Unusual localization of an aneurysmal bone cyst in ulnar coronoid process

Aneurysmal bone cysts are non-neoplastic, expansile, osteolytic tumor-like conditions. All bones may be involved, but the most commonly affected is the metaphysis of the long bones, especially the tibia, humerus and femur. We present a 13-year-old female patient with a cystic lesion with cortical continuity and a large bone cyst in the coronoid process of the ulna. The bone cyst was treated with curettage, phenol application and cement implantation following cyst debulking. Aneurysmal bone tumors are rare tumor-like conditions and localization at the coronoid process of the ulna with mechanical block of the elbow motion has yet to be reported. Debulldng and curettage of the lesion and bone cement implantation are useful methods for local control of aneurysmal bone cysts

Preventing neurovascular invasion in desmoid tumors

Desmoid tumors or aggressive fibromatoses are rare, non-encapsulated, infiltrative and locally aggressive tumors originating from deep musculo-aponeurotic structures. Traditionally, preferred treatment method for desmoid tumors is wide local excision. Depending on the side and type of resection, the reported local recurrence rates range from 15 to 77%. Similarly, in our institution there is a significant recurrence rate (24%) in patients who underwent surgery for desmoid tumor. After several recurrences, amputation may be inevitable following repeating vascular and nerve reconstructions. There is a need for a nonviable barrier in order to prevent the invasion of the viable tumor to the neurovascular structures which are also viable tissues. Depending on this need, we present two cases that we used synthetic vascular graft in their operations to cover neurovascular structures in order to prevent tumor invasion. For patients who are not suitable for radiotherapy and the neurovascular structures need to be secured because of the risk of local recurrence, this method can prevent possible future invasion of vessels and nerves

Midfoot reconstruction with free vascularized fibular graft after wide resection: A case report

Malignant foot tumours are often treated with amputations due to anatomical difficulties. Limb salvage techniques are difficult to perform, as a stable, sensible and plantigrade foot should be obtained to prevent further problems. In this report, we present a midfoot reconstruction with a vascularized free fibula, osteomized in a V-shape after wide resection of a midfoot synovial sarcoma. We describe the reconstruction of both longitudinal arches in which using a vascularized autograft facilitated union, remodeling of the bone, and obtaining a functional foot

Biological reconstruction of the femur using double free vascularized fibular autografts in a vertical array because of a large defect following wide resection of an osteosarcoma: a case report with 7 years of follow-up

Free vascularized fibular autograft transfer to the defect area after wide resection of bone sarcoma is one of many biological reconstruction methods. We report on an 8-year-old girl with 7 years of follow-up treated for right femur osteosarcoma. A 26 cm long tumor was resected with clear margins. Because the length of one fibular autograft was shorter than the defect length, bilateral free vascularized fibular autografts were used in a vertical array on top of one another, and placed inside a fresh-frozen femoral allograft. The original length of the femur was maintained by this technique. J Pediatr Orthop B 22:52-58 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

Cystic transphyseal bone tuberculosis: a report of two cases

We present two cases of tuberculosis osteomyelitis mimicking subacute osteomyelitis and treated without extensive debridement. Tuberculous osteomyelitis should be considered in the differential diagnosis of proximal tibial infections in children and early diagnosis and treatment is possible without extensive debridement

A neuroblastoma case presenting with pathologic femur fracture

Neuroblastoma is the most common extracranial solid tumor of childhood which should be considered in the differential diagnosis of bone metastases and resultant pathological fractures, especially in children under 5 years old. We present an 11-month-old girl who presented with a pathological femur fracture and was diagnosed with metastatic neuroblastoma

Surgical management of sacral chordoma

Treatment results of 17 patients who were diagnosed with sacral chordoma between 1993 and 2007, were analyzed retrospectively. The mean duration of symptoms was 30.2 months. The mean tumour size was 10.7 cm; the location was S2 or more proximal in ten-patients. A wide resection was achieved in 14 patients, a marginal resection in one patient and two patients had intralesional excision. Seven patients had a recurrence after a mean time interval of 36.3 months. Wound dehiscence and infection were the major problems. Four patients required continuous urinary catheterization because of incontinence, and ten patients had colostomy or ileostomy simultaneously with tumour resection. This study showed that tumour size and a wide surgical margin are importance factors for survival in chordoma patients. Use of a combined anterior and posterior approach could increase the chance of achieving a wide margin. A multidisciplinary approach is required to achieve this goal