Wrist preserving surgery for multifocal giant cell tumor of carpal bones in a skeletally immature patient: a case report.
Ontology highlight
ABSTRACT:
SUBMITTER: Ansari MT
PROVIDER: S-EPMC6583204 | biostudies-literature | 2014 Nov
REPOSITORIES: biostudies-literature
Publications
Wrist preserving surgery for multifocal giant cell tumor of carpal bones in a skeletally immature patient: a case report.
Ansari Mohammed Tahir MT Prakash P Kotwal K Machhindra Morey Vivek MV
Orthopaedic surgery 20141101 4
Similar Datasets
Project description: Not available
| S-EPMC10851733 | biostudies-literature
Project description:The optimal treatment of recurrent shoulder instability in skeletally immature athletes remains controversial, especially if there is significant growth remaining. Some investigators advocate conservative treatment until patients are close to skeletal maturity, whereas others push for earlier surgery to avoid further damage. The objective of this technical note is to describe a technique for labral repair using an anchorless approach to avoid potential damage to the glenoid physis. Technique Video Video 1 The procedure is performed in the left shoulder with the patient in the lateral decubitus position under general anesthesia. Both axial traction and abduction traction are used. Standard posterior, anterosuperior, and anteroinferior portals are established, with the latter 2 portals in the rotator interval. Diagnostic arthroscopy reveals that the labrum is torn from the glenoid inferiorly in a bucket-handle fashion and is displaced into the joint. Although the inferior and posterior capsules remain affixed to the glenoid, the anterior capsule is torn and scarred medially along the glenoid neck. The labrum is reduced, and the rim of the glenoid is abraded with a shaver and rasp to encourage healing. A 7-o’clock portal is established. Starting from posteriorly and working anteriorly, the surgeon uses a 45° curved suture hook to perform retrograde passage of a No. 2 braided absorbable suture through the capsule and through the cartilaginous rim of the glenoid and around the glenoid. Because of the young age of the patient, no anchors are placed and the rim of the glenoid is used as an anchor. The labrum is subsequently tensioned anteriorly while each simple suture is tied. Anteriorly, the capsular tear is scarred medially along the neck and is then elevated and incorporated into the labral repair to properly re-tension the glenohumeral ligaments and stabilize the shoulder. A total of 7 simple sutures are placed at the 8-, 7-, 6-, 5-, 4-, 3-, and 2-o’clock positions, re-establishing labral position, labral height, and capsular tension. Finally, the capsular holes made by the cannulas are repaired.
| S-EPMC9705910 | biostudies-literature
Project description:Despite the extreme morphological variability of the canine species, data on limb development are limited and the time windows for the appearance of the limb ossification centres (OCs) reported in veterinary textbooks, considered universally valid for all dogs, are based on dated studies. The aim of this study was to acquire up-to-date information regarding the arm, forearm and leg bone development in skeletally-immature large-sized dogs from 6 weeks to 16 weeks of age. Nine litters of 5 large-sized breeds (Boxer, German Shepherd, Labrador Retriever, Saarloos Wolfdog, White Swiss Shepherd Dog) were included, for a total of 54 dogs, which were subject to radiographic examination on a bi-weekly basis. The appearance of 18 limb OCs was recorded and 14 radiographic measurements were performed; their relationship with age and body weight was investigated and any breed differences were analysed using different statistical non-parametric tests. The number of OCs present was significantly different at 6 and 8 weeks of age between the investigated breeds. The appearance of the OCs occurred earlier in the Saarloos Wolfdog, while the Labrador Retriever was the later breed. In Boxers and Labrador Retrievers, various OCs showed a delayed appearance compared to the data reported in the literature. The number of OCs was strongly and positively correlated to body weight. Breed differences were also observed in the relative increase of the measured OCs and were not limited to dogs of different morphotypes. Statistically significant differences were most frequently observed between Saarloos Wolfdogs and the other breeds. The OCs that showed a greater variability in their development were the olecranon tuber, the patella and the tibial tuberosity. Their increase was more strongly correlated with the dog's age and body weight. Our data strongly suggest that differences in limb development exist in dog breeds of similar size and morphotype.
| S-EPMC8301671 | biostudies-literature
Project description:Graft failure after anterior cruciate ligament reconstruction remains a challenging complication in the pediatric population. The anterolateral ligament (ALL) contributes to rotational stability, and early evidence in adults suggests that ALL reconstruction may lower the risk of anterior cruciate ligament graft rupture. We present a technique for combined ALL reconstruction and anterolateral capsular reinforcement using iliotibial band autograft in skeletally immature patients. This procedure seeks to provide additional rotational stability in varying degrees of flexion while avoiding the physes and eliminating the need for implants.
| S-EPMC7588023 | biostudies-literature
Project description:The number of anterior cruciate ligament (ACL) reconstructions in skeletally immature patients has been gradually increasing in recent years owing to the poor outcomes of conservative treatment. However, ACL reconstruction in children is a challenging procedure and may lead to severe complications, such as growth disturbance. Although double-bundle (DB) ACL reconstructions are preferable because of their superior clinical outcomes, there are few reports of DB ACL reconstruction in children with open epiphyses. In this Technical Note, an all-epiphyseal sparing DB ACL reconstruction technique, which is considered to help avoid growth disturbance, is described. This procedure does not create a thick tunnel and may facilitate subsequent revision surgery.
