Purpose In 1999, we developed a technique using frozen autografts-tumour-containing bone treated with liquid nitrogen-for the reconstruction of malignant bone tumours. The purpose of this study was to evaluate the functional and oncological outcomes of frozen autografts for intercalary reconstruction of malignant bones and soft tissue tumours. Methods This retrospective study was designed to assess 34 patients of mean age 35 (range, 6-79) years. The mean followup period was 62 (24-214) months. The median length of the frozen autografts was 138.4 ± 60.39 (50-290) mm. Results Postsurgically, 20 patients remained disease-free, seven patients survived with no evidence of disease, five patients were alive with disease, and two patients died of disease. The five-and ten-year survival rates of the frozen autografts were 91.2% and the mean International Society of Limb Salvage score was 90%. Complete bony union was achieved in 97% of the patients. There were five cases of nonunion, six cases of fracture, two cases of deep infection and four cases of local recurrence. Conclusion Utilizing intercalary frozen autografts for patients with a nonosteolytic primary or secondary bone tumour without involvement of the subchondral bone is a good alternative treatment, because it is a straightforward biological technique and can provide excellent limb function.

The use of two stage reconstruction in cases of resistant infected tibial diaphyseal nonunion gives comparable results to the Ilizarov ring external fixator in cases associated with bony defects within the confines of 6 cm with superiority in preservation of ankle and subtalar joints range of motion.

Purpose: The aim of this study is to report the clinical and radiological outcomes following surgical treatment of chondroblastoma by means of an extended intralesional curettage using high-speed burr, with phenol as a local adjuvant which is followed by the implantation of synthetic bone graft, aiming to lower the recurrence rate of this tumor. Patients and Methods: This retrospective study included 20 patients with chondroblastoma lesions during the period between 2000 and 2015. Results: Fifteen males and five females were followed up for a mean of 63.35 (26–144) months with average age at the time of presentation was 20.8 (range: 12–32) years. Nineteen patients (95%) were complaining of pain at the time of presentation, and the lesion was discovered accidently in one patient. The mean operative time was 138.5 min (75–250). At the most recent follow-up, all patients had regained full physical function without pain at the operation site. Conclusion: The aggressive treatment of chondroblastoma by an extended intralesional curettage using high-speed burr with phenol as a local adjuvant seems effective in lowering the incidence of local recurrence and secondary more aggressive surgeries. Implantation of the bone defects that result from curettage with the synthetic bone substitutes is a good alternative due to rapid restoration of the mechanical strength with good remodeling.

BackgroundReconstruction of chronic ruptures of the Achilles tendon poses a great challenge for the orthopaedic surgeon both technically and functionally. The aim of this study was to assess the results of a new technique for reconstruction of chronic Achilles tendon ruptures with defects longer than 5 cm using the triple-loop plantaris tendon autograft wrapped in a central turndown flap from the proximal portion of the Achilles tendon.Patients and methodsEighteen patients (14 female and 4 male; mean age, 40.7 years), having chronic ruptures of the Achilles tendon Myerson type III, were enrolled in this study. The mean follow-up period of our patients was 21.8 months. All patients were assessed via the following parameters: lag of interference since the first complaint, length of the defect, length of the turndown flap and length of the harvested plantaris tendon, surgery time, complications, active range of motion at the ankle and the final score. Average values were presented as means. Independent sample t test, Mann Whitney test, paired sample t test and Pearson’s correlation coefficient were used to evaluate the clinical and functional results. The results were considered statistically significant if a P value was <0.05. To analyse the time course of the gap following surgery, the data from the first MRI session were compared with those from the second and third sessions using the Wilcoxon’s signed rank test. In addition, the paired data of the tendon gap disappearance rate between T1-weighted and T2-weighted images were also compared using the McNemar test.ResultsThe mean preoperative American Orthopaedic Foot and Ankle Society score was 62.2 points while at the patients’ last follow-up, the mean postoperative score was 94.9 points. The results of this study confirmed that both the Achilles tendon healing and tendon gap disappearance have been perceived with higher sensitivity in T2-weighted images than in T1-weighted images.ConclusionsWe believe that this new technique is biologic, synchronous and reliable in cases of chronic Achilles tendon ruptures with defects longer than 5 cm.

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