Temporary resection-arthrodesis of the knee using an intramedullary rod and bone cement.

A temporary arthrodesis of the knee, using an intramedullary Küntscher rod and bone cement, was carried out in 76 patients after resection of tumours of the distal femur or proximal tibia. In contrast to primary arthrodesis with bone grafting, this procedure allows the patient to bear weight on a stable limb a few days after operation, reduces the risk of infection and avoids the negative effect of chemotherapy on graft incorporation. In 12 cases (16%) the implant failed mechanically by fracture, or by bending or migration of the rod, at from 13 to 54 months after operation.

Resection of the proximal humerus and I.O.R. modular prosthesis in the treatment of metastatic lesions.

The authors report a series of 20 patients affected with metastatic lesions of the proximal humerus (19 cases) or scapula (one case) treated by intra-or extra-articular resection of the humerus and successive reconstruction with an I.O.R.

Staging of intraosseous extent of osteosarcoma: correlation of preoperative CT and MR imaging with pathologic macroslides.

The accuracy of preoperative computed tomography (CT) and magnetic resonance (MR) imaging in the measurement of intraosseous tumor extent in 17 cases of osteosarcoma of an extremity was compared with macroslides of surgical specimens. Longitudinal intraosseous extension of tumor from the adjacent articular surface was measured on imaging studies and macroslides to the nearest millimeter. The average difference between macroslide and CT measurements (15 cases) was 16.

Lumbar disc herniation: diagnosis, surgical treatment, recurrence. A review of 872 operated cases.

This review is based on 972 cases treated surgically for lumbar disc herniation between 1974 and 1984. The authors discuss several problems related to this condition. The importance of the history and clinical assessment are emphasized, as well as the role of instrumental tests such as radiculography and CT scan.

[CT evaluation of sacrococcygeal chordoma].

From June 1985 to September 1986, eight patients affected by sacrococcygeal chordoma were examined by means of conventional radiography and tomography first, and then by high-resolution CT. All patients underwent surgery and an histologic examination of the surgical specimen was carried out. CT always allowed to detect the sacro-coccygeal neoplasm, which looked like a solid non-homogeneous mass; in 50% of cases coarse calcifications were found.

Neoadjuvant chemotherapy for osteosarcoma of the extremity.

Eighty-five patients with nonmetastatic, high-grade osteosarcoma of an extremity received intravenous methotrexate and intraarterial cisplatinum and then a definitive surgical resection. The preliminary results suggest that preoperative chemotherapy with a delayed surgical resection is as safe as immediate surgery. More patients are candidates for limb salvage after chemotherapy.

Resection of the distal tibia in bone tumours.

The authors report five cases of tumour of the distal tibia treated by resection and reconstruction by autoplastic grafting and tibiotarsal arthrodesis with fixation by a Kuntscher nail or a plate. This type of surgery is indicated for the treatment of benign tumours, aggressive pseudotumours (Enneking stage 3), or for Enneking stage 1A or 2A malignant tumours. Infection was the most frequent complication (2 out of 5 cases, both of which healed after surgical cleansing).

The Mazabraud syndrome: case report and review of the literature.

The authors report a case of Mazabraud's syndrome in a patient aged 57 years with a history of fibrous dysplasia of the skeletal system which had commenced at the age of 10. This became associated with myxomas of the soft tissues at the age of 42. This rare association was described by Mazabraud in 1957.

A study of the bone-cement interface in upper limb prostheses not subjected to loading.

The appearance of a radiolucent band at the cement-bone interface is a frequent finding in lower limb prostheses. This is still a controversial subject, but almost certainly has a multifactorial basis. Stress related to loading may be one of the causal factors.

Complications of pelvic resections.

The authors report on complications that occurred with 63 pelvic resections. There were 43 complications: 13 infections, seven cases of nerve palsy, 12 cases of vascular or visceral damage, six mechanical and five aesthetic complications. Infection and vascular and visceral damage were more frequent in anterior arch resections, neurological damage in iliac wing resections, and mechanical complications in periacetabular resections.

Adriamycin-methotrexate high dose versus adriamycin-methotrexate moderate dose as adjuvant chemotherapy for osteosarcoma of the extremities: a randomized study.

Adjuvant chemotherapy comprising Adriamycin (ADM) and Methotrexate (MTX) with Citrovorum Factor (CF) was administered on a randomization basis to 2 groups of patients with osteosarcoma after surgical ablation of the primary tumor. One group received high dose MTX (regimen I) and the other moderate dose MTX (regimen II). In both groups a short period of heparin treatment was also administered to prevent neoplastic emboli during surgery.

Reconstruction after resection of the distal fibula for bone tumor.

We have reviewed 11 patients after distal fibular resection for benign or malignant tumors with different techniques of reconstruction. Seven patients had normal function and four had reduced mobility, one of whom had a lateral subluxation of the talus. All the patients were without pain.

Subtotal and total femoral resection: an alternative to total femoral prosthetic replacement.

Two cases of chondrosarcoma involving the proximal femur and the soft tissues are reported. Both patients underwent subtotal femoral resection and quadriceps excision followed by reconstruction with a special prosthesis and arthrodesis of the knee. The tibial stem of the prosthesis was fixed with cement.

A humeral modular prostheses for bone tumour surgery: a study of 56 cases.

Fifty six humeral prostheses were inserted from 1974 to 1984 for primary bone tumours of the shoulder. In 40 patients a proximal humeral resection was performed and in the remaining 16 cases a Tikhoff-Linberg procedure was employed. The length of humeral resection ranged from 9 cm to 24 cm.