Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2012
Extraskeletal myxoid chondrosarcoma: a review of 23 patients treated at a single referral center with long-term follow-up.
Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue sarcoma. Although it has been regarded as a low-grade sarcoma unassociated with tumor-related death, a recent study has suggested an insidious nature with a high propensity for relapse during a long disease course. The aim of this study was to clarify the long-term clinical features of EMC treated at a single referral center using state-of-the-art techniques. ⋯ EMC is indolent but has a high propensity for relapse over 5 years of follow-up. Definitive initial surgery and careful monitoring for a prolonged period are important. Radiotherapy seems beneficial in an adjuvant setting and as palliative therapy for metastatic disease.
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Arch Orthop Trauma Surg · Oct 2012
6-Year follow-up of ventral monosegmental spondylodesis of incomplete burst fractures of the thoracolumbar spine using three cortical iliac crest bone grafts.
Autologous bone graft is the gold standard for vertebral body replacement. Currently, after modern implants for vertebral body replacement are available, controversies exist regarding the optimal implant strategy. ⋯ High rates of osseous consolidation are visible 6 years after ventral spondylodesis by iliac crest bone grafts. A further improvement of consolidation can be expected after dorsal implant removal. But the surgical approach to the iliac crest is accompanied with a relevant complication rate.
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Arch Orthop Trauma Surg · Oct 2012
Blood transfusion and cytokines' changes in total knee replacement.
The aim of this prospective comparative study was to evaluate the serum levels of different cytokines and the frequency of adverse reactions and wound infections in patients who underwent total knee replacement (TKR) and were not transfused or received either allogeneic blood transfusion or postoperative auto-transfusion (PAT) with unwashed shed blood. ⋯ The immunological status-as expressed by the measured cytokine levels-is altered in patients receiving blood transfusion compared to patients receiving no blood transfusion during the first five postoperative days. PAT is preferable to allogeneic blood transfusion in terms of the rate of adverse reactions and superficial wound infections.
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Arch Orthop Trauma Surg · Oct 2012
Injection-induced low-grade infection of the shoulder joint: preliminary results.
Purulent arthritis of the shoulder has been widely reported. Low-grade post-operative infections of the shoulder have also been observed. Low-grade infections of the shoulder without prior surgery have not been reported in the literature. The purpose of this study is to present our experience of seven patients with low-grade infections of the shoulder without a history of prior surgery. ⋯ Level IV, retrospective case series, treatment study.
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Arch Orthop Trauma Surg · Oct 2012
Predictors of blood transfusion in patients undergoing elective surgery for degenerative conditions of the spine.
The requirement of blood in the surgery of degenerative conditions of lumbar spine is around 10 %. Preoperative autologous blood donation is an effective method that is used in surgeries with an important blood loss. This is an expensive method because of the great number of predonated blood units not used in the postoperative period (around 70 % in our practice). ⋯ Females, ASA 3, preoperative hemoglobin ≤136 g/L and age older than 60 years increase the risk to be transfused in the postoperative period for degenerative conditions of the spine.