- MeSH
- kortikální kost chirurgie MeSH
- kyretáž * metody MeSH
- lidé MeSH
- nádory kostí * chirurgie patologie sekundární MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND AND OBJECTIVES: Curettage is the removal of a tumor from the bone while preserving the surrounding healthy cortical bone, and is associated with higher rates of local recurrence. To lower these rates, curettage should be combined with local adjuvants, although their use is associated with damage to nearby healthy bone. OBJECTIVE: The purpose of this analysis is to determine the effect of local adjuvants on cortical porcine bone by using micro-computed tomography (micro-CT) along with histological and mechanical examination. METHODS: Local adjuvants were applied to porcine specimens under defined conditions. To assess changes in bone mineral density (BMD), a micro-CT scan was used. The pixel gray values of the volume of interest (VOI) were evaluated per specimen and converted to BMD values. The Vickers hardness test was employed to assess bone hardness (HV). The depth of necrosis was measured histologically using hematoxylin and eosin-stained tissue sections. RESULTS: A noticeable change in BMD was observed on the argon beam coagulation (ABC) sample. Comparable hardness values were measured on samples following electrocautery and ABC, and lowering of bone hardness was obtained in the case of liquid nitrogen. Extensive induced depth of necrosis was registered in the specimen treated with liquid nitrogen. CONCLUSION: This study determined the effect of local adjuvants on cortical bone by using micro-CT along with histological and mechanical examination. Phenolization and liquid nitrogen application caused a decrease in bone hardness. The bone density was affected in the range of single-digit percentage values. Liquid nitrogen induced extensive depth of necrosis with a wide variance of values.
- Klíčová slova
- Bone hardness, Bone necrosis, Giant cell tumor of bone, Local adjuvants, Micro-CT,
- MeSH
- kortikální kost * patologie diagnostické zobrazování chirurgie účinky léků MeSH
- kostní denzita * účinky léků MeSH
- kyretáž * metody MeSH
- nádory kostí * chirurgie patologie MeSH
- prasata MeSH
- rentgenová mikrotomografie * MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE OF THE STUDY: Hand enchondromas are benign cartilage bone tumors. Curettage represents the actual gold standard for hand enchondromas. Little has been written about the effectiveness of curettage on hand functionality. MATERIAL AND METHODS: In this retrospective study, we evaluated the effectiveness of curettage and bone grafting on the hand. For each case, we compared the pre-operative and post-operative QuickDASH of the treated limb. The final functional outcome was also evaluated by calculating the affected finger's Total Active Movement (TAM). Complications and local recurrences were recorded. RESULTS: Forty-five cases were included in our study. Fifteen of them had a pathological fracture. The mean pre-operative QuickDASH score was 48.4. No intraoperative complications occurred. After a mean follow-up of 38.1 months, the mean QuickDASH score had decreased to 4.4, and the TAM was optimal or sub-optimal. QuickDASH and TAM were significantly better for those with pathologic fractures before surgery. Only 3 cases (7%) had postoperative complications, and 1 (2%) had a local recurrence. DISCUSSION: Our results prove the effectiveness of curettage and early rehabilitation in increasing and restoring the performances of the treated hands. Our patients experienced a significant improvement in their functionality after surgery, generally passing from a poor to an excellent status. In our cohort, those who had a pathologic fracture before surgery had slightly but significantly worse functional outcomes compared to those who did not suffer pre-operative lesions. CONCLUSIONS: Curettage and early postoperative rehabilitation can lead to good clinical and functional outcomes for hand enchondromas. Patients with pathologic fractures, although slightly exposed to a higher risk of sub-optimal outcomes, can also aim for good post-operative functionality. KEY WORDS: hand, chondroma, QuickDASH, fracture, rehabilitation.
- MeSH
- chondrom * chirurgie MeSH
- kyretáž * metody MeSH
- lidé MeSH
- nádory kostí * chirurgie MeSH
- retrospektivní studie MeSH
- transplantace kostí metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Since aspiration curettage is increasingly common, we undertook a study aimed at comparing the histological suitability of samples acquired by this method to conventional curettage methods. Both types of curettage were performed on 123 women aged 23-76. Before undergoing aspiration curettage, women received 50 mg. Pethidine and .01 mg. Atropine/kg. body weight. Anesthetics for conventional curettage were hexabarbitol and nitrous oxide. Histological reports on samples acquired by both methods of curettage were identical in ale 15 cases of breakthrough bleeding, in all 6 patients with hypermenorrhea, in both patients on whom the procedure was done for diagnostic purposes, and in 18 of 21 cases of long-term bleeding. 47 of 63 women with post-menopausal bleeding had identical findings in both samples; 9 of these women had significant findings in the conventionally obtained sample only and 7 in the aspirated sample only. Of 16 cases of cervical polyps detected in the conventional curettage samples, only 3 were simultaneously discovered in the aspirated samples. 5 cases of uterine cancer were simultaneously detected in both samples. Aspiration curettage dectected cervical cancer in one case where conventional caurettage did not, but one case of cervical cancer in conjunction with polyps was not detected by aspiration curettage. Thus, except in cases where cervical polyps are suspected the diagnostic and therapeutic utility of aspiration curettage is high. An advantage of aspiration curettage is that it need not be done under general anesthesia and may be done on an out-patient basis. This reduces surgical risks to the patient and promotes the efficient utilization of hospital facilities.
- Klíčová slova
- Anesthesia, Bleeding, Cervical Cancer, Curettage--therapeutic use *, Evaluation *, Obstetrical Surgery, Surgery, Treatment,
- MeSH
- dospělí MeSH
- jehlová biopsie metody MeSH
- kyretáž metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory dělohy patologie MeSH
- nemoci dělohy patologie MeSH
- senioři MeSH
- uterus patologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
