a road traffic accident, with the fracture being adjacent to an ipsilateral intramedullary nail inserted 10 years previously for a midshaft femoral fracture; the nail was broken, with its proximal fragment lying behind the greater trochanter. The patient was operated on within 6 hours from the injury.

Revision total elbow arthroplasty with impaction allografting and uncemented partially hydroxyapatite-coated custom-made prostheses.

Total elbow arthroplasty has become a relatively common procedure in the last decade, and the number of primary total elbow replacements performed is likely to continue to increase as the population ages. The incidence of technically demanding prosthesis revisions involving complex problems such as major bone loss is therefore expected to increase. We report 3 cases of total elbow revision arthroplasty, all of which represented patients with severe bone loss.