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Biomedical subjects

F H Sim

Publications and source records attributed to F H Sim.

At least 109 records · Page 6Linked to original sources
PubMed1989

Wedge resection of the symphysis pubis for the treatment of osteitis pubis.

Ten patients had a wedge resection of the symphysis pubis for the treatment of symptoms of osteitis pubis that had been recalcitrant to non-operative treatment for at least six months. Preoperatively, the average duration of symptoms was thirty-two months. The symptoms included a waddling gait and crepitus, pain, and tenderness over the symphysis pubis. The early radiographic signs of the disease were rarefaction of the adjacent pubic bones and widening of the symphysis pubis. Later signs included sclerosis and narrowing of the symphyseal joint space. Pathological examination of the resected joint revealed chronic inflammatory reaction in all patients. At an average of fourteen months postoperatively, all of the patients had marked improvement and were fully active. However, at an average of ninety-two months postoperatively, three of the ten patients were not satisfied with the result. One patient needed bilateral sacro-iliac arthrodesis for pain that was caused by instability.

Adult↗
PubMed1988

Soft-tissue sarcoma: Mayo Clinic experience.

Soft-tissue tumors encompass a wide variety of lesions and continue to pose a difficult treatment problem. The outlook, however, is improving, and there have been recent advances in pretreatment assessment, clinicopathologic correlation, and adjuvant treatment programs. We retrospectively reviewed our experience in a large series of soft-tissue tumors treated at the Mayo Clinic as well as recent experience using chemotherapy and radiation treatment.

Adult↗
PubMed1988

Anterior knee pain.

Anterior knee pain is a common symptom, especially in adolescence, and often no specific cause is sought or identified. Physicians who treat patients with knee pain should understand the normal anatomic features and the biomechanics of the patellofemoral joint. We review this information and discuss important aspects of the physical examination and roentgenographic evaluation in patients with anterior knee pain. Once the clinical cause of anterior knee pain has been established, directed nonoperative treatment including physical therapy should be initiated. Surgical intervention is generally reserved for patients in whom nonoperative management is unsuccessful and identifiable abnormalities exist.

Adolescent↗
PubMed1988

Xanthoma of bone.

The authors report on 21 cases of "primary" xanthoma of bone. Twenty of the patients were older than 20 years old. The male-female ratio was 2:1. The presenting symptom was pain in 13 patients and neurologic symptoms in 2; in 6 patients, the lesion was an incidental finding. All but one of the lesions in this series were solitary, and the flat bones (pelvis, rib, skull) were the most frequently involved sites. Radiographically, a well-defined, sometimes expansile lytic lesion, with either a small area of surrounding reactive bone or a distinct sclerotic margin, was seen. Microscopically, foam cells, giant cells, cholesterol clefts, and fibrosis were present in varying degrees. In none of these cases was there an identifiable underlying lesion. The differential diagnosis includes Erdheim-Chester disease (a multisystemic granulomatosis) and bone involvement in sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease). More important is the differential diagnosis with metastatic clear cell carcinoma. Xanthoma of bone is a benign lesion, and complete or even partial removal is effective. Xanthomas may represent a "burnt-out" benign condition such as fibrous dysplasia or histiocytosis X.

Adolescent↗
PubMed1988

Ice hockey injuries.

Ice hockey is a team sport that has recently grown in popularity not only in the United States but also in Canada and Europe. With this increase in popularity has come a growing concern about the number and severity of injuries. The world literature on the biomechanics and physiology of ice hockey was reviewed in an attempt to evaluate the forces and mechanisms involved in the game. The influence of rule and equipment changes on injury patterns was particularly studied. Several studies on the epidemiology of injuries, providing data on the types of injuries and the mechanisms of those injuries, were analyzed to determine the conclusions that could be supported and those that require further study. Possible changes in the patterns and types of injury are outlined.

Adolescent↗
PubMed1988

Metastatic tumors of the foot and ankle.

