RESUMEN
Ewing sarcomas are highly malignant bone tumors and usually occur in childhood. Radiation therapy, chemotherapy, and surgical methods increase the survival rate of the affected patient, but infertility and reduced reproductive capacity are common late effects of pediatric cancer treatment.
RESUMEN
Ewing sarcomas are the second most common primary malignant bone tumors in childhood and adolescence which rapidly metastasize. Due to improvement of treatment options in recent years, the survival rate has significantly increased. Nevertheless, lethality is still high, and neurologic symptoms are frequent. To the best of our knowledge, this is the first reported case of a sacral osteoneogenesis after complete sacrectomy in a patient with Ewing sarcoma.
RESUMEN
The treatment of unstable trochanteric femoral fractures is still challenging. The ideal implant should be easy to handle, allow for immediate full weight-bearing postoperatively and should have sufficient purchase in the femoral head/neck-fragment to limit cut-outs due to varus-deviation and rotation. The proximal femoral nail antirotation (PFNA), designed by AO, is an intramedullary device with a helical blade rather than a screw for better purchase in the femoral head and was tested in a clinical study. Consecutive patients with unstable trochanteric fractures (AO-classification 31.A.2 and A.3 only) were included and followed for 1 year. Primary objectives were assessment of operative and postoperative complications, whereas secondary objectives included surgical details, general complications and final outcome measurements. In 11 European clinics, 315 patients were included and treated with a PFNA. Almost all fractures healed within 6 months. Fifty-six percent of the patients regained the pre-trauma mobility and 18% died within the follow-up period. Forty-six implant-related complications--leading to 28 unplanned re-operations--were recorded, with four acetabular penetrations (three of which were after a new fall on that hip) and seven ipsilateral femoral shaft fractures as the most serious ones. As the joint-penetrations did not resemble the cut-out seen with other implants it is concluded that the PFNA--due to its helical blade--possibly limits the effects of early rotation of the head/neck-fragment in unstable trochanteric fractures and therefore seems currently to be the optimal implant for the treatment of these fractures especially in osteoporotic bone.
Asunto(s)
Clavos Ortopédicos/normas , Cabeza Femoral/cirugía , Fijación Interna de Fracturas/efectos adversos , Fracturas de Cadera/cirugía , Actividades Cotidianas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Diseño de Equipo , Femenino , Fémur/cirugía , Cabeza Femoral/lesiones , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Estadística como Asunto , Resultado del TratamientoRESUMEN
The incidence of periprosthetic fractures is increasing because of the increasing age and the rising number of joint replacements. Elderly patients are endangered because of a higher rate of co-morbidity such as osteoporosis or cardiovascular diseases. The treatment of periprosthetic fractures depends on these preconditions and has to solve the problem after an exact analysis of the fracture. An understanding of the biomechanical principles and risk factors is necessary for an effective treatment. Intraoperative and postoperative periprosthetic fractures will be discussed with emphasis on classification and treatment. The aim has to be an early functional postoperative treatment with partial/full weight bearing in order to avoid postoperative complications. In discussing the scope of periprosthetic fractures, the site, incidence, treatment and outcome of periprosthetic fractures of the hip and knee will be outlined.
Asunto(s)
Fracturas del Fémur , Fracturas Óseas , Prótesis de Cadera , Prótesis de la Rodilla , Factores de Edad , Anciano , Anciano de 80 o más Años , Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Fenómenos Biomecánicos , Placas Óseas , Tornillos Óseos , Enfermedades Cardiovasculares/complicaciones , Fijadores Externos , Femenino , Fracturas del Fémur/diagnóstico por imagen , Fracturas del Fémur/cirugía , Fracturas Óseas/clasificación , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/cirugía , Fracturas Óseas/terapia , Humanos , Masculino , Metaanálisis como Asunto , Osteoporosis/complicaciones , Cuidados Posoperatorios , Complicaciones Posoperatorias/prevención & control , Radiografía , Factores de Riesgo , Factores de TiempoAsunto(s)
Clavícula/lesiones , Fracturas Óseas , Adolescente , Adulto , Factores de Edad , Placas Óseas , Niño , Clavícula/diagnóstico por imagen , Diagnóstico Diferencial , Femenino , Fijación Interna de Fracturas , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/cirugía , Fracturas Óseas/terapia , Humanos , Recién Nacido , Masculino , Persona de Mediana Edad , Seudoartrosis/cirugía , Radiografía , Recurrencia , Escápula/lesionesAsunto(s)
Clavícula/lesiones , Fijación Interna de Fracturas , Clavícula/diagnóstico por imagen , Clavícula/cirugía , Curación de Fractura/fisiología , Humanos , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/cirugía , Radiografía , Reoperación , Factores de RiesgoAsunto(s)
Fijación de Fractura/métodos , Fracturas de la Tibia , Fenómenos Biomecánicos , Clavos Ortopédicos , Placas Óseas , Fijadores Externos , Fijación Interna de Fracturas/métodos , Humanos , Técnica de Ilizarov , Complicaciones Posoperatorias , Fracturas de la Tibia/diagnóstico , Fracturas de la Tibia/cirugíaRESUMEN
The different treatments for femoral fracture after total knee arthroplasty are discussed. A new method with the LIS system (Synthes) is described and first clinical results presented.