[Herniation pits]. / Herniation pit.

"Herniation pit" is a benign bone affection described first in 1982 by Michael J. Pitt et al. It is located typically in the proximal anterior and upper quadrant of the neck of the femur and develops as a result of the mechanical action of pressure of the adjacent articular capsule and synovialis. On the X-ray picture it is seen as a lighter spot which is relatively well defined, surrounded by a narrow margin of sclerotic bone; it is either round or oval and usually not more than 1 cm in diameter. In the authors' group of 100 patients selected at random from patients who had an X-ray picture of the hip joint taken during the last three years for different indications a herniation pit was found in six patients--4 women and 2 men. In one patient the finding was bilateral. This result is practically consistent with the 5% in the normal adult population, as reported in the world literature. In clinical practice the herniation pit is in the majority asymptomatic and is only an incidental finding during X-ray examination of patients with unexplained pain in the hip joint. Its importance is thus above all that it may be mistaken for other usually oncological bone affections such as osteoid, osteoma, Brodie's abscess, intraosseous ganglion or skeletal metastases of carcinoma.

[Use of cement plugs in the care of giant cell bone tumors]. / Aplikace cemetové plomby pri osetrování obrovskobunecného kostního nádoru.

The classical giant cell tumor represents a problem as the clinical, radiological and histological parameters not always exclude the tendency to local recurrences, rarely also to metastases. Surgical treatment of this tumor is characterized by a relatively high percentage of local recurrences. In the years 1965-1987 patients with 72 giant cell tumors were treated within the Prague Team for Bone Tumors. In 1980 the existing results were revised in 37 patients operated on to that time and the therapeutical scheme was changed by the introduction of new methods mainly the application of bone cement. While in 17 patients we have primarily operated on in the years 1965-1980 recurrence occurred in 36 per cent, in the period 1981-1987 in 32 patients primarily operated on the recurrence amounted to 9.4 per cent, i.e. it occurred in three patients. In these three patients it was the case of excochleation and primary filling by autografts. In 13 cases of the application of bone cement for the filling of the defect after the removal of the tumor there was no recurrence. In the average interval of 1 year since the operation bone cement was substituted by author allografts. In case of an extensive resection of greater part of the joint the application proved right of the massive allografts, fixed by stable osteosynthesis, exclusively in some cases also the application of a special tumorous endoprosthesis in the area of the hip, knee and shoulder.

[Aggressive fibromatosis in the extremities]. / Problematika agresivní fibromatózy lokalizované na koncetinách.

The authors demonstrate in a group of 10 patients treated in the course of 15 years the rare incidence of aggressive fibromatosis of the extremities and the large number of relapses after surgery. They also emphasize the necessity of detailed preoperative examination, priority of a surgical approach, as compared with radiotherapeutic procedures, and the possibility of skeletal and vascular reconstruction after radical surgery.