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Query: UMLS:C0027627 (metastases)
103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report a new technique in arthrodesis of the sub-occipital spine which has been experienced since 1973 in case of metastases at CI-C2 level. An occipitovertebral metal plate, inverted Y shaped has been realised after anatomical and biomecanical studies. It is adapted to the occipito-vertebral curvature and screwed in the articular processes of C3 and C4 (14 mm screw), and in the pedicles of C2 (32 mm screw). At the upper part, the occiptal ridge offers fixation by 12 and 14 mm Muller's screw. In addition CI is attached to the plate, by a nylon thread. After the report of the first clinical case with a nine month period of follow up technical features of the material as well as practical problems are exposed. Tomograms of the cervical spine as well as bilateral brachial angiography are of paramount value. The latter investigation may reveal anomalies of the vertebral artery that can hinder of forbid the pedicular fixation. Finally the authors discuss the extension of this technique to complexe trauma of the suboccipital column.
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PMID:[Arthrodesis of the sub-occipital spine by screwed occipito-cervical plate. Clinical case and technical notes]. 121 92

Thirteen patients with soft tissue sarcomas were treated with a combination of intra-arterial Adriamycin, conventionally fractionated radiotherapy (2 Gy per day), and conservative surgery (trimodal therapy). Severe acute complications occurred in 10 patients: 3 brachial artery thromboses, 6 delayed wound healing, 4 wound infections, and 3 cases of necrosis of the skin plus subcutaneous tissues. Three patients have developed local recurrence. Five patients are alive, 4 of whom are disease-free, and the median follow up time of surviving patients is 56 months. One has significant impairment of limb function due to joint ankylosis. An additional 2 patients were treated with intra-arterial Adriamycin and conservative surgery for local recurrence after previous surgery and radiotherapy; both died of subsequent metastatic disease, one having a further local recurrence. One patient with multifocal angiosarcoma was treated with intra-arterial Adriamycin and radiotherapy but no surgery, and is alive free of disease 49 months later. The combination of radiotherapy and intra-arterial Adriamycin with surgery resulted in significant acute toxicity. This small study has not demonstrated any improvement in local control compared with that expected with conservative surgery and radiotherapy alone.
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PMID:Intra-arterial adriamycin, conventionally fractionated radiotherapy and conservative surgery for soft tissue sarcomas. 173 76

Between June 1985 and March 1990, 25 patients with primary malignant bone tumors, including 15 cases of osteogenic sarcoma, two cases of periosteal osteogenic sarcoma, six cases of chondrosarcoma, and two cases of malignant fibrous histiocytoma, were treated with limb-salvage procedures. Fourteen patients underwent limb salvage operations with tumor prosthesis arthroplasty, 6 with resection-arthrodesis, 4 with wide resection, and 1 with autoclaved autograft. Pre- and/or post-operative chemotherapy with or without radiotherapy was combined with these limb salvage operations. The average follow-up period was 25.2 months (6 to 52 months) since diagnosis. The estimated 3.5-year survival rate of the total 25 patients was 39.5% based on the Kaplan-Meier survival plot. In the 15 cases of osteogenic sarcoma, the estimated Kaplan-Meier 34-month survival rate was 46.2%. Seventeen patients who were followed up for more than 1 year were grouped by functional grading: 11 (65%) were excellent; 3 (18%) good; 2 fair (12%); and 1 poor. Complications occurred in 4 patients, 1 had a local recurrence, 2 had superficial wound infections, and 1 a loosening of the femoral stem. Metastases were shown in 15 case, and the most common location was the lung.
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PMID:Limb-salvage operations in primary malignant tumors of the bone--interim report. 196 35

A therapeutic concept for the treatment of acute and chronic cervical spine lesions is presented. Unstable fractures and dislocations of the cervical spine should be reduced as soon as possible. Most frequently, we employ the anterior approach using the Smith and Robinson technique (37) with the addition of an H-shaped plate. The posterior approach is mainly indicated for the release of irreducible locked facets. Unstable odontoid fractures, especially those in group II of Anderson and d'Alonzo (3), are stabilized by screw osteosynthesis. Between 1971 and 1989, 306 patients with cervical spine lesions were treated surgically. In these cases, there were 205 acute injuries and 52 chronic instabilities. Forty-nine patients had tumors or metastases. Ninety-two patients with acute injuries (group I) and 24 with chronic lesions (group II) were reexamined. Out of 53 group I patients, the neurologic symptoms improved in 45 cases (85%), and in 30 of these (mainly with radicular compression syndromes) a complete recovery was noted. Seventy-two percent of the patients were symptom-free. Seventy-four percent of the acute and 58% of the chronic lesions showed a good or very good result having little or no limitation of motion and minimal or no pain. Irrespective of neurologic deficits, 89% of the acute traumatized patients were able to work after 5 months. The rate of pseudarthrosis was 2%. The risks of an anterior interbody arthrodesis are small when using a careful and standardized operative technique. It allows an early functional treatment and shortens the rehabilitation time.
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PMID:A review of the therapeutic concept and results of operative treatment in acute and chronic lesions of the cervical spine: the Hannover experience. 202 35

