1/16. Effect of myocutaneous inflammatory changes caused by intra-arterial chemotherapy on the outcome of patients who undergo limb-saving surgery.BACKGROUND: This study examined the effect of myocutaneous inflammatory changes caused by intra-arterial chemotherapy on the outcome of patients who undergo limb-saving surgery. methods: One hundred seven patients with malignant bone and soft tissue tumors were administered intra-arterial cisplatin and caffeine preoperatively with or without doxorubicin. Nine patients (8.4%) who had had myocutaneous inflammatory reactions were reviewed to determine the effects of this complication on limb-saving surgery. RESULTS: The patients complained of unbearable and continuous pain while undergoing intra-arterial infusion. gait disturbances and muscle weakness were caused by their severe regional pain, resulting in the use of crutches even before surgery. Extended areas of necrotic skin and muscle were resected simultaneously with limb-saving surgery on four patients. Myocutaneous necrosis in one patient, indurations in two patients, and flares in two patients were not treated surgically. pain relief was provided to eight patients at some point. Four patients with extensive myocutaneous necrosis around the knee joint had restricted range of motion and poor functional results. radionuclide angiography using 99m-technetium-macroaggregated albumins was performed to evaluate the blood flow to the affected muscle and tumor. It showed marked increase of the radioisotope perfusion in the affected muscles but little uptake in the tumor. These results may suggest that the affected muscles diminish the effects of anticancer drugs on the tumors. CONCLUSIONS: Myocutaneous inflammatory reactions should be prevented if possible to obtain good limb function and chemotherapeutic effects in patients who undergo intra-arterial chemotherapy. Resection of necrotic tissue is mandatory to relieve pain.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/16. Intra-articular elastofibroma of the shoulder joint.A 19-year-old man presented with an elastofibroma in his left shoulder joint. The patient had had limitation of motion in his left arm for 3 years, especially when rotating internally. radiography of his left shoulder showed bone erosion in the neck of the humerus. On MR imaging, a soft tissue mass was noted in the shoulder joint eroding bone. The mass showed similar signal intensity to that of surrounding muscles on T1- and T2-weighted images. At surgery, a soft, encapsulated mass was found attached to the subscapularis muscle. It was pathologically confirmed as an elastofibroma. This unusual manifestation of an elastofibroma is discussed.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/16. Intra-articular hemangioma of the knee as a cause of knee pain.We report the case of a young patient with knee pain, limited range of motion, and swelling due to an intra-articular hemangioma. Clinically, the symptoms and findings were similar to those of a meniscal lesion. The diagnosis of an intra-articular tumor was made using magnetic resonance imaging. The tumor was excised, and the definitive diagnosis was made histologically. After tumor excision, the patient was pain free.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/16. Arterialized venous flow-through flap for simultaneous reconstruction of a radial artery defect and palmar forearm soft-tissue loss from sarcoma resection.A 50-year-old right-handed male presented with a previously incompletely excised low-grade fibrous histiocytoma on his distal radial palmar forearm. Reoperative wide resection resulted in a segmental defect of the radial artery and a large soft-tissue defect with exposed tendons denuded of paratenon. An arterialized venous fasciocutaneous flow-through flap, measuring 8 x 3 cm, was harvested from the dorsal ipsilateral hand and used to reconstruct both the soft-tissue and the segmental radial-artery defects. A full-thickness skin graft was harvested from the ipsilateral groin to cover the dorsal hand wound. Moderate venous congestion was noted in the flap on postoperative day 1 and treated with four days of leeches. Approximately 10 percent of the flap was lost due to the venous congestion. The flap healed well without further complications. At 33 months the flap remained well-perfused, with excellent flow through the reconstructed radial artery evidenced by both clinical examination and by color vascular Doppler exam. The patient had full range of motion in his right hand despite initial postoperative stiffness and reported no cold intolerance in the right hand. There has been no local recurrence of the sarcoma. The authors believe that this is the largest arterialized venous flow-through flap currently reported to have survived, as well as the first reported case of its use for the simultaneous reconstruction of a radial artery defect and an associated soft-tissue loss.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/16. Use of polypropylene mesh to stabilize the "floating humerus" after total scapulectomy.Total scapulectomy for malignant disease is a rarely performed procedure that presents a significant challenge for shoulder reconstruction. Failure to stabilize the resulting "floating humerus" may result in significant esthetic and functional problems. Current techniques of reconstruction and stabilization may yield suboptimal results and significant morbidity. We report a case of Ewing's sarcoma of the scapula, which required total scapulectomy. Polypropylene mesh was used in an attempt to prevent migration of the head of the humerus. The result was a stable shoulder with satisfactory motion and no additional morbidity. We believe that polypropylene mesh offers an advantage in shoulder reconstruction after total scapulectomy and should be considered as an option for stabilization of the humerus.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/16. Arthroscopic excision of synovial hemangioma of the knee.A synovial hemangioma in the knee joint of a 33-year old woman was diagnosed and removed arthroscopically. Preoperatively, this rare benign soft tissue lesion had caused recurrent swelling of the knee along with persistent pain and occasional buckling. Two years after surgery, the patient has a painless range of motion with no evidence of recurrence.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/16. Elastofibroma dorsi. A case report and review of the literature.Elastofibroma dorsi is a benign soft-tissue tumor characterized by the presence of elastic fibers among a stroma of collagenous and fatty connective tissue. This lesion characteristically is located in the subscapular region; however, it has been infrequently described in other anatomic locations. In the subscapular region, it can be a cause of periscapular pain, discomfort, and loss of range of motion. This paper presents a typical case and a brief review of the literature, concentrating on the clinical aspects of elastofibroma dorsi in addition to recent advances regarding the pathogenesis of this unusual lesion.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/16. Tumoral calcinosis in a child.Tumoral calcinosis is a rare benign tumor found adjacent to large joints, restricting motion and sometimes eroding through the skin. We report a case of this disease in a 9-month-old treated with surgical excision.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/16. A tendon sheath tumour presenting as trigger finger.The symptom of trigger finger may be caused by a variety of lesions. This report describes a trigger finger caused by a tumour in the tendon sheath. Trigger finger refers to transient arrest of motion in a finger. It may be caused by a variety of lesions such as those of the volar plate (Yancey & Howard, 1962) and joint capsule (Aldred, 1954), structural abnormalities of the metacarpal head (Flatt, 1961), lacerations of the flexor tendons (Janecki, 1976) and 'loose bodies' (Milford, 1971). Triggering as a result of tumour of the tendon sheath does not, however, appear to have been reported.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/16. fibroma of tendon sheath.Three cases of fibromas involving tendon sheath of right index finger, left ring finger, and tibial ligament in a 62-, a 54-, and a 30-year-old male patients, respectively, are described. Two cases (1 and 2) represented painless, slowly enlarging masses that limited motion of the involved digits. The third case was discovered at surgery during the repair of a tibial ligament after a motorcycle accident. Following surgical excisions, no recurrences were present 18 months and 9 months after resection. The fibromas of tendon sheath origin are distinct entities and should be separated from other lesions of tendon sheaths. Trauma should be considered as the etiology. The fibromas are benign lesions but may recur.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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