Chondrosarcoma of the Chest Wall: A Single Institution Review of 50 Cases.

Introduction: Chondrosarcoma (CS) is most common primary osseous tumor of the chest wall. The aim of this study was to report results from surgical procedures and evaluate clinical factors predicting survival of patients with chest wall CSs treated in a single tertiary sarcoma center.

Materials And Methods: Fifty patients with primary CS located in the ribs and sternum were included.

Visual Counting and Automated Image-analytic Assessment of Ki-67 and their Prognostic Value in Synovial Sarcoma.

Background: Ki-67 is a widely used proliferation marker reflecting prognosis in various tumors. However, visual assessment and scoring of Ki-67 suffers from marked inter-observer and intra-observer variability. We aimed to assess the concordance of manual counting and automated image-analytic scoring methods for Ki-67 in synovial sarcoma.

Soft Tissue Sarcoma of Lower Extremity: Functional Outcome and Quality of Life.

Background: Few studies have focused on patient-related factors in analyzing long-term functional outcome and health-related quality of life (HRQoL) in patients with postoperative lower extremity soft tissue sarcoma (STS).

Objective: The purpose of this study was to investigate factors associated with postoperative functional outcome and HRQoL in patients with lower extremity STS.

Methods: This cross-sectional study was performed in a tertiary referral center using the Toronto Extremity Salvage Score (TESS), Quality-of-Life Questionnaire (QLQ)-C30 and 15 Dimension (15D) measures.

Further validation of the Toronto extremity salvage score for lower extremity soft tissue sarcoma based on Finnish patients.

The most widely used patient-reported outcome (PRO) measure for soft tissue sarcoma (STS) patients is the Toronto Extremity Salvage Score (TESS). The aim of the study was to validate and test the reliability of the TESS for patients with lower extremity STS based on Finnish population data. Patients were assessed using the TESS, the QLQ-C30 Function and Quality of life (QoL) modules, the 15D and the Musculoskeletal tumour Society (MSTS) score.

Functional Outcome Measurement in Patients with Lower-Extremity Soft Tissue Sarcoma: A Systematic Literature Review.

Background: The importance of functional outcome (FO) in the treatment of patients with extremity soft tissue sarcoma (STS) has been increasingly recognized in the last three decades. This systematic review aimed to investigate how FO is measured in surgically treated lower-extremity STS patients.

Methods: A systematic search of PubMed, Web of Science, and Scopus was performed based on the PRISMA guidelines.

Assessment of the structural validity of three foot and ankle specific patient-reported outcome measures.

Background: The structural validity of the Lower extremity functional scale (LEFS), the Visual analogue scale foot and ankle (VAS-FA), and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) has not been compared earlier in patients after foot and ankle surgery.

Methods: Altogether 165 previously operated patients completed the foot and ankle specific instruments, the 15D health-related quality of life (HRQoL) instrument, and general health (VAS).

Results: The LEFS, the VAS-FA and the WOMAC had slight differences in their measurement properties.

Toward a Consensus on Centralization in Surgery.

Objectives: To critically assess centralization policies for highly specialized surgeries in Europe and North America and propose recommendations.

Background/methods: Most countries are increasingly forced to maintain quality medicine at a reasonable cost. An all-inclusive perspective, including health care providers, payers, society as a whole and patients, has ubiquitously failed, arguably for different reasons in environments.

Rasch analysis of the Lower Extremity Functional Scale for foot and ankle patients.

The Lower Extremity Functional Scale (LEFS) is a widely used 20-item patient-reported outcome instrument with five response categories. We investigated the measurement properties of the Finnish version of the LEFS among foot and ankle patients to refine the scale to measure more accurately what is relevant for patients. Data were obtained from 182 patients who had undergone foot and ankle surgery for various reasons.

Oncologic Resection and Reconstruction of the Chest Wall: A 19-Year Experience in a Single Center.

Background: The aim of this study was to analyze chest wall reconstruction following oncologic resection performed by a single surgeon over a 19-year period.

Methods: A retrospective review was performed for 135 patients who underwent oncologic chest wall resection from 1997 to 2015.

Results: Average patient age was 57.

Reliability and validity of the Finnish version of the Visual Analogue Scale Foot and Ankle (VAS-FA).

Background: There have previously been no validated foot and ankle-specific patient-reported outcome measures in Finnish.

Methods: The Visual Analogue Scale Foot and Ankle (VAS-FA) was translated and adapted into Finnish. Thereafter, 165 patients who had undergone foot and ankle surgery completed a questionnaire set on two separate occasions.

Reliability and validity of the Finnish version of the prosthesis evaluation questionnaire.

Background: Thus far there have been no specific patient-reported outcome instrument in Finnish for health-related quality of life (HRQoL) assessment after major lower extremity amputation and successful prosthesis fitting.

Methods: The prosthesis evaluation questionnaire (PEQ) was translated and cross-culturally adapted into Finnish. Participants completed a questionnaire package including the Finnish version of the PEQ and the 15 D HRQoL instrument.

Reliability and validity of the Finnish version of the Lower Extremity Functional Scale (LEFS).

Purpose: The present study aimed to assess the psychometric properties of the Finnish version of the Lower Extremity Functional Scale (LEFS) among foot and ankle patients.

Methods: The LEFS was translated and cross-culturally adapted to Finnish. We assessed the test-retest reliability, internal consistency, floor-ceiling effect, construct validity and criterion validity in patients who underwent surgery due to musculoskeletal pathology of the foot and ankle (N = 166).

Improved prognosis in soft-tissue sarcoma of extremity and trunk wall.

Background and purpose - Soft-tissue sarcoma (STS) is rare, with challenging individualized treatment, so diagnostics and treatment should be centralized. Historical controls are sometimes used for investigation of whether new diagnostic or therapeutic tools affect patient outcome. However, as yet unknown factors may affect the outcome.

Treatment of compound tibial fracture with free osteomuscular latissimus dorsi scapula flap.

Background: Compound tibial fractures with extensive comminution and soft tissue defects are limb-threatening reconstructive challenges. The purpose of this study was to assess the long-term outcomes and the reliability of the latissimus dorsi scapula flap for this indication.

Methods: The hospital records of 26 compound tibial fracture patients treated with the latissimus dorsi scapula flap were reviewed.

The desmoid tumour: local control after surgical treatment.

Desmoid tumours are uncommon non-malignant tumours that show a locally aggressive growth pattern and a high local recurrence rate after surgery. Approximately 10% of the desmoid tumours are associated with familial adenomatous polyposis (FAP). Variable natural history of the disease challenges treatment decision-making in the absence of prospective, randomised data.

Marginal miss or radioresistance? The pattern of local recurrence after operation and 3D planned radiation treatment in soft tissue sarcoma of the extremities and the limb girdles; an analysis based on image fusion.

Background: Most local recurrences have developed in the clinical target volume in previously published series after combined modality treatment for soft tissue sarcoma. However, marginal misses were seen in almost 20% of the patients. The aim of the present study was to determine the location of the recurrence and the total dose at the centre point of the local recurrence for future radiation therapy planning.

Soft tissue sarcoma - a population-based, nationwide study with special emphasis on local control.

Background: A prospective diagnostics and treatment protocol for extremity and trunk wall soft tissue sarcoma (STS) was introduced by the Scandinavian Sarcoma Group in 1986 and it was also widely adopted in Finland. We have updated the protocol and made it more detailed at the Helsinki University Central Hospital. We retrospectively compared diagnostics and treatment of STS in a nationwide population-based material to this protocol with special emphasis on local control.

The cost utility of reduction mammaplasty at medium-term follow-up: a prospective study.

Purpose: The effects of reduction mammaplasty (RM) have been proved in several randomised trials. However, publications regarding cost utility are infrequent and lacking with regard to medium-term follow-up. Therefore, we decided to assess the cost utility of RM at 2-5 years' follow-up, when later costs and possible re-operations have been incurred.

The outcome of reduction mammaplasty remains stable at 2-5 years' follow-up: a prospective study.

Purpose: Several randomised studies have proved the effectiveness of reduction mammaplasty in short-term follow-up. However, medium-term prospective follow-up studies are rare. Therefore, a prospective study was conducted to assess the medium-term results and to see whether there are any changes in the intervention effect during the first years.

Vascular invasion is an early event in pathogenesis of Merkel cell carcinoma.

This study investigated vascular and especially lymphovascular invasion in primary Merkel cell carcinoma and its value as a prognostic factor. Paraffin-embedded blocks prepared from tumor samples obtained from 126 patients diagnosed with Merkel cell carcinoma in 1979-2004 were immunohistochemically stained using antibodies CD31 and D2-40 to detect intravascular tumor emboli. This finding was compared with the clinical data and the disease outcome.

Acute unreamed intramedullary nailing and soft tissue reconstruction with muscle flaps for the treatment of severe open tibial shaft fractures.

Background: The treatment of open tibial shaft fractures remains controversial. Important considerations in surgical management include surgical timing, fixation technique and soft tissue coverage. This study was performed to evaluate the results of acute surgical debridement, unreamed nailing and soft tissue reconstruction in the treatment of severe open tibial shaft fractures.

Distally-based peroneus brevis muscle flap: a successful way of reconstructing lateral soft tissue defects of the ankle.

Sixteen distally-based peroneus brevis muscle flaps were used to cover soft tissue defects in the lateral side of the ankle. The defect in 13 cases was on the lateral malleolus, in two on the lateral side of the calcaneus, and in one case in the Achilles tendon. The patients were all followed up until full recovery (mean 7.

Reconstruction of soft tissue after complicated calcaneal fractures.

A total of 35 flap reconstructions were done to cover exposed calcaneal bones in 31 patients. All patients had calcaneal fractures, 19 of which were primarily open. Soft tissue reconstruction for the closed fractures was indicated by a postoperative wound complication.

Salvage of major amputation stumps of the lower extremity with latissimus dorsi free flaps.

In some severe lower limb injuries, the level of bone trauma enables preservation of the knee joint or adequate length of the femoral stump only if the soft tissues can be reconstructed over the exposed bone. The options for soft-tissue reconstruction of an amputation stump are to use a flap from the amputated distal part, a local flap possibly after tissue expansion or a free flap. To preserve an adequate length of stump we reconstructed 10 stumps with latissimus dorsi free flaps: above the knee in one patient and below the knee in nine.

Radical excision and reconstruction of chronic tibial osteomyelitis with microvascular muscle flaps.

We report a series of 21 patients with chronic osteomyelitis of the tibia treated with microvascular muscle flap reconstruction. All patients underwent a radical bone and soft-tissue excision until healthy, well-bleeding tissue was exposed. Six patients required cancellous bone grafting.