In a review of the Mayo Clinic files, 17 biopsy-proven cases of metastatic tumors of the foot and ankle were found; 4 additional cases were considered to have metastatic disease on the basis of clinical and radiographic evidence but no histological confirmation was available. Lung, kidney, and colon were the most common sites of the primary tumors. The patients survived as long as 28 months after discovery of the metastasis. Treatment consisted of individualized combinations of orthotics, surgery, and radiotherapy to maintain mobility. In 9 of these 17 cases, no primary lesion was identified at the time the metastasis was diagnosed. Metastatic tumors of the foot present special problems in diagnosis and management.

Adult↗
PubMed1988

Primary leiomyosarcoma of bone.

Adequate treatment of primary leiomyosarcoma of bone requires surgical ablation with the goals being those for any malignant tumor of bone--eradication of the lesion and preservation of as much function as possible. Careful preoperative staging will determine whether amputation is necessary or whether successful limb-saving resection is possible.

Aged↗
PubMed1988

Intraosseous ganglion cysts.

An illustrative case report of intraosseous ganglion cyst is presented. Intraosseous ganglion cysts are uncommon, juxta-articular, and benign. They are thought to arise from an intramedullary metaplastic event. Intraosseous ganglia are most common in middle-aged patients. They usually involve the tibia but also are located in other skeletal sites. The lesion is typically epiphyseal and appears benign. It is successfully treated with curettage and bone graft if it is symptomatic or progressively increasing in size. It is important to avoid extensive surgical procedures. Recurrence is unlikely.

Bone Cysts↗
PubMed1988

Bone banks and allografts in community practice.

The increasing volume of orthopaedic reconstructive procedures requiring replacement of bone stock justifies the initiation of programs of bone banking in community hospitals. Provided that strict criteria are followed to assure rigorous screening of donor bone and the reliable preservation of bone graft material, community banking is safe and cost-effective. Banked allograft bone can be used successfully in a wide variety of orthopaedic procedures performed in community hospitals. In general, the best uses are filling bone cavities, buttressing, and augmenting the quantity of autograft bone. In revision reconstructive surgery of the hip, bank bone is used to replace bone stock in protrusio, acetabular dysplasia, and proximal femoral deficiency. The best and most common indication for the use of bank bone in tumor surgery is after curettage or excision of benign lesions. Allografts may be used to reconstruct bony defects after excision of malignant tumors and in the surgical treatment of metastatic disease. These instances require larger bone bank facilities than those commonly available in a community hospital setting. Medicolegal considerations related to bone banking and the use of allografts in community practice include the regulatory requirements outlined in the UAGA, questions concerning negligence liability, and theories of strict product liability. Overall, good medical practice and obtaining informed consents will minimize legal risks related to bone banking and transplantation in a community setting.

Bone Transplantation↗
PubMed1988

Comparison of replacement prostheses for segmental defects of bone. Different porous coatings for extracortical fixation.

The extent of extracortical bone-bridging and ingrowth into porous-coated prostheses for the stabilization of segmental defects was studied in a canine model. Initial fixation of the implant was achieved using bone cement. Autogenous bone grafts were applied over the porous-coated segmental portion of the prosthesis to stimulate the ingrowth and formation of bone. At twelve weeks, bone-bridging and ingrowth occurred uniformly in both the titanium fibermesh and the cobalt-chromium-molybdenum beaded prostheses. Maximum formation of osseous tissue over the implants occurred at two to four weeks. More bone formed in the posterior aspect of the prosthesis. At twelve weeks, 26 per cent of the porous space of the titanium fibermesh prosthesis and 47 per cent of the porous space of the cobalt-chromium-molybdenum beaded prosthesis were filled with bone. The torsional strength and stiffness of the prosthetic midsection that contained a conical coupling joint were increased significantly due to bone-bridging and ingrowth. The cortical bone that was apposed to the segmental prosthesis showed an increase in porosity. The use of bone cement did not appear to impede new-bone formation extracortically. The initial stability of the implant and the application of sufficient autogenous bone grafts are two important factors that contribute to the ultimate stable fixation of an implant by extracortical bone formation.

Animals↗
PubMed1988

Prosthetic replacement of the femoral head for fracture of the femoral neck in patients who have Parkinson disease.

