Assuntos
Parafusos Ósseos/efeitos adversos , Fraturas do Fêmur/cirurgia , Migração de Corpo Estranho/cirurgia , Fixação Intramedular de Fraturas/efeitos adversos , Pelve/diagnóstico por imagem , Idoso de 80 Anos ou mais , Feminino , Fraturas do Fêmur/diagnóstico por imagem , Migração de Corpo Estranho/diagnóstico por imagem , Humanos , Limitação da Mobilidade , Dor Pós-Operatória/etiologia , Falha de Prótese , Radiografia , Reoperação , Resultado do TratamentoRESUMO
En bloc removal of the lower lumbar vertebral bodies (VBs) is a major surgical challenge. The authors describe the surgical technique used in two patients who presented with chordoma confined to the L-5 and L-4 VB, respectively. These tumors were diagnosed using magnetic resonance (MR) imaging during investigation for back pain. Both patients underwent a combined (two-stage) anterior-posterior approach. In the first case the posterior stage of the procedure was followed by an anterior retroperitoneal approach, and in the second case a lateral retroperitoneal approach was used. Complete en bloc excision of the tumor was achieved in each case, even though in the second case the VB fractured when it was mobilized. The correlation between the MR imaging findings and surgical specimens was remarkable. The authors conclude that en bloc resection is feasible in these cases. Because mobilization of the VB is more difficult in the lateral approach, the authors favor the anterior retroperitoneal approach. The authors anticipate the need for such procedures to increase with the widespread use of MR imaging, which demonstrates the extent of these tumors with remarkable accuracy.
Assuntos
Cordoma/cirurgia , Vértebras Lombares/cirurgia , Procedimentos Neurocirúrgicos , Neoplasias da Coluna Vertebral/cirurgia , Adulto , Cordoma/diagnóstico , Cordoma/diagnóstico por imagem , Cordoma/radioterapia , Terapia Combinada , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Vértebras Lombares/efeitos da radiação , Imageamento por Ressonância Magnética , Masculino , Prognóstico , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/radioterapia , Tomografia Computadorizada por Raios XRESUMO
Calcaneal fractures in very young children are thought to be rare. We report on seven calcaneal fractures in children under the age of 36 months in the absence of a history of significant injury. In five cases plain radiology was normal, but the diagnosis was reached using scintigraphy. We suggest that this is not such a rare injury, and that wider use of scintigraphy will assist in making the diagnosis. The prognosis of this injury is excellent.
Assuntos
Calcâneo/lesões , Fraturas Fechadas/diagnóstico por imagem , Calcâneo/diagnóstico por imagem , Pré-Escolar , Humanos , Lactente , Radiografia , CintilografiaRESUMO
A patient with branchio-oto-renal dysplasia and associated shoulder abnormalities is presented. The combination of features makes discrimination from the oto-facial-cervical syndrome difficult. Shoulder abnormalities should be regarded as a rare feature of the branchio-oto-renal syndrome.
Assuntos
Anormalidades Múltiplas , Branquioma/complicações , Orelha Externa/anormalidades , Neoplasias de Cabeça e Pescoço/complicações , Rim/anormalidades , Ombro/anormalidades , Criança , Surdez/complicações , Diagnóstico Diferencial , Humanos , Instabilidade Articular/complicações , Masculino , Articulação do Ombro , SíndromeRESUMO
We have conducted a prospective trial of the management of 135 adult patients who had sustained soft-tissue injuries of the neck in vehicle accidents. Early traction and physiotherapy was compared with rest in a collar and unsupervised mobilisation. No benefit from the active treatment could be identified; moulded collars in slight flexion gave the best pain relief and are recommended.
