Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2001
Case ReportsTwenty-six-years' survival with multiple bone metastasis of malignant pheochromocytoma.
The prognosis of metastatic pheochromocytoma is poor in general. There have been few instances of long-term survival reported. We report a case of a 44-year-old woman who has survived for 26 years after bone metastasis. ⋯ The primary lesion was removed, and posterior lumbar spinal fusion was performed for immobilization. The metastatic lesion in the ilium was left untouched. After 26 years, she is well despite a recurrence of the tumors in the skull and a new metastasis in the left abdomen.
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Arch Orthop Trauma Surg · Nov 2001
The association of HLA-DR4 antigen with juvenile chronic arthritis and slipped capital femoral epiphysis.
Seventeen children who met the criteria for juvenile chronic arthritis (JCA) were reviewed. Throughout the study, the clinical examination, HLA phenotyping, and radiological assessment of the hips were performed by separate authors who were blinded to other data. At the end of the study, the results were also compared with 25 healthy, age- and sex-matched children. ⋯ The difference was not significant when the patients without SCFE were compared with the control group (p = 1.0). The relative risk of cases with DR4 antigen for SCFE was 57.5, while it was below I for the other antigens. These results suggest that although DR4 is not specific for JCA, it is the common HLA antigen for those who have SCFE, and patients with JCA and HLA-DR4 antigen should be examined for evidence of SCFE, which was not reported before to exist with JCA.
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Arch Orthop Trauma Surg · Nov 2001
Case ReportsPeriosteal Ewing's sarcoma: radiological imaging and histological features.
Periosteal Ewing's sarcoma is very rare. In this report, we describe three cases of periosteal Ewing's sarcoma, illustrating the principal clinical, radiographic, and histologic features. The patients were aged 15, 16, and 20 years old, with an average of 17 years. ⋯ The unusual site of Ewing's sarcoma was clearly visualized by computed tomography (CT) and magnetic resonance imaging (MRI) and confirmed by histological examination. Chemotherapy and/or irradiation was employed before and after wide excision. The patients have survived an average of 6 years after the primary surgery.
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Arch Orthop Trauma Surg · Nov 2001
Case ReportsNatural history of paediatric intervertebral disc calcification.
This case report concerns a 5-year-old boy who had intervertebral disc calcification with involvement of two disc spaces and herniation of nucleus pulposus in one. The patient's symptoms resolved completely in a week with conservative measures. At the 4-year follow-up, the child was symptom-free and in full health, the herniation of nucleus pulposus had resolved completely, and calcification had disappeared in one of the disc spaces. Although the cause of this disorder is uncertain, the course is benign and self-limiting, it seldom requires surgical intervention, and the natural history is one of resolution and complete resorption of the calcification.
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Arch Orthop Trauma Surg · Nov 2001
Light and electron microscopic study of stress-shielding effects on rat patellar tendon.
In this second part of our study, the histomorphologic changes occurring in the patellar tendon (PT) of rats after sole stress-shielding were evaluated. In seven adult albino rats, both PTs were exposed by straight skin incision and then stress-shielded on one side by a cerclage, while the contralateral PT served as the sham-operated control. One animal died after the operation and was used as a negative control. ⋯ Ultrastructural evaluation and morphometry revealed a predominance of large diameter (peak between 180 and 260 nm) collagen fibrils in the sham-operated controls, while in the stress-shielded tendons the number of apparently new, small-diameter (peak between 40 and 60 nm) collagen fibrils increased (up to 77% per cross-sectional field of view). The difference in peak diameters was statistically significant (p < 0.0005). This rat model demonstrated that sole stress-shielding not only causes biomechanical alterations, but also intense tissue remodelling and significant morphological changes in the collagen fibrils in the patellar tendon, comparable to so-called 'ligamentization' in experimental and clinical patellar tendon grafts for anterior cruciate ligament reconstruction.