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Biomedical subjects

Mihir M Thacker

Publications and source records attributed to Mihir M Thacker.

13 recordsLinked to original sources
PubMed2007

Case report. Granular cell tumors of extremities: comparison of benign and malignant variants.

Granular cell tumors are uncommon soft tissue neoplasms that arise from cells of neural origin. We present three patients with this rare tumor: one with a benign tumor, one with a malignant tumor, and one with a histologically benign tumor that later metastasized to the lung. We studied the difficulty in differentiating between the benign and malignant variants using only histology. We also compared the clinical, radiographic, and pathologic features and the criteria for malignancy, natural history, and prognosis.

Adult↗
PubMed2006

Coxa vara: a novel measurement technique in skeletal dysplasias.

Coxa vara can be a progressive deformity in children with skeletal dysplasia. Preoperative anteroposterior pelvic radiographs of 30 children with spondyloepiphyseal dysplasia congenita and spondyloepimetaphyseal dysplasia were used to test the reliability of a new radiographic measure of coxa vara, the Hilgenreiner-trochanteric angle. An additional 10 patients (20 hips) with coxa vara deformities needing valgus-producing proximal femoral osteotomies also were reviewed. Interobserver reliability with plain radiographs was 0.929 for the left side and 0.914 for the right side using interclass correlation coefficients. Intraobserver reliability also was high, with an interclass correlation coefficient of 0.875. Twelve hips corrected by osteotomy had adequate ossification to measure the Hilgenreiner-epiphyseal angle, head-shaft angle, and Hilgenreiner-trochanteric angle. Only one of these hips had a recurrence. The results were good in all of the other ossified hips. Eight hips had limited ossification; only two of these hips maintained acceptable alignment. Six hips had less postoperative correction and progressive deformity at the final followup. We present a novel measurement technique to determine the degree of coxa vara deformity in children with delayed or absent ossification of the capital femoral epiphysis.

Adolescent↗
PubMed2006

Distal femur replacement is useful in complex total knee arthroplasty revisions.

UNLABELLED: Revision total knee arthroplasty can be considerably more difficult in cases involving severe bone loss, complete absence of collateral ligaments, and persistent periprosthetic supracondylar femoral fractures. Modular segmental endoprosthetic distal femur replacement is a limb salvage option when other surgical options are unfeasible. The clinical performance of rotating hinge knee prostheses has greatly improved with the evolution of second and third generation designs. The increased freedom of rotation decreases the prosthetic bone stresses and the longevity. While designs have improved, the prostheses still do not match the function and longevity of condylar components with approximately a 90% survivorship at 20 years. The modular endoprosthesis rotating hinge knee prosthesis is useful for total knee arthroplasty revision in patients with inadequate bone stock, ligamentous instability, or difficult supracondylar femur fractures, especially in low demand elderly patients. LEVEL OF EVIDENCE: Therapeutic study, level V (expert opinion). See Guidelines for Authors for a complete description of levels of evidence.

Aged↗
PubMed2006

A safe technique for sternoclavicular stabilization.

Sternoclavicular stabilization using metal implants is associated with an unacceptably high complication rate. A simple and safe technique of sternoclavicular stabilization utilizing sutures and the clinical results thereof are described in this case of an 11-year-old boy with an unstable anterior sternoclavicular dislocation.

Accidental Falls↗
PubMed2005

Ganglioneuromas of the sacrum-a report of two cases with radiologic-pathologic correlation.

Ganglioneuromas are rare, benign, well-differentiated, slow-growing tumors, composed of ganglion cells and Schwann cells. Ganglioneuromas are derived from the neural crest cells and can arise anywhere from the base of the skull to the pelvis. We present and discuss the clinicopathologic and radiographic features of two patients with ganglioneuroma arising from the sacrum, a rare anatomic location.

Adult↗
PubMed2005

Dysplasia epiphysealis hemimelica of the tibial tubercle.

