Romanian Journal of Orthopaedic Surgery and Traumatology最新文献_第10页

Transarterial Embolization Treatment of Sacral Tumors 经动脉栓塞治疗骶骨肿瘤

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0046

D. Anghelescu, E. Popescu, A. Cursaru, A. Dimitriu, R. Ene, C. Cîrstoiu

{"title":"Transarterial Embolization Treatment of Sacral Tumors","authors":"D. Anghelescu, E. Popescu, A. Cursaru, A. Dimitriu, R. Ene, C. Cîrstoiu","doi":"10.2478/rojost-2018-0046","DOIUrl":"https://doi.org/10.2478/rojost-2018-0046","url":null,"abstract":"Abstract Objectives. Sacral tumors represent about 1-4,3% of all bone tumors. They typically present with an abundance of blood vessels. Due to their anatomical localization, they are hard to approach surgically. Thus, a presurgical neoadjuvant therapy is indicated. The preoperative angiography with the embolization of the nutritive arteries decreases the perioperative blood loss and the symptomatology, and even decreases the volume of the tumors that cannot be surgically approached. Materials and methods. The principle of embolization consists in the targeting of the nutritive tumoral artery and in obturating it with embolic agents (polyvinyl alcohol, embospheres, etc.) through selective catheterization under angiographic control. The biopsy of the tumor is essential for certain diagnosis. The histological type of the tumor and the degree of differentiation influence the tumor’s physiopathology and often influence the therapeutic decision regarding its degree or recurrence. In some cases in which the tumor’s degree of extension increases the surgical risk, serial embolization can be used as a primary method of treatment. Because of the late onset symptomatology, when they are discovered they are extended and the degree of invasion in adjacent tissues is so high that it requires en bloc resection with nerve root sacrifice to assert complete excision and low recurrence rates. Results. The patients who undergo surgical treatment usually bleed, and the perioperative blood loss and the need for blood transfusion volumes were halved in the cases in which presurgical transarterial embolization was performed. Conclusions. Transarterial embolization of sacral tumors is a procedure indicated as a neoadjuvant presurgical therapy to decrease the blood loss risks and for the tumors that cannot be surgically removed it is used in the palliative treatment to reduce symptomatology.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130133089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Romanian Journal of Orthopaedic Surgery and Traumatology (ROJOST), a new journal in the Romanian academic environment 罗马尼亚骨科外科和创伤学杂志(ROJOST)，罗马尼亚学术环境中的新期刊

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/ROJOST-2018-0001

C. Cirstoiu

引用次数: 0

Challenges in treating pleomorphic bone sarcoma in elderly patients: a case report 老年患者多形性骨肉瘤治疗的挑战:1例报告

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0006

Cristina Orlov, C. Nitipir

引用次数: 0

Conventional Radiography and MRI Diagnosis of Bone Tumors Developed at the Knee 膝关节骨肿瘤的常规影像学和MRI诊断

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0038

I. Codorean, I. Codorean

{"title":"Conventional Radiography and MRI Diagnosis of Bone Tumors Developed at the Knee","authors":"I. Codorean, I. Codorean","doi":"10.2478/rojost-2018-0038","DOIUrl":"https://doi.org/10.2478/rojost-2018-0038","url":null,"abstract":"Abstract Introduction. It is known that bone tumors have a predilection to develop for a certain skeletal bone segment. Also, bone tumors have a predilection for certain age groups. The knee is a common site for bone tumors. Purpose. Presentation of diagnostic parameters of conventional radiography as the first technique in the detection and characterization of bone tumors developed at the knee level and the criteria for differentiation of the malignant substrate from the benign (the type of bone destruction, the type of periosteal response, poorly defined margins) one. The value of MRI is also presented and illustrated as a unique imaging technique that allows the direct visualization of bone marrow with high spatial resolution for local staging of bone tumors. Material and method. The present study aimed to investigate the radiographic and MRI imaging characteristics of bone tumors developed at the knee joint, which were retrospectively analyzed (October 2007 and November 2017) in a selected group of 91 patients. The limit of age between 11 and 67 years, 73(70%) men, 18 (30%) women. Examination protocol: complete clinical examination, radiographic knee examination in anteroposterior and lateral incidents. MRI standard protocol, native, and post paramagnetic contrast. Results. Conventional Radiographic and MRI have been detected and characterized a number of 55 (67%) primary malignant bone tumors confirmed by histopathological diagnosis, ranging from 8 histopathological types and 37 (33%) cases of benign tumors with 9 histopathological types. Conclusions. Radiological examination is the first investigation in the evaluation of knee bone tumors, suggesting the malignant nature expressed by the badly defined margin, bone destruction, discontinuous peristaltic reaction, and extension to the soft parts. MRI is a unique imaging technique that allows direct visualization of bone marrow with high spatial resolution and best tool for local staging of bone tumors.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116293741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reconstruction in Malignant Tumors of the Calf After Tumoral Resection in Children 儿童小腿恶性肿瘤切除后的重建