A retrospective study was performed of forty-nine patients (fifty fractures of the femoral neck) who had Parkinson disease and who had had an endoprosthetic replacement of the femoral head. The average age of the patients was seventy-four years (range, forty-seven to ninety-two years). All of the fractures were Garden Stage III or IV. An anterolateral surgical approach was used in twenty-five hips; a posterior approach, in twenty hips; and a transtrochanteric approach, in five hips. An adductor tenotomy was required in five patients to release an adduction contracture. Ten patients died by the sixth postoperative month. The remaining thirty-nine patients were followed for a minimum of two years (average, 7.3 years). Common postoperative complications were infection of the urinary tract (20 per cent) and pneumonia (10 per cent). There was only one dislocation. At the time of writing, nineteen (80 per cent) of the surviving patients could walk.

Aged↗
PubMed1988

Fracture of the patella after total knee arthroplasty.

Patellar fracture after knee arthroplasty was found in 11 patients (12 knees) during a 15-year period. Causes of this fracture include trauma, technical factors, and biophysical factors. The incidence of this infrequent complication was significantly increased after patella resurfacing and revision arthroplasty. Minimally displaced, non-comminuted fractures were immobilized, whereas displaced, comminuted fractures with loose patellar prostheses were treated operatively. At a mean follow-up period of 28 months, the average knee score was 75 points. The average arc of motion was 87 degrees, and six of the 11 patients have returned to their prefracture functional level. Treatment should be individualized on the basis of fracture displacement, comminution, and button fixation.

Adult↗
PubMed1987

Liposarcoma of the musculoskeletal system.

Two hundred eleven cases with the diagnosis of liposarcoma of the musculoskeletal system were reviewed. The mean age at diagnosis was 52.9 years. The primary site was the proximal lower extremity in 52%. Myxoid-type liposarcoma was most frequent (60%). Metastasis was observed in 45%. One hundred two patients without prior treatment or distant spread at diagnosis were studied separately. Recurrence was noted in 26%. The median survival time was 7.5 years, with a 5-year survival of 59% and a 10-year survival of 45%. Significant variation in survival time was related to histologic grade, Enneking's stage, tumor size, and histologic type.

Adolescent↗
PubMed1987

Musculoskeletal injuries in competitive swimmers.

Competitive swimming is a rigorous sport being engaged in by an increasing number of young athletes. In swimmers, shoulder pain is the most common musculoskeletal complaint and is usually due to supraspinatus or biceps tendinitis. Glenohumeral instability (often multidirectional) can also be a cause of shoulder pain in swimmers and may be more common than has been reported. Surgical treatment is seldom indicated. Physical therapy modalities and training modifications are the mainstay of treatment. Medial knee pain in breaststroke swimmers and extensor tendon inflammation over the dorsum of the foot are less common injuries and respond to conservative therapy. These overuse syndromes are best prevented by proper training schedules, strength training, flexibility exercises, and avoidance of errors in stroke technique. The rehabilitation program for a competitive swimmer should be chosen with an understanding of the goals of the swimmer and the cooperation of the coach.

Athletic Injuries↗
PubMed1987

Vascularized bone transfer for limb salvage and reconstruction after resection of aggressive bone lesions.

At our institution from 1980 to 1985, 30 patients underwent resection of malignant or locally aggressive bone tumors, with limb salvage and reconstruction by free vascularized bone grafts. Of the 26 patients followed up for at least four months (average, 21 months), four had complications. In these four, there were three nonunions, two infections, and one stress fracture. The average duration of immobilization was 7.6 months in the lower extremity, five months in the pelvis, and 3.8 months in the upper extremity. The average time to union was 6.3 months in the lower extremity, five months in the pelvis, and five months in the upper extremity. Although the technique of oncologic reconstruction must be individualized, our experience indicates that vascularized bone grafts offer significant advantages over conventional methods in selected patients.

Adolescent↗
PubMed1987

Liposarcoma of the soft tissues.

A case report presents a liposarcoma of the extremities and an overall review of this disease entity. Past and present histologic classifications of liposarcoma are discussed, as are the clinical behavior and treatment options in relation to the surgical stage of the tumor. The importance of a well-planned biopsy site is stressed.

Adult↗