Edwin R Guise

Metastatic tumors of the hand: A report of six cases

Six metastatic tumors of the hand of mammary, renal, pulmonary, colonic, and humeral origins are described. The areas involved were the distal phalanges, the metacarpal bones, a carpal bone, the nail bed, and the soft tissue of the dorsum of the hand. All six patients died within a few months after the metastatic lesions were diagnosed correctly. Metastases to the bone can cause destruction, pain, and swelling and may be misdiagnosed before operation as osteomyelitis. Metastases to the soft tissues tend to be asymptomatic and can closely mimic benign soft tissue tumors.

Rotational ligamentous injuries to the ankle in football

It is the authors belief that supination injuries with tear of the talofibular ligament are the most frequent ankle ligamentous injuries encountered on the football field (Figure 4). However, the author believes that the more significant injury is the rupture of the tibiofibular ligament and interosseous ligament incurred in pronation and external rotation. (Figure 5). Twenty time-loss injuries of significance, encountered over a five year period in one football team, are presented. The mechanism of injury and the force encountered at the ankle during an interruption of the normal sequence of running and turning on the football field are presented. It is the authors opinion that rigid immobilization of the more significant injury is necessary in order to return the participant to active athletics within a reasonable length of time. It is hoped that this report will stimulate others to closely evaluate ankle injuries occurring on the football field.

Malignant hemangioendothelioma of bone: a clinical analysis of 11 cases treated at Henry ford hospital.

This article describes the clinical manifestations, roentgenographic appearance, gross and microscopic pathologic features, treatments, and long-term results of 11 cases of malignant hemangioendothelioma of bone. The authors recommend that surgery, radiotherapy, and chemotherapy be integrated carefully and tailored to meet the needs of each individual patient.

Infrapatellar Tendon Ruptures

This is a retrospective study of 23 infrapatellar tendon ruptures in 22 patients seen at Henry Ford Hospital from 1969 to 1980. Two of the patients had a systemic disease known to predispose to tendon ruptures, while the remainder of the tendon ruptures occurred in otherwise normal individuals as the result of either repetitive or isolated trauma.

METASTATIC BRONCHOGENIC CARCINOMA TO THE FINGER SIMULATING ACUTE OSTEOMYELITIS

A case of metastatic bronchogenic carcinoma to the distal phalanx of the ring finger was initially misdiagnosed as osteomyelitis. The presence of constitutional symptoms, past history of malignancy, the milder and relatively protracted clinical course, the negative culture and lack of response to surgical drainage and antibiotics should make the diagnosis of hand metastasis a distinct possibility. Amputation of the involved digit is an effective palliative treatment and the other foci of metastases should also be treated with systemic chemotherapy.

Pigmented villonodular synovitis: a clinical analysis of twenty-four cases treated at Henry ford hospital.

This article describes the clinical findings, roentgenographic manifestations, gross and microscopic pathology, treatment, and results of 24 cases of pigmented villonodular synovitis treated at Henry Ford Hospital over a period of 25 years. We conclude that synovectomy is the treatment of choice, and we have experienced a 16.7% recurrence rate.

Synovial chondrosarcoma: a case report.

This paper reports a synovial chondrosarcoma in the knee of a thirty-four year old white male. An above-knee amputation produced a more than 12 year cure for this patient.

Osteochondroma of the atlas: a case report.

An extremely rare case of osteochondroma arising from the right lateral mass of an atlas was successfully treated by a complete removal through an oblique high cervical incision coupled with a transection of the underlying sternocleidomastoid muscle and careful freeing and retraction of the adjacent vital neurovascular structures.

Atlantoaxial arthrodesis: a clinical analysis of 22 cases treated at Henry ford hospital.

The indications for our 22 cases of atlantoaxial arthrodesis include rupture of transverse ligament, fracture of odontoid process, and absence of odontoid process. The surgical techniques of H-shaped unicortical and bicortical iliac grafts have been described. All our patients experienced satisfactory relief of their symptoms and reversal of their neurological deficits. In spite of the relatively minor postoperative complications, we feel that atlantoaxial fusion is a safe and effective method in treating various diseases of the atlantoaxial region.

EXTRAOSSEOUS OSTEOGENIC SARCOMA: A CLINICAL ANALYSIS OF TEN CASES

This article describes the clinical manifestations, roentgenographic appearance, microscopic features and short- and long-term prognosis of ten cases of extraosseous osteosarcoma. The surgical technique of wedge biopsy and en bloc excision with interlocking sutures has also been illustrated. We feel that en bloc excision is the treatment of choice, and that amputation should be reserved for large tumors with major neurovascular involvement and unresectable recurrence. The overall five-year survival rate was 42.9%.