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D S Springfield

Publications and source records attributed to D S Springfield.

35 records · Page 2Linked to original sources
PubMed1988

Staging of intraosseous extent of osteosarcoma: correlation of preoperative CT and MR imaging with pathologic macroslides.

The accuracy of preoperative computed tomography (CT) and magnetic resonance (MR) imaging in the measurement of intraosseous tumor extent in 17 cases of osteosarcoma of an extremity was compared with macroslides of surgical specimens. Longitudinal intraosseous extension of tumor from the adjacent articular surface was measured on imaging studies and macroslides to the nearest millimeter. The average difference between macroslide and CT measurements (15 cases) was 16.5 mm +/- 10.7, and the average difference between macroslide and MR imaging measurements (17 cases) was 4.9 mm +/- 4.3. However, much of the latter difference appears to be caused by use of a different plane of section in MR imaging compared with that in macroslides, since in a subgroup of five specimens with an identical plane of section, the average difference was 1.8 mm +/- 1.6. The authors conclude that MR imaging is extremely accurate in the assessment of intraosseous extent of osteosarcoma.

Adolescent↗
PubMed1988

Surgical treatment for osteosarcoma.

Fifty-three patients who had a high-grade osteosarcoma had either a limb-salvage resection or an amputation. They all received adjuvant therapy that consisted of administration of Adriamycin (doxorubicin) and whole-lung irradiation. At the time of follow-up, the surgical margin was assessed by examination of the surgical specimen. Each patient was followed for at least three years or until death. The data suggested that a wide surgical margin is adequate to control a primary osteosarcoma. When a wide surgical margin can be used and a functional limb can be salvaged, an amputation probably is not required.

Adolescent↗
PubMed1987

Primary musculoskeletal tumors: examination with MR imaging compared with conventional modalities.

In 176 cases of primary musculo-skeletal tumors, the informative value of magnetic resonance (MR) imaging was compared with that of plain radiographic examination, angiography, scintigraphy, and computed tomography (CT). In all patients the surgical and histopathologic results were known. For bone tumors confined to the bone, MR imaging was excellent for evaluation of intraosseous extent, but it could not be proved significantly better than CT or scintigraphy. MR imaging was inferior to plain radiography and CT for evaluation of calcification, ossification, cortical destruction, and endosteal/periosteal reaction. For soft-tissue tumors and bone tumors with soft-tissue extension, MR imaging was significantly better than the other modalities in all variables examined: delineation between tumor and muscle, tumor and vessel, tumor and fat, tumor and joint, and tumor and bone, as well as depicting intralesional necrosis and bleeding.

Adolescent↗
PubMed1987

Massive autogenous bone grafts.

Autogenous bone graft is the best biologic material available to repair a skeletal defect. These necrotic grafts are revascularized and repaired through creeping substitution to provide an almost identical structure for the one it replaced. There is a limited supply of autogenous bone, but it is the standard against which other methods should be measured.

Animals↗
PubMed1987

Performance evaluation of a cement-augmented intramedullary fixation system for pathologic lesions of the femoral shaft.

To improve intramedullary fixation with polymethylmethacrylate for use in pathologic bone, a new fixation system was developed. A fluted intramedullary rod was modified to allow injection of low-viscosity polymethylmethacrylate (PMMA) through the rod with retrograde filling of the void spaces between the rod and the medullary canal. This provided uniform distribution of the cement along the length of the rod and significantly improved fixation stability. Biomechanical testing using this system on simulated pathologic lesions of the femur showed a twofold increase in torsional strength over intramedullary methods previously used, with strength approaching that of the intact femur. In 16 patients, the device made mobilization possible immediately after the operation.

Adult↗
PubMed1985

Juxtaepiphyseal aneurysmal bone cyst.

Nine cases of aneurysmal bone cyst arising in juxtaepiphyseal locations with gross invasion of the adjacent growth plate are reported. In five of these patients an abnormality of growth, due to premature fusion of the affected growth plate, ultimately developed. Treatment of these lesions should attempt to avoid this complication, which appears to be more common than has been appreciated in the past. These nine cases represent 23% of 39 cases of aneurysmal bone cyst occurring in a long bone adjacent to an open epiphyseal plate. This series was extrapolated from a total of 198 cases of aneurysmal bone cyst in the files of the Istituto Ortopedico Rizzoli, Bologna, Italy.

Adolescent↗
PubMed1985

Limitations of computed tomography following excisional biopsy of soft tissue sarcomas.

Twenty-one patients were evaluated by computed tomography (CT) following complete or incomplete excisional biopsy of soft tissue sarcomas. Since the surgical margins were inadequate, additional treatment was required, and CT was intended to identify and delineate any residual tumor. Thirteen patients had no palpable mass in the operative area. In these, eleven CTs showed no tumor, but microscopic tumor was found in seven. The other two CTs showed masses, but both proved to be hematomas. Eight patients had palpable masses and seven proved to be residual tumor. Of these, two CTs failed to show the residual tumor. Five CTs correctly identified residual tumor, but two of them failed to show the entire tumor extent. Computed tomography did not correctly predict the presence or absence of microscopic residual tumor when there was no palpable mass, and was at least partly inaccurate in delineating residual tumor in four of eight patients with palpable masses.

