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PubMed1979

Subungual exostoses.

From 1910 through 1975, forty-four patients with subungual exostoses were seen at the Mayo Clinic. Thirty-four of them had the exostosis on the great toe. Forty-three of the patients were treated by local excision and one was treated by amputation of the hallux. Five patients had local recurrence. None of the tumors underwent malignant change. Histologically, the tumors consisted of a proliferating fibrocartilaginous gap that merged into mature trabecular bone at its base. The growth in the cap was so active that is sometimes mimicked sarcoma, but no true anaplasia was seen. The subungual exostoses were uniformly benign, and local excision was the treatment of choice.

Adolescent↗

PubMedDate not supplied

Essay on total knee arthroplasty.

Patient selection in total knee arthroplasty can be a difficult problem for the surgeon. It appears that more young patients are appearing with advanced arthritis of the knee than in the past. Many patients have had previous knee injuries resulting in premature development of degenerative arthritis. The authors believe that in selected cases total knee arthroplasty may be offered to younger patients. Young patients incapacitated by rheumatoid or inflammatory arthritis should not be denied reconstruction by total knee arthroplasty. The problem arises in the more active patient in his forties or fifties who has advanced arthritis of the knee not suitable for treatment by other means. The authors believe that these patients should not be treated by conventional total knee arthroplasty. On an experimental basis, the authors have been performing cementless total knee arthroplasty in younger, more active patients with disabling arthritis. Precision of surgical technique is critical with the newer cementless type of knee replacement.

Adult↗