| S-EPMC7768289 | biostudies-literature
Project description:BACKGROUND: In the pediatric gymnast, stress-related physeal injuries have been well described with characteristic imaging findings. However, a spectrum of overuse injuries, some rarely reported in the literature, can be encountered in the gymnast's hand and wrist. OBJECTIVE: To demonstrate the MR appearance of a spectrum of overuse injuries in the skeletally immature wrist and hand of pediatric gymnasts. MATERIALS AND METHODS: A total of 125 MR exams of the hand and wrist in skeletally immature children were performed at our institution during a 2-year period. Clinical histories were reviewed for gymnastics participation. MR studies of that subpopulation were reviewed and abnormalities tabulated. RESULTS: Of the MR studies reviewed, ten gymnasts were identified, all girls age 12-16 years (mean age 14.2 years) who presented with wrist or hand pain. Three of these children had bilateral MR exams. Abnormalities included chronic physeal injuries in three children. Two girls exhibited focal lunate osteochondral defects. Triangular fibrocartilage tears were present in three girls, one of whom had a scapholunate ligament tear. Two girls manifested metacarpal head flattening and necrosis. CONCLUSION: A variety of soft-tissue and osseous lesions can be encountered in the skeletally immature gymnast. Familiarity with these stress-related injuries is important for accurate diagnosis.
| S-EPMC2776148 | biostudies-other
Project description:ObjectiveDespite the general awareness that cyclo-oxygenase-2 (COX-2) is crucial for endochondral ossification, the role of COX-2 in skeletal development is largely unknown. We hypothesized that inhibition or genetic loss of COX-2 leads to impaired growth plate development and consequently impaired postnatal development of the long bones.DesignSkeletally immature (5 weeks old) B6;129S-Ptgs2tm1Jed/J wildtype mice were treated for 10 weeks with celecoxib (daily oral administration 10 mg/kg) or placebo and compared with B6;129S-Ptgs2tm1Jed/J homozygous knockout mice (n = 12 per group).ResultsFifteen weeks postnatally, no significant difference in growth plate (zone) thickness was found between groups. However, significantly higher proteoglycan content and lower expression levels of collagen type II and X staining in the growth plates of celecoxib-treated mice, and to a lesser extent in COX-2 knockout mice. In addition, a significantly decreased cell number and cell size were observed in the hypertrophic zone of the growth plates of both experimental groups. Micro-computed tomography analysis of the subchondral bone region directly beneath the growth plate showed significantly higher bone density and trabecular thickness, following celecoxib treatment. Despite the detected differences in growth plate extracellular matrix composition and subchondral bone morphology, no difference was found in the length of the tibia in celecoxib-treated mice or COX-2 knockout mice.ConclusionsGenetic loss of COX-2 or treatment with celecoxib did not result in detectable differences in gross murine formation of the tibia or femur. However, there were notable phenotypic features detected in the maturation of the growth plate (hypertrophic zone and subchondral bone) as a result of the celecoxib treatment.
| S-EPMC8236650 | biostudies-literature
Project description:The wrist can be considered a 2 degrees-of-freedom joint with all movements reflecting the combination of flexion-extension and radial-ulnar deviation. Wrist motions are accomplished by the kinematic reduction of the 42 degrees-of-freedom of the individual carpal bones. While previous studies have demonstrated the minimal motion of the scaphoid and lunate as the wrist moves along the dart-thrower's path or small relative motion between hamate-capitate-trapezoid, an understanding of the kinematics of the complete carpus across all wrist motions remains lacking. To address this, we assembled an open-source database of in vivo carpal motions and developed mathematical models of the carpal kinematics as a function of wrist motion. Quadratic surfaces were trained for each of the 42-carpal bone degrees-of-freedom and the goodness of fits were evaluated. Using the models, paths of wrist motion that generated minimal carpal rotations or translations were determined. Model predictions were best for flexion-extension, radial-ulnar deviation, and volar-dorsal translations for all carpal bones with R 2 > 0.8, while the estimates were least effective for supination-pronation with R 2 < 0.6. The wrist path of motion's analysis indicated that the distal row of carpal bones moves rigidly together (<3° motion), along the anatomical axis of wrist motion, while the bones in the proximal row undergo minimal motion when the wrist moves in a path oblique to the main axes. The open-source dataset along with its graphical user interface and mathematical models should facilitate clinical visualization and enable new studies of carpal kinematics and function. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2661-2670, 2019.
| S-EPMC7376386 | biostudies-literature
Project description:A 38-year-old man with pancreatic cancer was scheduled to undergo pancreaticoduodenectomy. He had an unremarkable past medical history. After inducing general anesthesia, a left radial arterial catheter was successfully placed at first attempt. A wrist splint was used to obtain good arterial pulse waveforms. After the operation, he was transferred to the intensive care unit. The radial artery catheter was removed on the fourth postoperative day. He experienced numbness and a tingling sensation in the left thumb, the second and third fingers, and the lateral half of the fourth finger. He was diagnosed with carpal tunnel syndrome. Diagnostic imaging revealed a swollen median nerve, but no hematoma or injury. Some studies have suggested that excessive extension of the wrist may cause neuropathy. We recommend that patients' wrists not be over-extended, even if good arterial waveforms cannot be obtained.
| S-EPMC5804647 | biostudies-literature
Project description: Not available
| S-EPMC4245408 | biostudies-literature