A 4-year-old Springer Spaniel was referred because of a 6-week history of progressive left forelimb lameness. A marked pain response was elicited by palpation over the left accessory carpal bone. Radiography revealed a lytic, markedly expansile lesion of the accessory carpal bone. The bone was excised, and pancarpal arthrodesis was performed. Histologic examination of the excised bone revealed giant cell tumor. At 14 months after surgery, the dog was using the limb normally. Radiography of the carpus revealed satisfactory progression of the arthrodesis, and thoracic radiographs were negative for metastases.
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PMID:Giant cell tumor of the accessory carpal bone in a dog. 222 74

A patient treated with curettage and bone grafting for a chondroblastoma of the distal femur sustained a pathologic fracture after a local recurrence. He then underwent a local, radical resection and an arthrodesis of the knee. Ten years after the first operation, pulmonary metastases were found, for which he underwent a metastasectomy (thoracotomy). At the latest follow-up, 1 year later there were no signs of tumor.
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PMID:Late pulmonary metastases from chondroblastoma of the distal femur. A case report. 223 76

The outcomes of 31 cases of limb salvage procedures for malignant bone tumors performed between 1974 and August 1988 were investigated. The age at operation ranged from 7 to 76. Thirteen cases were growing children under 15. The site of lesions were humerus in 6 cases, femur in 20, tibia in 3 and fibula in 2. Pathological diagnoses were osteosarcoma in 19, chondrosarcoma in 5 and others in 7. Reconstructive procedures were performed in 28 cases, consisting of endoprosthetic replacements in 18, vascularized fibula grafts in 6 and free autogenous bone grafts in 4. Two cases of osteosarcoma recurred, and amputations were performed. Six cases died of pulmonary metastases, while 22 cases (71%) are alive and free of disease. Functional results depended mainly on the size and site of resection rather than on the reconstructive procedures, and were generally good in the proximal femur and fibula, and poor in the distal femur and proximal tibia. Discrepancy in the length of lower limbs occurred in 8 cases of growing children; 5 of 6 vascularized fibula grafts showed thickening of the grafted bones, and one of them grew by 2.5 cm in length. Endoprosthetic replacements are adequate for hip and shoulder regions, and for low grade sarcoma which does not require chemotherapy or irradiation. Free autogenous bone grafts are good for narrow defect of bone, and cases of arthrodesis of joint. Vascularized fibula grafts are adequate for the upper limb, and lower limb of growing child.
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PMID:[Limb salvage procedures in malignant bone tumors of the extremities, with special reference to the various reconstructive procedures of bone defects]. 265 32

Eighteen giant-cell tumors in the distal end of the radius were treated by block resection and arthrodesis of the wrist utilizing a fibular autograft. The mean length of follow-up was 7.1 years. Local recurrence occurred in five patients, and one patient died of pulmonary metastases. In five patients, non-union developed between the graft and the radius. Three patients sustained a fracture of the graft. No patient had a pseudarthrosis. The average grip strength was 40 per cent of that of the unaffected hand. Pain was absent or slight. No patient required an amputation.
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PMID:Giant-cell tumors in the distal end of the radius. Treatment by resection and fibular autograft interpositional arthrodesis. 372 25

Limb salvage was accomplished by using a frozen allograft bone and arthrodesis of the stifle joint in a 5-year-old male German Shepherd Dog with a chondrosarcoma in the proximal tibia. At 17 months after surgery, limb function was satisfactory, and thoracic radiography did not reveal evidence of pulmonary metastases.
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PMID:Limb salvage in a dog with chondrosarcoma of the tibia. 391 Jun 28

A case of distant metastases of a giant cell tumor of the radius is presented. The tumor within the radius was excised, followed by arthrodesis of the wrist and bone grafting with tibia. At the time she came to us, the patient presented distal dissemination, so we performed curettage of each one of the multiple metastases of soft tissues of the hand. After 9 months, a local recurrence in the radius was resected, and reconstruction was done with a vascularized graft of fibula. Later treatment consisted of intraarterial chemotherapy. The patient is in satisfactory condition 1 year after surgery.
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PMID:Extensive distal subcutaneous metastases of a "benign" giant cell tumor of the radius. 391 15


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