The Clinical Characteristics, Treatments and Oncologic Outcomes of Chondroblastoma: Comparison with Giant Cell Tumor / 대한정형외과학회잡지

PURPOSE: The purpose of the study was to compare clinical, oncological outcomes between chondroblastoma and giant cell tumor. MATERIALS AND METHODS: This retrospective study reviewed 25 patients with histologically confirmed chondroblastoma of bone between 1998 and 2012. During the same period, 42 patients diagnosed as a giant cell tumor were also reviewed. We then analyzed clinical and oncological results of chondroblastoma compared with giant cell tumor. In chondroblastoma, 17 cases were male, and 8 cases were female, with a mean age of 20.6 years (range from 11 to 38 years). In giant cell tumor, 20 cases were male, and 22 cases were female, with a mean age of 39.26 years (from 17 to 75 years). All patients underwent surgical treatment that extended curettage with electrocauterization. After curettage, bony cavity was filled with autogenous bone, allogenic bone chip, bone cement, tricalcium phosphate, and so on. The results were compared in recurrence and metastatic rate. The minimum follow-up period was 1 year. RESULTS: In chondroblastoma, mean size was 2.18 cm (0.3 to 9.5 cm). Local recurrence and metastasis were absent. In giant cell tumors, mean size was 3.71 cm (0.3 to 11 cm). Local recurrence rate was 9.5% (4 of 42 cases) and there was one lung metastasis. CONCLUSION: Chondroblastoma is less invasive with better prognosis than giant cell tumor. Treatment of chondroblastoma and giant cell tumor is surgery. Electrocauterization as an adjuvant therapy showed good results.

A Comparison of the Results between Intramedullary Nailing and Minimally Invasive Plate Osteosynthesis in Distal Tibia Fractures / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to compare the results of treatment of distal tibial fractures between intramedullary (IM) nailing and minimally invasive plate osteosynthesis (MIPO). MATERIALS AND METHODS: Between January 2007 and February 2012, 57 patients (57 cases) were treated for distal tibial fractures. Thirty-two patients (32 cases) were treated with IM nailing (nail group) and the 25 patients (25 feet) were treated with MIPO (plate group). Clinical results were compared using range of motion (ROM) of the ankle joint, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Olerud-Molander score between nail group and plate group. Radiographic results were compared using mean bony union time, coronal and sagittal malunions, and shortening between the groups. RESULTS: Mean ROM of the ankle joint was significantly larger in nail group until 6 months after surgery; however, it was not different between two groups at the last follow-up. AOFAS score and Olerud-Molander score were not different between two groups at the last follow-up. In the nail group, two malunions more than 5 degrees were observed in coronal and sagittal planes, respectively. One case showed non-union in the plate group, however, bone union was obtained after autogeneous bone graft. CONCLUSION: Treatment using IM nailing is more advantageous in terms of postoperative rehabilitation than MIPO in distal tibial fractures.

Results of Re-Excision Following Unplanned Excision of Soft Tissue Sarcoma: Comparison with the Group of Planned Excision / 대한정형외과학회잡지

PURPOSE: This study was designed to investigate the clinical and oncological results of the unplanned excision group, and to compare the results with those of the planned excision group. MATERIALS AND METHODS: A total of 41 patients who underwent re-excision of sarcoma in Yeungnam University Medical Center, from January 2000 to December 2012, after unplanned excision in local medical centers were reviewed retrospectively. We analyzed the clinical and oncological results according to age, gender, tumor size, depth, and locations. As a control group of planned excision, 81 patients with a similar state, were selected and reviewed among the group of 480 patients who underwent planned excision during the same period. We then compared the results of the two groups. RESULTS: In the unplanned excision group, only the age factor was statistically significant to survival (p=0.048). In comparison of clinical and oncological results of the unplanned and planned excision groups, recurrence rate was 11.1% in the unplanned group, 10.5% in the planned group and did not show statistical significance (p=0.18). Survival rate was 74% in the unplanned group, 76.6% in the planned group and did not show statistical significance (p=0.06). Necessity of additional surgery for coverage of soft tissue defects was 46% in the unplanned group, 14% in the planned group and showed statistical significance (p=0.00). CONCLUSION: No significant difference in survival and local recurrence rate was observed between the groups of re-excision with microscopic remnant tumor after unplanned excision and planned excision. However, unplanned excision might lead to unnecessary additional surgery like skin-graft, skin-flap if it were planned.