1.Non-Operative Treatment Versus Steroid Injections in the Management of Unicameral Bone Cysts
WI Faisham ; AH Nawaz ; AM Ezane ; W Zulmi ; S Ibrahim ; AR Abdul Halim
Malaysian Orthopaedic Journal 2011;5(2):11-14
The cases of nine patients with unicameral bone cysts were
reviewed from two orthopaedic centres. In one hospital, five patients received serial steroid injections, and at the other hospital four patients were treated conservatively following fractures. In the steroid injection group, three cases were in
the proximal femur and two in the proximal humerus. The
five steroid injection patients showed radiological evidence of cyst healing within six months of treatment. Subsequently four of the patients showed a satisfactory radiological outcome after a year and complete resolution after 2 years. In the conservative group, all four cases were in the proximal humerus. Persistent cystic lesions were observed in all four patients and two was complicated by another fracture within six months.
2.Early Functional Outcome of Resection and Endoprosthesis Replacement for Primary Tumor around the Knee
AR Sharil ; AH Nawaz ; MZ Nor Azman ; W Zulmi ; WI Faisham
Malaysian Orthopaedic Journal 2013;7(1):30-35
We evaluated functional outcomes for patients who
underwent surgery for resection and endoprosthesis
replacement for primary tumours around the knee. We used
the Musculoskeletal Tumour Society Scoring System
(MSTS) for functional evaluations to compare differences
between distal femur (DF) and proximal tibia (PT)
placements. The study sample included 34 cases of distal
femur and 20 cases of proximal tibia endoprosthesis
replacement. Primary tumours were classified as follows: 33
osteosarcoma, 20 stage III giant cell tumour (GCT) and one
case of mesenchymal chondrosarcoma. The mean MSTS
score for both DF and PT endoprosthesis together was 21.13
(70.43%), and The MSTS scores for DF was 21.94 (73.13%)
and PT was 19.75 (65.83%) Infection developed in 7 cases
and 5 of which were PT endoprosthesis cases. Three deep
infections required early, two-stage revision and resulted in poor MSTS scores. We conclude that endoprosthesis
replacement for primary bone tumours had early good to
excellent functional outcome. There were no differences in
functional outcomes when comparing distal femur
endoprostheses with proximal tibia endoprostheses.
3.Outcome of Surgical Treatment of Pelvic Osteosarcoma: Hospital Universiti Sains Malaysia Experience
MS Ariff ; W Zulmi ; WI Faisham ; MZ Nor Azman ; AH Nawaz
Malaysian Orthopaedic Journal 2013;7(1):56-62
We reviewed the surgical treatment and outcomes of 13
patients with pelvic osteosarcoma treated in our centre in the past decade. The study sample included 9 males and 4
females with a mean age of 28.1 years. Four patients had
ileal lesions, five had acetabulum lesions, one had a
ischiopubis lesion, and three had involvement of the whole
hemipelvis. Seven patients presented with distant metastases at diagnosis. Limb salvage was performed in 6 patients and amputation in 7. In 60% of cases in the limb salvage surgery group, we attempted wide resection with positive microscopic margin compared to only 16.7% in the
amputation group. Local recurrence was higher in the limb
salvage group. Overall survival was 18 months for mean
follow up of 14.8 months. Median survival was 19 months in
the limb salvage group compared to 9 months in amputation
group. The outcome of surgical treatment of pelvic
osteosarcoma remains poor despite advancements in
musculoskeletal oncology treatment.