G. Bettelli

Complications of pelvic resections.

SummaryThe authors report on complications that occurred with 63 pelvic resections. There were 43 complications: 13 infections, seven cases of nerve palsy, 12 cases of vascular or visceral damage, six mechanical and five aesthetic complications. Infection and vascular and visceral damage were more frequent in anterior arch resections, neurological damage in iliac wing resections, and mechanical complications in periacetabular resections. The treatment and outcome of the complications are reported.

Reconstruction after resection of the distal fibula for bone tumor

We have reviewed 11 patients after distal fibular resection for benign or malignant tumors with different techniques of reconstruction. Seven patients had normal function and four had reduced mobility, one of whom had a lateral subluxation of the talus. All the patients were without pain. After resection of the lateral malleolus without replacement the soft tissues should be reinforced.

Osteoid osteoma and osteoblastoma of the pelvis

Benign osteoblastic tumors of the pelvis are rarely encountered in orthopedic practice. In most of the cases they involve the acetabular area, as was the case in nine of 14 cases of osteoid osteoma and osteoblastoma presented in this study. Especially with small tumors, such as osteoid osteomas, such a rare occurrence together with difficulties in the interpretation of roentgenograms can lead to mistakes and delays in diagnosis. To reduce these risks, a high grade of clinical suspicion and the use of tomograms or computed tomography (CT) scan and isotope bone scan are required. CT scan is an invaluable tool also for planning the surgical treatment in cases in which the tumor involves the acetabulum. Whereas an intracapsular excision is an adequate treatment for pelvic osteoid osteoma, pelvic osteoblastoma due to its size may need more aggressive surgery, even leading in some cases to a partial pelvic resection. The risk of recurrence is higher for osteoblastoma than for osteoid osteoma, as well as the rate of complications.

Modular Kotz Prosthesis

The functional results of 94 cementless Kotz prostheses are reported according to Enneking’s system. Excellent or good results were obtained in 61% of the patients who had a proximal femur resection and in 75% of the patients who had a knee resection. Only 10% of the patients had a complication that altered the functional status, and only 5% required surgical treatment for their complications. No case of loosening was observed at a mean follow-up of 2 years.

Prognostic significance of serum lactic acid dehydrogenase in Ewing's tumor of bone.

SummaryPretreatment serum lactic acid dehydrogenase (LDH) levels were examined in 82 patients with Ewing’s tumor of bone (23 metastatic and 59 localized). The percentage of patients with increased serum LDH levels was significantly higher in the metastatic group than in the group of patients with localized disease (87 vs. 45%). After treatment with combined therapy, in this latter group the recurrence rate was significantly higher in patients with elevated serum LDH levels at admission than in those with normal serum LDH levels (50 vs. 9%). Of the 16 patients with localized disease who relapsed, 13 (81%) had elevated serum LDH levels at the time of recurrence. These results indicate that in Ewing’s tumor serum LDH levels may serve as useful prognostic markers and could be valuable in monitoring the effectiveness of combined therapy.