Angioleiomyoma: A Rare Cause of Fixed Flexion Contracture of the Elbow

We describe an unusual case of a patient presented with a painless fixed flexion contracture of the elbow due to an angioleiomyoma. This benign smooth muscle tumour should be considered in the differential diagnosis of flexion contractures of the elbow

A simple technique to position patients with bilateral above-knee amputations for operative fixation of intertrochanteric fractures of the femur: a case report

<p>Abstract</p> <p>Introduction</p> <p>Intertrochanteric fractures of the femur are common fractures in the elderly, and management includes operative fixation after patient positioning on the fracture table. Patients with bilateral above-knee amputations are challenging in terms of positioning on the table. We describe a simple technique to overcome this special problem.</p> <p>Case presentation</p> <p>A 75-year-old wheelchair-bound Caucasian man with bilateral above-knee amputations presented to our hospital after a fall. Plain radiographs showed an intertrochanteric fracture of the femur, and operative fixation with a dynamic hip screw was planned. His positioning on the table posed a particular problem, and therefore we developed a technique to overcome this problem.</p> <p>Conclusion</p> <p>Positioning of patients for fixation of intertrochanteric fractures of the femur poses a particular problem that can be solved by using our simple technique.</p

Periprosthetic osteolysis due to metastatic renal cell carcinoma: a case report

Failure of total hip arthroplasty through septic or aseptic loosening, periprosthetic fracture, or recurrent dislocation is well recognized and understood. We present an unusual cause of failure of total hip replacement which occurred on a 79 year old gentleman: that of prosthetic loosening secondary to malignant infiltration around components. Our aim is to highlight the fact that malignant infiltration should be considered as part of the differential diagnosis in aseptic and septic loosening of prosthetic implants

Ewing σάρκωμα της πυέλου

We are reporting our experience on patients with pelvic Ewing’s Sarcoma treated in the Royal Orthopaedic Oncology Unit. We retrospectively reviewed a series of patients with non-metastatic pelvic Ewing’s sarcoma treated between 1977 and 2009. Patients were classified into three groups according to the local treatment received: Group 1: Radiotherapy-chemothrapy; Group 2: Surgery-chemotherapy and Group 3: Radiotherapy-surgery-chemotherapy. Recurrence free and overall survival rates were calculated using the Kaplan-Meier method. Influence of various factors (age at diagnosis, gender, tumour site and size, chemotherapy response, surgical margins and type of treatment) on survival was assessed with a logistic regression model. A total of 85 patients were treated with a mean follow-up of 65.8 months and mean tumour volume of 435ml. The 5-year survival for all patients was 40.7% decreased to 36.2% at 10 years. A significant prognostic factor identified was chemotherapy response only. There was a trend for improved survival and local control rates for patients who had chemotherapy and surgery and the results were apparent for all tumours irrespective of size but not statistically significant. Currently, the optimal management of pelvic Ewing’s sarcoma is controversial but our study shows a trend for improved survival for patients treated with chemotherapy and surgery.Aναφέρουμε την εμπειρία μας σε ασθενείς με σάρκωμα Ewing πυέλου που έλαβαν θεραπεία στην Ογκολογική Μονάδα στο Βασιλικό Ορθοπεδικό Νοσοκομειο. Εξετασαμε αναδρομικά μια σειρά ασθενών με σάρκωμα μη μεταστατικόυ πυέλου του Ewing που αντιμετωπιστηκαν μεταξύ 1977 και 2009. Οι ασθενείς ταξινομήθηκαν σε τρεις ομάδες ανάλογα με την τοπική αγωγή που έλαβε: Ομάδα 1: Ακτινοθεραπεία- χημειοθεραπεία, Ομάδα 2: Χειρουργική-χημειοθεραπεία και Ομάδα 3: Ακτινοθεραπεία-χειρουργική-χημειοθεραπεία. Τα ποσοστα υποτροπής και τα συνολικά ποσοστά επιβίωσης υπολογίστηκαν χρησιμοποιώντας τη μέθοδο Kaplan-Meier. Επίδραση διαφόρων παραγόντων (ηλικία κατά τη διάγνωση, το φύλο, την περιοχή του όγκου και του μεγέθους, επιδραση της χημειοθεραπείας, χειρουργικά όρια και το είδος της θεραπείας) στην επιβίωση αξιολογήθηκε με ένα μοντέλο λογιστικής παλινδρόμησης. Συνολικά 85 ασθενείς υποβλήθηκαν σε θεραπεία με μέσο ορο παρακολούθηση 65,8 μηνών και ο μέσος όγκος του όγκου των 435ml. Η 5-ετή επιβίωση για όλους τους ασθενείς ήταν 40,7% και μειώθηκε σε 36,2% στα 10 χρόνια. Ένας σημαντικός προγνωστικός παράγοντας ήταν η επιδραση της χημειοθεραπείας. Υπήρχε μια τάση για βελτιωμένα ποσοστα επιβίωσης και ελέγχου τοπικα για τους ασθενείς που είχαν χημειοθεραπεία και χειρουργική επέμβαση και τα αποτελέσματα ήταν εμφανή για όλους τους όγκους ανεξάρτητα από το μέγεθος, αλλά όχι στατιστικά σημαντική. Επί του παρόντος, η βέλτιστη διαχείριση του σαρκώματος Ewing πυέλου είναι αμφιλεγόμενη, αλλά η μελέτη μας δείχνει μια τάση για βελτιωμένη επιβίωση για τους ασθενείς που έλαβαν θεραπεία με χημειοθεραπεία και χειρουργική επέμβαση

Pelvic Ewing’s Sarcoma: oncologic outcomes and evaluation of prognostic factors

We are reporting our experience on patients with pelvic Ewing’s Sarcoma treated in our unit. We retrospectively reviewed a series of patients with non-metastatic pelvic Ewing’s sarcoma treated between 1977 and 2009. Treatments included surgery, radiotherapy, chemotherapy, or any of them in combination. Recurrence free and overall survival rates were calculated using the Kaplan-Meier method. Influence of various factors (age at diagnosis, gender, tumour site and size, chemotherapy response, surgical margins and type of treatment) on survival was assessed with a logistic regression model. A total of 85 patients were treated with a mean follow-up of 65.8 months and mean tumour volume of 435ml. The 5-year survival for all patients was 40.7% decreased to 36.2% at 10 years. A significant prognostic factor identified was chemotherapy response only. There was a trend for improved survival and local control rates for patients who had chemotherapy and surgery and the results were apparent for all tumours irrespective of size but not statistically significant. Currently, the optimal management of pelvic Ewing’s sarcoma is controversial but our study shows a trend for improved survival for patients treated with chemotherapy and surgery