Dysplasia epiphysealis hemimelica (DEH) is a rare skeletal dysplasia with epiphyseal involvement first described by Mouchet and Belot in 1926. Lower extremity involvement is common and might involve a single or multiple epiphyses in the affected extremity. We report an unusual case of involvement of the tibial tubercle in a girl aged 4 years 8 months, and we present the clinical, radiographic and pathologic findings. We discuss the role of MRI in the diagnosis and treatment plan.

Child, Preschool↗
PubMed2005

Current treatment for Ewing's sarcoma.

Ewing's sarcoma is the second most common primary bone tumor seen in children and adolescents, and was described by James Ewing in 1921 as a diffuse endothelioma of bone. It is one of the differential diagnoses of pediatric small round blue cell tumors. This is not a single condition, but a group of morphologically and clinically closely related disorders with similar molecular biology -- expression of tumor-specific chimeric oncoproteins through balanced chromosomal translocations involving the EWS gene -- often referred to as the Ewing family of tumors. This includes Ewing's sarcoma of bone, extra-osseous Ewing's sarcoma, Askin tumor and peripheral neuroectodermal tumor. These are aggressive neoplasms with almost 25% of patients having clinically evident metastases at presentation. Ewing's sarcoma has therefore been considered as a systemic disease necessitating local as well as systemic treatment. An aggressive multidisciplinary approach has resulted in significant improvement in prognosis for patients with these tumors. Despite aggressive treatment, 20-40% of patients with localized disease and almost 80% of patients with metastatic disease at presentation succumb to the illness. Advances in understanding the molecular biology of these tumors will hopefully result in the development of novel treatment approaches. The aim of this article is to review the existing treatment methods and to highlight the more recent approaches to the treatment of this condition.

Adolescent↗
PubMedDate not supplied

Hinged distraction of the adolescent arthritic hip.

From 1996 to 2000, 11 adolescents with hip joint arthritis secondary to osteonecrosis or idiopathic chondrolysis were treated with articulated hinged distraction arthroplasty. Indications for surgery were severe pain and limited ambulation. Charts and radiographs were reviewed. Clinical status was assessed preoperatively and at latest follow-up (mean 4.8 years after surgery) using criteria of pain, range of motion, and ambulation level. Ten patients showed improved clinical status, with seven having an excellent outcome and three a good outcome. One patient failed distraction. Mean joint space was 2.6 mm before surgery and 4.8 mm at latest follow-up. Average duration of fixator use was 4.4 months. Four patients (36.4%) had complications. Articulated hip distraction was effective in eliminating pain, improving function, and preventing progressive degenerative changes in young patients' hips. It should be considered a salvage procedure for arthritic hips and an alternative to arthrodesis in this difficult-to-treat group of patients.

Adolescent↗
PubMedDate not supplied

Use of the foot abduction orthosis following Ponseti casts: is it essential?

The purpose of this study was to evaluate the need for the use of a foot abduction orthosis (FAO) in the treatment of idiopathic clubfeet using the Ponseti technique. Forty-four idiopathic clubfeet were treated with casting using the Ponseti method followed by FAO application. Compliance was defined as full-time FAO use for 3 months and part-time use subsequently. Noncompliance was failure to fulfill the criteria during the first 9 months after casting. Feet were rated according to the Dimeglio and Pirani scoring systems at initial presentation, at the time of FAO application, and at 6 to 9 months of follow-up. At the time of application, no significant differences in scores were found between the groups. At follow-up, the compliant group's scores were significantly (P < 0.01) better than those of the noncompliant group. From the time of application to follow-up, for the compliant group, the Dimeglio scores improved significantly (P = 0.005). For the noncompliant group, the Dimeglio scores deteriorated significantly (P = 0.001). The feet of patients compliant with FAO use remained better corrected than the feet of those patients who were not compliant. Proper use of FAO is essential for successful application of the Ponseti technique.

Casts, Surgical↗