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Fractures of the carpal bones other than lunate and navicular.

Injuries to the carpals and their ligaments are difficult to diagnose unless one utilizes special X-ray techniques based upon a careful history of the injury and examination for tender points and painful joints. Use of only standard X-rays and cursory examinations caused many injuries to be missed in earlier years. Many fractures resolve with simple splinting or casting, but many do not, and late sequelae are now being diagnosed more commonly than in the past. Localization of pathologic conditions by diagnostic injections of local anesthesia or arthrography (or both) is very helpful. Salvage may require excision of fragments, exostoses, reconstruction of ligaments, or local arthrodesis.

Adult↗

[The scapula: rare localization of osteochondroma].

The authors demonstrate their 6 cases of scapular exostoses which were operated on between 1973 and 1993 at the Orthopaedic Department of the Medical University of Pécs. Results of the surgery with a mean five year follow up are discussed, and the literature data of incidence, diagnosis and treatment are reviewed. With resection of the osteochondroma good results were achieved in all of the cases.

Adolescent↗

BMP-1 sublocalization on human chromosome 8. Molecular anatomy and orthopaedic implications.

Bone morphogenetic proteins are capable of inducing mesenchymal tissue to form mature bone. Bone morphogenetic protein 1 (BMP-1) has a structure unique from the other bone morphogenetic proteins and may be involved in activation of other bone morphogenetic proteins. Localization of the human BMP-1 gene to chromosome 8 led to its consideration as a candidate gene for Langer-Giedion syndrome. Individuals with Langer-Giedion syndrome (also known as trichorhinophalangeal syndrome Type II) exhibit several skeletal abnormalities, including multiple exostoses and cone-shaped epiphyses of the hands and feet. The genetic locus responsible for this disease has been localized to the long arm of human chromosome 8 at 8q24.1. Somatic-cell hybrid and molecular biology techniques were used to sublocalize the BMP-1 gene to the short arm of chromosome 8 within the 8p22-cen region. Although this locus falls outside the Langer-Giedion syndrome region, and therefore excludes BMP-1 as a candidate gene for this disorder, BMP-1 gene sublocalization establishes a chromosomal landmark for evaluating other possible disease associations with BMP-1.

Animals↗

[Lengthening, axial correction and segmental reconstruction of the extremities using the distraction method].

Between 1988 and 1992 lengthenings axial, corrections and reconstructions have been performed by distraction on lower arms, upper and lower legs in 25 patients because of deviations in length due to either congenital or acquired (multiple cartilaginous exostoses, posttraumatic conditions, congenital pseudarthrosis deformations or defects (fibula-defect, amnion-band-complex, amputation). On the average elongation amounted to 4 cm for an average installation time of the fixator system of 22 weeks and a mean duration of 25 weeks for the adaptation to full strength. Problems arose in the form of soft tissue infections at the rod perforation sites, the necessity for secondary interventions because of early fractures and for corrections of the fixator respectively. Complications compromising the expected goal of treatment did not occur. Consideration of the biological principle of distraction is essential whereas the type of fixator-system is of only minor importance.

Adolescent↗

Differential diagnosis of pedal osseous neoplasms.

Topics discussed in this article include osteogenic sarcoma, osteoid osteoma, osteoblastoma, chondrosarcoma, chondromyxoid fibroma, chondroblastoma, chondroma, Ollier's disease, Maffucci's syndrome, osteochondroma, hereditary multiple exostoses, unicameral bone cyst, fibrous dysplasia, Albright's syndrome, nonossifying fibroma, giant cell tumor, Ewing's sarcoma, and metastasis. Numerous radiographs, CT scans, MR images, arteriograms, and photomicrographs supplement the text.

Bone Neoplasms↗

Pes anserinus syndrome due to solitary tibial spurs and osteochondromas.

We studied 19 children with the pes anserinus syndrome due to proximal tibial exostoses. Nine children had a solitary sessile or pedunculated osteochondroma that produced a painful lump that was readily palpable. The symptoms resolved following removal of the osteochondroma. Ten children had a bone spur that was shaped like a rose thorn. It produced pain with snapping or a feeling of locking of the pes anserinus tendons. Careful palpation was required to detect the tender bone spur beneath the pes anserinus. In five children, the bone spurs were excised because of persistent symptoms, and each was shown to be an exostosis without a cartilage cap. The symptoms resolved. However, the bone spurs need not be excised if the symptoms improve with rest and do not recur following resumption of activities.

Adolescent↗

[Cartilaginous tumors of the skeleton].

Chondrogenic tumors of the skeleton are divided into 6 separate groups: 1. chondroblastomas 2. chondromyxoidfibromas, 3. osteochondromas (cartilaginous exostoses), 4. enchondromas, 5. periostal chondromas, and 6. chondrosarcomas. The presentation of the different types of tumors demonstrates the pathogenesis, pathology, clinical findings, treatment, and prognosis. States of tumors before and after operative treatment are illustrated.

Aged↗

[Exostosis].

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Bone Neoplasms↗