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0027

C. Vlad, L. Dobre, S. Hamei, Ș. Gavriliu

{"title":"Reconstruction in Malignant Tumors of the Calf After Tumoral Resection in Children","authors":"C. Vlad, L. Dobre, S. Hamei, Ș. Gavriliu","doi":"10.2478/rojost-2018-0027","DOIUrl":"https://doi.org/10.2478/rojost-2018-0027","url":null,"abstract":"Abstract Purpose. Evaluation of reconstructive procedures after oncologic resection of malignant bone tumors of the calf in children. Materials and methods. The study contains 4 patients with ages between 5 and 18 years, 2 of the cases being diagnosed with osteosarcoma, respectively 2 with Ewing sarcoma of the tibia. In 3 of the cases, the surgical treatment consisted of en bloc tumoral resection and reconstruction with metal acrylic spacer and, in the 4th case, the tumoral resection was followed by endoprosthetic replacement. In all cases, the surgical treatment was preceded by biopsy and chemotherapy. Results. In 3 of the patients we used a gastrocnemius flap and one patient needed a negative pressure dressing for 11 days after surgery. The follow-up varied between 8 and 17 months after surgery. The patient who underwent endoprosthetic replacement was immobilized in a mobile orthosis and partial weight bearing at 2 weeks PO. The patient who underwent endoprosthetic replacement needed a surgical revision at 10 months PO consisting in the reinsertion of a locking screw of the patellar tendon fixation device. 2 of the presented cases are waiting for replacement of the metal acrylic spacer with a definitive reconstruction procedure, 1 case is proposed for amputation. Conclusions. Malignant bone tumors of the calf in children represent a pathology with high complexity giving the possible complications that can occur, a redoubtable risk being implant loss due to lack of coverage. The discussion remains open regarding the right time for definitive surgical procedure with modular endoprosthesis in children, and other reconstructive techniques available in these cases.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127035030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tumor with Aggregate Cells at the Level of Radial Distance Pipe - Treatment and Evolution 细胞聚集在径向距离管水平的肿瘤-治疗和演变

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0066

D. Tarnita, D. Grecu, M. C. Tenovici, R. Vaduva, A.D. Tudora, A. Grecu, I. L. Petrovici, B. Căpitănescu

{"title":"Tumor with Aggregate Cells at the Level of Radial Distance Pipe - Treatment and Evolution","authors":"D. Tarnita, D. Grecu, M. C. Tenovici, R. Vaduva, A.D. Tudora, A. Grecu, I. L. Petrovici, B. Căpitănescu","doi":"10.2478/rojost-2018-0066","DOIUrl":"https://doi.org/10.2478/rojost-2018-0066","url":null,"abstract":"Abstract A 20-year-old patient presented to the emergency service with radial distal epiphysis after a minor trauma. The radiological examination indicated a fracture at the radial distal epiphysis on the background of a tumor that occupied the radial epiphysis in its entirety, with cortical burglary in some places. When consulting the oncologist, a surgical intervention for biopsy material harvesting was performed. The anatomopathological exam showed: multiple fragments microscopically representing a tumor proliferation consisting of two cell populations, mononuclear cells, densely cellular and strobe pattern; areas of infarction, haemorrhage areas, rare intratumoral osteoid formation zones; appearance of giant cell tumor. The immunohistochemical examination confirmed the anatomopathological diagnosis adding, therefore, the aggressive character and the local relapse. The oncologist decided that it did not require oncology treatment but only orthopedic treatment. Orthopedic treatment required repeated surgery at intervals of about 5 months apart, caused by tumor recurrence. The first intervention consisted of 1/ 3 distal radius resection and replacement with a graft harvested from the peroneum. Tumor recurrence after 5 months required extirpation of tumor tissue and filling of caries caused in the graft with a fluid bone substitute. Recurrence after another 5 months required removal of the graft that was invaded by the tumor and cubitusmetacarpal arthrodesis fixed with a screw plate. Currently, the patient is undergoing complementary oncology treatment finally initiated by a medical oncologist.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"140 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127482762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Giant Cell Tumours of the Tendon Sheath – Particular MRI Aspect 腱鞘巨细胞瘤-特殊的MRI表现

