Long Bones Of Lower Extremities Research Articles

Assessment of bone quality by the technique of multispiral computer tomography in patients with chronic osteomyelitis

Purpose - to study the roentgenomorphological features of the lower limb long bones in patients with chronic osteomyelitis using the technique of multi-spiral computer tomography (MSCT), and to propose the complex of parameters to assess bone quality. Material and methods. Roentgenography and computer tomography of the hips were performed in 49 patients with chronic osteomyelitis of long bones of lower extremities. The studies made using computer tomographs GE Light Speed VCT, Toshiba Aquilion-64, Somatom Smile. Results. The changes in bone structure of proximal femur were characterized by extremely marked polymorphism, and they almost didn’t repeat in the anatomical component. The cortical plate had heterogenous structure with resorption zones in the area of its transfer to the shaft. The character of roentgenomorphological changes in the shaft was individual in all the patients, but there were common manifestations as well which consisted in thickening of the cortical plate, different intensity of periosteal and endosteal layers. The cortical plate was significantly different in density, which exceeded 1700 HU in some places. When osteomyelitic process localized in the knee marked changes affected its all components, they manifested themselves in extended osteoporosis and local osteosclerosis. When osteomyelitic process localized in proximal tibia extensive resorption zones observed, the cortical plate thinned in proximal parts, its density was not more than 350 HU. Conclusion. The data demonstrated that bone quality in patients with chronic osteomyelitis had significant deviations from normal values in terms of changing both its density and architectonics. The deviations consisted in bone density decrease in the meta-epiphyseal part regardless of the process localization, in highly variable density values of the cortical plate as a result of its thickening or thinning, presence of resorption or sclerosis areas.

English

Chondromyxoid fibroma, a rare primary benign bone tumor usually affecting long bones of lower extremities in younger age group. An old patient presented with recurrent chondromyxoid fibroma of mastoid process of temporal bone, which is extremely rare. Chondromyxoid fibroma is known for recurrence after curettage, which often poses diagnostic difficulties and sometimes difficult to differentiate from more aggressive tumors like Chordoma and Chondrosarcoma. Though rare, Chondromyxoid fibroma should be considered in the differential diagnosis of primary skull base tumors.

Incidence of Post-Operative Venous Thromboembolism Using Compression Ultrasonography Following Trauma to Spine and Long Bones of Lower Extremity

Background: Venous thromboembolism is an important and potentially a fatal complication if not suspected and treated promptly. Various diagnostic modalities are available to detect Deep Vein Thrombosis (DVT), but each has its merits and demerits. Compression ultrasonography is a non-invasive method to diagnose DVT. This study was undertaken to evaluate the incidence of DVT using compression ultrasonography in the patients who underwent surgery of the spine and long bones of lower extremity following trauma. Material & Methods: All patients who underwent surgery following trauma to the spine and long bones of lower extremity were screened using Venous B-mode ultrasonography and color Doppler imaging. None of the patients received prophylaxis against DVT. The patients were selected on the basis of the following findings: 1) Immediately in patients found to have clinical DVT following surgery; 2) Every odd number of patients who underwent surgery and did not show signs and symptoms of DVT on the 7th, 14th post operative day and 6th post operative week. Results: The incidence of DVT using compression ultrasonography in the patients who underwent surgery of the spine and long bones of lower extremity following trauma was 17 percent. The incidence of DVT has no correlation with various clinical variables. Conclusion: The observed incidence of DVT is reasonably high and it is a potential risk factor for the development of pulmonary embolism.

Camptomelic dysplasia: A case report

Campomelic/camptomelic dysplasia is a very rare, severe osteochondrodysplasia characterised by severe skeletal and nonskeletal malformations and lethal outcome mainly in neonatal period. Characteristic abnormality by which the syndrome got its name is short, bowed long bones of lower extremities, most often of femur, manifested by short and bowed legs. Skin dimpling on tibial anterior side is another prominent characteristic of this syndrome. Severe cases are inherited by autosomal dominant trait, by mutation Sox9 gene on chromosome 17, with lethal outcome in the first days of life. Less severe forms of the disease are due to balanced translocation t (13;17) with life span up to the third decade of life. A majority of karyotypic males present as phenotypic females. We report a case of a female neonate, without consanguinity between parents, with characteristic signs of camptomelic dysplasia with short birth length of 46 cm, macrocephaly (head circumference 39 cm), dolichocephaly, hydrocephalus, short trunk and legs. Narrow rib cage, bowed lower extremities, short hand and foot phalanges, nail hypoplasia were noticed. Anterior fontanelle was enlarged, high forehead, face small and flat, hypertelorism, low nasal bridge, micrognathia, low set ears, cleft palate, were found. Characteristc skin dimpling on anterior side of tibia was present on both legs. Bone X-ray studies presented the following changes: anterior bowing of shortened femurs, hip dislocation, cervical vertebrae, scapulas, eleven pairs of slender ribs. Hip luxation. Karyotype was normal for a female, 46 XX. Respiratory insufficiency was present since birth, exacerbated, and led to lethal outcome in the second day of life, as described in the majority of these patients.

Battered baby syndrome with severe malrotation deformities of all long bones of lower extremities: A case report

Battered baby syndrome with severe malrotation deformities of all long bones of lower extremities: A case report

External Fixation and Infection of Soft Tissues Close to Fracture Localization

We evaluated the method of external fixation for stabilization of unstable closed and open first-degree diaphyseal fractures of long bones of lower extremities in 19 patients with infections of soft tissues close to the fracture location. The results are compared with those of another group (n = 392) of patients, with similar fractures without infections close to the fracture site, treated with inner stabilization methods. In the first group of patients, we noticed postoperative osteitis of the tibia in two cases (10%), but no pseudarthrosis or lesions of important blood vessels. In the second group of patients, the incidence of postoperative osteitis was 8.6% (n = 34) and the incidence of pseudarthrosis was 2% (n = 8). Among these patients, three lesions of important blood vessels were diagnosed. Our conclusion is that when the method of external fixation is used in combination with skillful operative techniques, the infection of soft tissues near the fracture location has no principal influence on the frequency of osteitis.