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HYBRID EXTERNAL FIXATOR FOR THE TREATMENT OF UNICAMERAL BONE CYSTS WITH pathological fracture IN THE PROXIMAL HUMERUS

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Chinese Journal of Cancer Research 2004年第1期16卷 62-66页

作者：郭征王臻赵黎 Department of Orthopaedic Surgery Xijing Hospital Fourth Military Medical University

Objective: Unicameral bone cyst is a nonneoplasticbone lesion characterized by its tenacity and risk ofrecurrence. pathological fracture is common and is often the presenting symptom. The objective of the present study was to evaluate the results of hybrid external fixator for thetreatment of a unicameral bone cyst with a pathologicalfracture. Methods: Hybrid external fixator for thetreatment of a unicameral bone cyst was performed intwelve patients. These patients presented with a pathological fracture and were managed immediately with hybridexternal fixator, of whom four had been managedconservatively at other clinics before they were referred toour department. The cyst was located in the proximalhumerus in all patients. The mean age of the patients at the time of surgery was 8.7 years, and the mean duration offollow-up was 32.6 months. Radiographic evaluation wasperformed according to the criteria of Capanna et al., andthe cyst was classified as completely healed, healed withresidual radiolucency (osteolysis), recurred, or having noresponse. Results: The healing period ranged from three to eight months. Eight cysts healed completely, and threehealed with residual radiolucent areas visible onradiographs. There was recurrence of one cyst that hadhealed with residual radiolucency. All of the cysts in thepresent study responded to treatment. A modulation ofhybrid external fixator was necessary in three patients, asthe bars had become too short after bone growth or the pins had been loose. No major complications were ***: Hybrid external fixator provides earlystability, which allows early mobilization and thus obviates the need for a plaster cast. This method of treatment alsoallows for an early return to normal activity.

关键词： Unicameral bone cyst External fixator pathological fracture Bone graft

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pathological humerus fracture due to anti-interferon-gamma autoantibodies:A case report

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World Journal of Orthopedics 2021年第11期12卷 938-944页

作者： Cheng Hsun Yang Feng-Chih Kuo Chen-Hsiang Lee Division of Infection Disease Department of Internal MedicineKaohsiung Chang Gung Memorial HospitalKaohsiung 833Taiwan Department of Orthopaedic Surgery Kaohsiung Chang Gung Memorial HospitalKaohsiung 833Taiwan Division of Infection Disease Department Internal MedicineChang Gung UniversityCollege MedicineChang Gung Memorial HospitalKaohsiung Medicine CentreKaohsiung 833Taiwan

BACKGROUND Various etiologies contribute to pathological fractures,including bone ***,non-tuberculosis Mycobacterium-related bone infections among patients with anti-interferon-gamma autoantibody-induced adult-onset immunodeficiency has raised concerns in Southeast Asia,with the common presentations including ***,it also rarely manifests as traumatic fractures,as reported in this *** SUMMARY A diabetic female fractured her humerus after a traumatic accident and received fixation *** necrotic bone tissue and abscess formation were noted,and she was diagnosed with a pathological fracture due to nontuberculosis Mycobacterium *** bone involvement was also revealed in a bone ***-interferon-gamma autoantibodies were then checked due to an unexplained immunocompromised status and found to be *** humerus fracture and multiple bone infections healed after steroid and anti-non-tuberculosis Mycobacterium medication treatment following fixation *** Comprehensive preoperative evaluations may help identify pathological fractures and guide the treatment course.

关键词： Immunocompromised status Neutralizing anti-interferon-gamma autoantibody Non-tuberculosis mycobacterium pathological fracture Pre-operative evaluations Case report

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fracture risk assessment in children with benign bone lesions of long bones

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World Journal of Clinical Cases 2021年第24期9卷 7053-7061页

作者： Hai-Bing Li Wen-Song Ye Qiang Shu Department of Paediatric Orthopaedics The Children’s HospitalZhejiang University School of MedicineHangzhou 310052Zhejiang ProvinceChina Department of Pediatric Surgery The Children’s HospitalZhejiang University School of MedicineHangzhou 310052Zhejiang ProvinceChina

BACKGROUND fracture risk assessment in children with benign bone lesions of long bones remains poorly *** To investigate the risk factors for pathological fracture in children with benign bone lesions and to propose a modified scoring system for quantitative analysis of the pathologic fracture *** We retrospectively reviewed 96 pediatric patients with benign bone *** compared radiographic and clinical features between 40 patients who had fractures through a benign bone lesion and 56 who had no *** including histological diagnosis,anatomical site,radiographic appearance,severity of pain,and lesion size was recorded for the patients.A modified scoring system was proposed to predict the risk of *** The univariate comparisons showed a significant difference between the fracture and non-fracture groups in terms of lesion type,pain,lesion-to-bone width,and axial cortical involvement of the patients(Pfracture group was 7.89,whereas the mean score of the non-fracture group was *** optimum cut-off value of the score to predict pathological fracture was *** scoring system had a sensitivity of 70%and a specificity of 80%for detecting patients with *** Youden index was 0.5,which was the maximum *** area under the receiver operator characteristic was *** Lesion type,pain,lesion-to-bone width,and axial cortical involvement are risk factors for pathological *** modified scoring system can provide evidence for clinical decision-making in children with benign bone lesions.A bone lesion with a total score>7 indicates a high risk of a pathologic fracture and is an indication for prophylactic internal fixation.