Adolescent↗
PubMed1985

Computed tomography of parosteal osteosarcoma.

Twelve patients with parosteal osteosarcomas were evaluated by computed tomography (CT). CT accurately defined the extent of the tumors for purposes of surgical planning, although tumor bone often could not be distinguished from thickened host bone. Nine tumors invaded the medullary cavity, a feature that implies a poorer prognosis when the tumor also contains high-grade areas. Six CT studies accurately detected the medullary invasion, but three did not. Lucent areas within dense tumors contained either benign tissue or high- or low-grade tumor; CT did not differentiate among these different tissues. CT also did not reveal small satellite nodules of tumor beyond the main tumor mass.

Adolescent↗
PubMed1985

Fractures of long bones previously treated for Ewing's sarcoma.

Patients with Ewing's sarcoma of a long bone who survive for two years from the time of diagnosis and have been treated with irradiation and chemotherapy have a significant risk of fracture of the involved segment of bone. In our experience, this risk is especially high when the humerus or femur is involved. Healing of these fractures is not normal, and our data suggest that early or even prophylactic internal fixation and bone-grafting may be indicated.

Adolescent↗
PubMed1985

Aneurysmal bone cyst of the spine.

The cases of twenty-two patients with an aneurysmal bone cyst of the spine above the sacrum were analyzed with regard to sex, age, site, symptoms, and radiographic findings. Four patients had extension of the lesion to the adjacent vertebra or rib, and twelve patients had neurological deficits. The primary treatment was either radiotherapy or surgery alone, or surgery and radiotherapy combined. No recurrences were found in patients who were treated with surgery alone or with surgery and radiotherapy, while three of the six patients who were treated with radiotherapy had a local recurrence, two of which were fatal. The patients with neurological deficits recovered after healing of the cyst.

Adolescent↗
PubMed1985

Chondroblastoma. A review of seventy cases.

We reviewed the cases of seventy patients with chondroblastoma who were treated at the Istituto Ortopedico Rizzoli between 1949 and 1983 and found that the proximal end of the humerus was the most common location (eighteen), with the proximal end of the femur (fifteen), distal end of the femur (fifteen), and proximal end of the tibia (twelve) being the other frequently involved sites. Sixty-three of the patients were between eleven and thirty years old. Fifty-eight patients sought medical attention because of an aching pain, usually referred to the adjacent joint. Fifty patients were followed for two years or longer after treatment. Seven patients had a local recurrence: four were successfully treated with a repeat curettage and one, by two subsequent marginal excisions; one was advised to have a repeat curettage; and the seventh was advised to have a resection and arthrodesis of the knee. The final functional results were considered to be excellent in forty-seven of the fifty patients who were followed for two years or more.

Adolescent↗
PubMed1977

Osteosarcoma.

Significant advances are being made in the treatment of osteosarcoma and improvement in the five year survival is being reported. Active study of the etiology, pathogenesis, immunology, immunotherapy, radiotherapy, chemotherapy, and surgical management is currently in progress. The preliminary survival statistics with adjuvant chemotherapy or immunotherapy are encouraging and it is hoped that these survival figures will be maintained with further follow-up. Our experience suggests that, when practical, patients with osteosarcoma should be treated in or in cooperation with centers actively involved in the evaluation of osteosarcoma therapy. Not only does this step offer the patient optimal opportunity to receive the most current therapy, but it is essential in obtaining adequate numbers of patients for critical analysis.

Adolescent↗
PubMedDate not supplied

Direct cortisone injection in eosinophilic granuloma of bone: a preliminary report on 11 patients.

Eleven patients, between 3 and 16 years of age (average 6.5 years), with eosinophilic granuloma of bone were treated with direct injection of methylprednisolone acetate. Methylprednisolone acetate was used at the dilution of 40 mg/ml. Each single injected dose varied from 1 to 4 ml, depending on the sizes of the radiolucent defect and the soft tissue mass. One patient had four separate injections, one had three injections, five had two injections, and four had a single injection. All 11 patients healed without complications. This method of management is recommended.

Adolescent↗
PubMedDate not supplied

Cystic intramuscular myxoma. Report of a case.

CT and ultrasound examination of a soft tissue mass in a 43-year-old woman revealed a large, cystic lesion. At surgery, a myxoma was found deep to a large cyst. Although myxomas have been reported frequently to contain one to 5 mm cysts, none has previously been reported associated with a large cyst that concealed the solid tumor. Large intramuscular cysts are rare; a cystic appearance on CT or ultrasound examination of an intramuscular mass should suggest a possible underlying solid lesion.

Adult↗