1/9. diffusion MR imaging of giant cell tumors in tuberous sclerosis.giant cell tumors were studied by diffusion MR imaging in three patients with tuberous sclerosis. diffusion MR imaging was performed on a 1.5-T unit with a gradient strength of 30 mT/m. b = 1000 seconds/mm2 images, and apparent diffusion coefficient (ADC) maps were studied. ADC values were recorded from ADC maps with particular care to obtain the values from the noncalcified regions of the giant cell tumors. ADC values of the normal brain parenchyma and hamartomas were also recorded by multiple evaluations. The ADC values in all three giant cell tumors (0.78, 0.92, and 0.92 x 10-3mm2/s) were within the ranges of the normal brain parenchyma (0.62-1.04 x 10-3mm2/s), and they were prominently less than those of parenchymal hamartomas (1.18-1.86 x 10-3mm2/s). The finding of ADC values of the noncalcified portions of the giant cell tumors being identical to those of normal brain parenchyma is consistent with the presence of normal molecular motion of water, hence relatively normal tissue integrity within these tumors. This was likely a reflection of benignity of these slowly growing tumors.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/9. Prosthetic replacement due to giant-cell tumor in the proximal humerus. A case report.A 45-year-old woman with an extensive giant-cell tumor of the right proximal humerus was treated by segmental resection and shoulder reconstruction. A Neer prosthesis and allogeneic bone grafts were used to reconstruct the shoulder joint. Autogeneic iliac bone was placed at the host-graft junction. The rotator cuff was reattached to the bone after making a semicircular trough. The long head of the biceps was reattached with stay sutures after making a trough between reattachments of the supraspinatus and the subscapularis. The patient regained almost full range of motion and excellent muscle power of the shoulder 60 months after operation. She did not have any difficulty with daily tasks of living. The prosthesis articulated with the glenoid well. There has been no evidence of tumor recurrence or metastasis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/9. Nonvascularized fibular autograft to treat recurrent giant cell tumor of the distal radius.We report a 22-year-follow-up of a giant cell tumor treated by en bloc excision of the distal radius and replacement with an autogenous fibular bone graft. There has been no recurrence of the tumor. The patient has a good functional result and is free of pain except with extremes of wrist motion.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/9. Allograft replacement of distal radius for giant cell tumor.Three cases of resection of the distal radius with allograft replacement for giant cell tumor of bone were reviewed. In one patient the tumor had penetrated the distal articular cortex; in another it had broken through the anterior cortex; in the third there had been recurrence of the tumor within a year of currettage and autogenous bone graft. In each case the allograft was glycerinized to help to preserve the viability of the articular cartilage and then it was frozen at -70 degrees C to decrease bone antigenicity. In all three patients rapid healing at the recipient-graft juncture took place, and none showed signs of rejection or of recurrence of the tumor. All three have a useful and relatively painless range of wrist motion. Distal radial resection and allograft replacement is recommended for giant cell tumor of bone if there has been spontaneous cortical or articular breakthrough, recurrence, or evidence of a rapidly enlarging lesion or a frankly malignant histologic appearance.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/9. Long-term follow-up of nonvascularized fibular autografts for distal radial reconstruction.Three patients with giant cell tumors of the distal radius had en bloc excision of the distal radius and replacement with the ipsilateral fibula. Two of the patients were followed for 16 years and one for 14 1/2 years. forearm rotation, as well as wrist motion, was limited in all three patients, yet they remained functional and pain free except during periods of prolonged or excessive use. All three patients were pleased with the results. Bone union occurred primarily in all three patients without a supplemental bone graft or microvascular anastomosis. This method has a definite place in the hand surgeon's armamentarium when compared with radial allografts and microvascular free fibular translocation.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/9. Fibular autografts for distal defects of the radius.A protocol for osteoarticular grafting was established to avoid fracture, nonunion, and loss of motion when replacing the distal radius. Proximal fibular autografts were used and stabilized proximally by compression plating and, at the wrist, by ligamentous reconstruction. Postoperative splinting and therapy were coordinated with graft healing, which was monitored by bone scans and roentgenograms. Graft incorporation in three patients appeared to be well-established within 1 year, but functional use of the extremity and return to duty were achieved much earlier.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/9. Metacarpal reconstruction with free autogenous cartilage and bone following tumor resection. A case report.A 26-year-old woman with a giant cell tumor of the metacarpal bone of the index finger was treated by en bloc resection and metacarpal reconstruction. A free autogenous iliac crest bone graft was used to reconstruct the metacarpal and a free autogenous costal cartilage graft was used to resurface the metacarpophalangeal joint. The bone graft was transfixed with a plate. The patient developed 12 degrees-62 degrees motion at the metacarpophalangeal joint and has maintained a stable joint space for 30 months. Viable hyaline cartilage was present when a biopsy procedure was performed on the joint at five months. The bone graft rapidly incorporated. There has been no evidence of tumor recurrence.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/9. Trigger wrist induced by finger movement. Pathogenesis and differential diagnosis.Four cases of trigger wrist induced by finger motion are reported. The cause of trigger wrist induced by finger motion was a rheumatoid nodule in one case, giant cell tumor of the flexor tendon sheath in one case, partial laceration of the flexor digitorium superficialis tendon in one case, and lipofibroma in one case. Triggering or snapping at the wrist is also induced by motion of the wrist and forearm. Reported cases were also analyzed and the clinical entity of the true trigger wrist and differential diagnosis were discussed.- - - - - - - - - - ranking = 3keywords = motion (Clic here for more details about this article) |
9/9. Giant-cell tumor of the patella: report of two cases.Two patients with giant-cell tumors of the patella are presented in this report. Both patients were young females who were noted to have had nonspecific anterior knee pain and mild swelling of 1 to 12 months' duration prior to admission to our hospital. Local tenderness over the peripatellar area and slight limitation of full flexion were noted during physical examination. The radiographic presentation of each patella appeared as an expansile and lytic lesion with a thin cortex, without evidence of intra-articular involvement. Chest radiography and routine laboratory examination results were normal. After biopsy, intralesional curettage with phenol cauterization and allograft reconstruction was the preferred treatment in these two patients, with both tumors considered to be stage 2 according to Enneking's staging system. Following surgery, range of motion exercise was started after 6 weeks of immobilization with a long leg splint. Both patients regained full range of motion and were pain free. Radiographically, bone remodeling without evidence of recurrence was noted in both patients 2 years postoperatively.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |