RESUMO
The patella may solve the problem of an osteocartilaginous autograft for the articular reconstruction of the knee after resection of certain bone neoplasms. Such a solution may be adopted mainly after the resection of tumors that have attacked part of the tibial plate or that have necessitated the removal of the tibial plate to ensure a radical procedure. The cartilaginous surface of either one or both of the patellar articular facets is well suited for restoring the continuity of the tibial articular surface lost through resection. Furthermore, all of the remaining part of the patella provides an excellent graft for replacing the underlying bone loss. This is sometimes sufficient in itself; at times, other bone grafts are required. In both cases, patellectomy is the preliminary procedure and is performed on the same side where tibial resection will be done immediately afterward. Using this procedure, eight cases of giant-cell tumor on the proximal extremity of the tibia and one case on the distal epiphysis have been treated. Consolidation, facilitated by a firm metal osteosynthesis, was rapid. The long-term results were excellent; there were no local recurrences of the tumor, and knee joint function was preserved with values only slightly below normal, even though roentgenograms showed signs of arthrosis.
Assuntos
Neoplasias Ósseas/cirurgia , Tumores de Células Gigantes/cirurgia , Articulação do Joelho/cirurgia , Patela/transplante , Adolescente , Adulto , Neoplasias Ósseas/diagnóstico por imagem , Parafusos Ósseos , Feminino , Tumores de Células Gigantes/diagnóstico por imagem , Humanos , Articulação do Joelho/diagnóstico por imagem , Masculino , Métodos , Patela/diagnóstico por imagem , Radiografia , Transplante AutólogoRESUMO
A chronic slip of the upper femoral epiphysis (also called by the authors inveterate epiphysiolysis) is a rare, but not an extremely rare, occurrence. This paper describes a simple linear intertrochanteric osteotomy which aims to centre the femoral head correctly in the acetabulum. A deformity in the sagittal plane alone or a combined deformity in the sagittal and frontal planes can be equally well corrected. There is always a residual deformity in the femoral neck, but this is of no importance. The operation has been carried out in 21 patients and in nearly all of them the functional result was excellent. Avascular necrosis has not occurred.
Assuntos
Epifise Deslocada/cirurgia , Fêmur/cirurgia , Osteotomia/métodos , Acetábulo/diagnóstico por imagem , Adolescente , Criança , Doença Crônica , Epífises/diagnóstico por imagem , Epifise Deslocada/diagnóstico por imagem , Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/cirurgia , Colo do Fêmur/diagnóstico por imagem , Colo do Fêmur/cirurgia , Humanos , Masculino , RadiografiaRESUMO
A chronic slip of the upper femoral epiphysis (also called by the authors inveterate epiphysiolysis) is a rare, but not an extremely rare, occurrence. This paper describes a simple linear intetrochanteric osteotomy which aims to centre the femoral head correctly in the acetabulum. A deformity in the sagittal plane alone or a combined deformity in the sagittal and frontal planes can be equally well corrected. There is always a residual deformity in the femoral neck, but this is of no importance. The operation has been carried out in 21 patients and in nearly all of them the functional result was excellent. Avascular necrosis has not occurred.