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0055

A. Bratu, I. Sălcianu, A. Nicula, C. Zaharia, A. Marinescu

{"title":"Giant Cell Tumours of the Tendon Sheath – Particular MRI Aspect","authors":"A. Bratu, I. Sălcianu, A. Nicula, C. Zaharia, A. Marinescu","doi":"10.2478/rojost-2018-0055","DOIUrl":"https://doi.org/10.2478/rojost-2018-0055","url":null,"abstract":"Abstract Giant cell tumor of soft tissue (GCTST) is usually of synovial origin. It affects synovial membrane, serous bursae, and tendinous tunnels. The most common localizations are in the hands and forearms. Anatomopathological, GCTST is considered as being composed of a cellular fibroblastic stroma in which the tumor cells are distributed. This type of tumor is composed of a mononuclear complex and osteoclast-like giant multinucleated cells, similar to those found in the giant cell tumor at the bone level. Histologically, some authors consider that GCTST is a strictly benign tumor, consisting of welldefined multinucleated histiocytes admixed with eosinophils, lymphocytes and scattered spindleshaped cells, or hemosiderin deposits in its structure, and tumor cells do not have mitosis or atypia. Other authors consider that GCTST is a type of low-grade sarcoma; this entity was named “malignant fibrous histiocytoma, giant cell type” due to the histological similarity with malignant fibrous histiocytoma. The case of a female patient, suspected of giant cell tumor of the brachioradialis tendon sheath was presented. The MRI aspect of this tumor is not the typical one. The MRI examination consisted of a series of sequences, with T1 and T2 weighted images, fat suppression sequence, performed in all three planes, axial, sagittal, and coronal. Also, the examination was performed native, after the administration of intravenous contrast substance, when the 3D multiplanar sequences were performed. The final diagnosis was the post-operative anatomopathological examination, which confirmed that it was a giant cell tumor. We present this case for its less frequent localization - forearm, and the interest it might have in surgical treatment.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132768450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical Options in Periprosthetic Fractures 假体周围骨折的手术选择

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0032

D. Popescu, R. Nedelcu, Şt. Trifu, C. Cirstoiu

{"title":"Surgical Options in Periprosthetic Fractures","authors":"D. Popescu, R. Nedelcu, Şt. Trifu, C. Cirstoiu","doi":"10.2478/rojost-2018-0032","DOIUrl":"https://doi.org/10.2478/rojost-2018-0032","url":null,"abstract":"Abstract Purpose. The periprosthetic fractures are a more and more often encountered type of pathology, in which the main problem is the indication for surgery. The most important thing is the choice of the best therapeutic option in order to get a solid fixation of the fracture and, in the end, to allow an early patient’s mobilization. Materials and method. 38 cases of periprosthetic fractures have been treated in the Orthopedics and Traumatology Department of University Emergency Hospital in Bucharest, between 2010 and 2016. International Vancouver classification was used for all cases. The osteosynthesis saving the femoral stem was preferred in 22 cases, as its stability was not affected. Stem revision was performed in 16 cases, as this was unstable due to the fracture. Acetabular component was also revised in 4 cases, as the PE insert presented severe wear. The patients were aged 52 to 84 years old and sex ratio M/ F = 13/ 25. Osteosynthesis was performed using Dall-Miles plates and molded plates, with braided cables or wire cerclage. Long stems, uncemented with or without distal locking, were used in 16 cases. Results. Postoperatively, the bone repair was efficient regarding the stability in most of the cases. The patients’ mobilization was early in most of the cases, except for the very old patients with associated comorbidities and limited biological resources. Conclusions. An appropriate surgical indication, adapted on each type of peri-implant fracture, leads to a good result, with early mobilization and the best consolidation of the fracture.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134074537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bone Metastasis Secondary to Vulvar Cancer 外阴癌继发骨转移

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/ROJOST-2018-0049

C. Berceanu, E. Brătilă, S. Berceanu, A. V. Tetileanu, N. Voicu, C. Mehedințu

引用次数: 0

Late Results after Cement Bone Filling in Treatment of Giant Cell Tumour (GCT) - Retrospective Study 骨水泥填充治疗巨细胞瘤(GCT)的晚期疗效回顾性研究

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/ROJOST-2018-0040

R. Prejbeanu, D. Crisan, A. Bălănescu, H. Haragus, B. Deleanu

{"title":"Late Results after Cement Bone Filling in Treatment of Giant Cell Tumour (GCT) - Retrospective Study","authors":"R. Prejbeanu, D. Crisan, A. Bălănescu, H. Haragus, B. Deleanu","doi":"10.2478/ROJOST-2018-0040","DOIUrl":"https://doi.org/10.2478/ROJOST-2018-0040","url":null,"abstract":"Abstract Introduction. Segmental or intralesional excision with curettage or complete resection can be one method of treatment for giant cell tumor (GCT), but the ideal filling material after curettage or resection remains controversial. The purpose of this retrospective study was to follow the latest results and complications regarding the recurrence or degradation of functional status that underwent cementation. Material and methods. We reported 24 cases with GCTs during the last 15 years. All the patients were treated by intralesional excision or segmental resection followed by acrylic cement filling with or no metal augmentation recurrence-free survival proportions were used to evaluate oncological outcomes. Other parameters including surgical complication, general condition, and radiological classification were analyzed. Results. We followed up 20 cases for at least five years postoperatory (from the 5th to the 9th year). The recurrence-free survival proportions showed that the recurrence rate in this group was for 4 patients (2 of them were at second surgery). 2 patients had degradation of implant cement fixation. Parameters including patients’ age, gender, tumor location, and radiological classification did not affect the surgeons’ treatments in cavity filling after GCT curettage. Conclusions. Cementation should be recommended because of easy usage, have long lasting better results, and the better local tumor control than other methods (ex: bone grafting). The risk of recurrence is low and is not related to the cementation and metal augmentation. The cost-benefit is also in favor of this technique.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"194 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133494862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0