关键词： Benign bone lesion pathological fracture Risk factor Children

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Current concepts in the surgical treatment of skeletal metastases

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World Journal of Orthopedics 2020年第7期11卷 319-327页

作者： Jessica Ehne Panagiotis Tsagozis Department of Orthopedic Surgery Karolinska University HospitalSolna 17176Sweden

Symptomatic metastatic bone disease affects a large proportion of patients with malignant tumours and significantly impairs patients’quality of *** are still controversies regarding both surgical indications and methods,mainly because of the relatively few high-quality studies in this ***,prosthetic reconstruction has been shown to result in fewer implant failures and should be preferred in patients with a good *** estimation tools should be used as part of preoperative *** treatment,which relies on radiotherapy and inhibition of osteoclast function may also offer symptomatic relief and prevent implant *** this review we discuss the epidemiology,indications for surgery,preoperative planning,surgical techniques and adjuvant treatment of metastatic bone disease.

关键词： pathological fracture Bone cancer Adjuvant radiotherapy Survival analysis fracture fixations Fixation devices Orthopaedic

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Coincident Bilateral Atraumatic Hip fracture in a Young Patient with Renal Osteodystrophy

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Open Journal of Orthopedics 2020年第11期10卷 313-320页

作者： Shukriah Aqilah Zakaria Mohd Shafiee Johan Chin Max Yong Guang Yi Mohd Atiq Che Roselam Mohamad Hafiz Mohmad Hassim Department of Orthopaedic Hospital Bintulu Bintulu Malaysia Department of Orthopaedic Hospital Kuala Lumpur Kuala Lumpur Malaysia Department of Orthopaedic Hospital Tuanku Jaafar Seremban Malaysia

Bilateral, coincident, atraumatic hip fracture is extremely uncommon and usually occurs secondary to seizures, trauma and metabolic disease including renal osteodystrophy. One of the major types, secondary hyperparathyroidism is associated with high bone turnover due to excess parathyroid hormone and usually seen in a chronic dialysis patient. We reported a 20-year-old woman with end stage renal failure and renal osteodystrophy. She sustained atraumatic right subtrochanteric fracture and left neck of femur fracture (Garden 1), then underwent bilateral long proximal femoral nail. Renal osteodystrophy causes pathological fracture by affecting calcium metabolism that stimulates bone resorptions and leads to osteoporotic bone. The aim of this case report is to discuss the approach and management done to the patient presented to our center. Bilateral long proximal femoral nail (PFN) was chosen, taking into account the patient’s premorbid, age, fracture pattern and potential complications. Careful multidisciplinary team approach led by the orthopaedic surgeon, nephrologist and physical therapist is vital for the patient to achieve good outcome postoperatively, thus reducing morbidity and mortality.

关键词： pathological fracture Hip fracture Secondary Hyperparathyroidism Renal Osteodystrophy

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Retrospective analysis of clinical characteristics and prognostic factors for pathologic fracture in 44 patients with extremity osteosarcoma

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The Chinese-German Journal of Clinical Oncology 2014年第1期13卷 35-41页

作者： Cong Tian Yujing Hang Lina Tang Feng Lin Daliu Min Yang Yao Medical School of Soochow University Department of Oncology The Sixth People's Hospital Shanghai Jiaotong University

Objective: The aim of this study was to identify the clinical features and prognostic factors associated with extremity osteosarcoma with pathologic fracture. Methods: The clinical records of 271 patients with extremity osteosarcomas were retrospectively reviewed. The data obtained covered the period from October 2003 to May 2012, and included sex, age, tumor site etc. The mean follow-up time was 25.2 months(ranged from 1 to 117). Chi-square method and Kaplan-Meier method were used to compare clinical differences and overall survival between patients with or without pathologic fracture, respectively. The univariate analysis was used to determine the prognostic factors related with survival rate by log-rank test. The multivariate analysis of prognosis was performed by COX proportional hazards regression model. Results: The proportions of patients having a tumor's diameter of 10 cm or more(P = 0.038), locating upper limbs(P = 0.004) and receiving amputation surgery(P = 0.02) were significantly higher with pathological fracture group than without pathological fracture group. The local recurrence rate(P = 0.000) was also significantly higher in the pathological fracture group. The median survival time of patients with or without pathological fracture was 16(95% confidence interval: 14.6–17.4) months and 22(95% confidence interval: 19.8–24.1) months(P = 0.002). The Log-rank univariate analysis indicated that the tumor size, Enneking's surgical staging, Karnofsky performance status(KPS) score, cycles of adjuvant chemotherapy, local recurrence and metastasis were significantly related to overall survival. Multivariate Cox regression analysis revealed KPS score, cycles of adjuvant chemotherapy and metastasis were independent prognostic factors(P pathological fracture, a higher proportion of patients receiving amputation surgery or having larger tumor size, humeral osteosarcoma or local recurrence was observed in patien

关键词： extremity osteosarcoma pathological fracture prognosis Cox proportional hazards regression model

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