RESUMEN

OBJECTIVES: This study aims to describe our surgery technique and discuss patients treated through the dorsoulnar artery (DUA)-based technique of osseous and osteo-fascio-cutaneous vascularized ulnar bone grafting. PATIENTS AND METHODS: Between January 2011 and January 2015, six male patients (median age: 22.5 years; range, 20 to 24 years) who underwent surgery during which the technique of DUA ulnar bone graft was utilized. One patient with scaphoid nonunion, three patients with Kienböck's disease, and two patients with a traumatic metacarpal defect were retrospectively evaluated. The joint range of motion (ROM), grip strength, Disabilities of the arm, shoulder and Hand (DASH) questionnaire score and Visual Analog Scale (VAS) score, and radiographies before and after surgery were examined. Scintigraphy was performed at 12 weeks postoperatively to monitor the viability of the bone graft. RESULTS: All patients showed improvements in the ROM, grip strength, VAS, and DASH scores. According to the radiographic examination, bone union was achieved in all patients and the scintigraphy revealed that vascularization was detected in the bone tissue. CONCLUSION: The advantages of DUA-based vascularized bone graft are good bone quality and quantity and versatility due to its long pedicle. The osteo-fasio-cutaneous DUA flap seems to be effective in the treatment of traumatic metacarpal bone defects accompanied by skin loss. The DUA-based vascularized ulnar bone may be a source for scaphoid and lunate biological bone reconstruction.

Asunto(s)

RESUMEN

Osteoarthritis is a chronic disorder characterized by joint cartilage degeneration with concomitant changes in the synovium and subchondral bone metabolism. Many conservative treatment modalities, one of which is intra-articular injections, have been described for the treatment of this disorder. Traditionally, hyaluranic acid and corticosteroids are the agents that have been used for this purpose. Recently, polyacrylamide hydrogels are being used widely. Biocompatibility, nonbioabsorbability, and anti-infectious effect obtained by silver addition made polyacrylamide hydrogels more popular. In this paper, we present a case and the method of our management, in whom host tissue reaction (foreign body granuloma, edema, inflammation, and redness induration) has been observed, as the first and unique adverse effect reported in the literature.

RESUMEN

OBJECTIVE: Multidisciplinary approach is a necessity for the appropriate diagnosis and treatment of bone and soft tissue tumors. The Ege University Musculoskeletal Tumor Council offers consultation services to other hospitals in the Aegean region. Since 1988 the Council has met weekly and spent approximately 1,500 hours evaluating almost 6,000 patients with suspected skeletal system tumors. Our objective was to present the data obtained from this patient group. METHODS: A total of 5,658 patients, suspected to have a musculoskeletal tumor, were evaluated retrospectively. Multiple records of the patients due to multiple attendance to the Council were excluded. The prevalance of the bone and soft tissue tumors in these patients were analysed. RESULTS: Malignant mesenchymal tumors accounted for 39.7% of the total patients, benign tumors for 17%, tumor-like lesions for 17.8% and metastatic carsinomas for 8.6%. Malignant bone tumors were 50.2% and malignant soft tissue tumors were 49.8% of all the sarcomas. Among the malignant bone tumors the most common was osteosarcomas at a rate of 33.6%, followed by Ewing-PNET at 25.5%, chondrosarcomas at 19.4% and haematopoietic tumors at 17.6%. Pleomorphic sarcomas (24.5%), liposarcoma (16.4%), synovial sarcoma (13%) and undifferential sarcomas (8.8%) were the most common types of malignant sof tissue tumors. Benign soft tissue tumors (48%), benign cartilage tumors (28%), giant cell tumor (15%) and osteogenic tumors (9%) were found among the benign tumors. Hemangioma, lipoma, agressive fibromatosis, enchondroma, solitary chondroma and osteoid osteoma were the most common tumors in their groups. Lung (27%), breast (24%), gastrointestinal system (10.5%) and kidney (8.2%) carcinomas were the most common primary sites of the bone metastasis. CONCLUSION: Turkey still lacks a comprehensive series indicating the incidence and diagnostic distribution of bone and soft tissue tumors. The presented data would add to our knowledge on the specific rates of the bone and soft tissue tumors in Aegean region.

Asunto(s)