Search

BACKGROUND : The histological response to chemotherapy is regarded as an independent prognostic variable in bone tumours. The surgical pathologist, thus has an important role in the management of primary malignant bone tumors like osteosarcomas and Ewing′s sarcoma subsequent to neoadjuvant chemotherapy. AIMS AND OBJECTIVES: We report a short series of fifteen cases of osteosarcoma and three cases of Ewing′s sarcoma in which the histological response of the tumor after giving neoadjuvant chemotherapy to the patient of bone tumours was assessed and graded. MATERIAL AND METHODS: Bone tumours was assessed and graded by Huvos grading. The correlation of this histopathologic tumor response with clinical outcome is a well-established routine investigation in patients with bone sarcomas and the grading of the tumor response is based on definable histopathologic criteria. RESULT: Fifteen out of eighteen cases in this study showed a response to neoadjuvant chemotherapy, which was categorized as Huvos Grade 1 (%50%) and Huvos Grade 2 (50% to 90%). One case of osteosarcoma showed a Grade 4 response with a total absence of tumor cells in all the sections. One case of osteosarcoma and Ewing′s sarcoma each were categorized as Grade 3, showing tumor foci. CONCLUSION: It was concluded that necrosis of tumor area when greater than 90%, is regarded as a powerful positive prognostic indicator for survival in patients of high grade bone sarcomas. [ABSTRACT FROM AUTHOR]

Introduction: Orthopaedic surgeons are among the most frequent users of radiation and are often exposed to X-Ray radiation regularly. There is an overall unsatisfactory level of knowledge, attitude, and practices regarding the same among surgeons. This study aimed to assess the practices among orthopaedic surgeons regarding radiation and its hazards in India., Methodology: This questionnaire-based survey was conducted between March and September 2022. The questionnaire broadly assessed the knowledge, awareness, and practices among orthopaedic surgeons regularly exposed to X-ray radiation. The questionnaire consisted of objective and Likert scale questions which were distributed to the respondents electronically using publicly available contact information. A qualitative review of interpretations obtained from the responses and available evidence in the literature was then performed., Results: The response rate for the survey was 36.4%. 65.9% reported using trunk protection all the time during procedures. 57.1% of respondents reported not using thyroid protection during procedures. 92.3% reported not using protective goggles and 100% did not use appropriate gloves. 76.9% were not issued dosimeters, and only 5.5% of those who had been issued one wore it during radiation procedures. 58.2% reported having a dedicated employee to operate the machine. 86.8% of respondents did not have formal training and 81.3% were not aware of institutes offering formal training., Conclusion: There is very high compliance with the use of protection aprons among the respondents however, the use of other apparel like thyroid shields, protection goggles and gloves was poor. The awareness regarding radiation exposure was also poor as most respondents were not issued dosimeters, however, those issued with one were well aware of their exposure. It is imperative to prioritize both surgeons' and patients' safety where radiation exposure is concerned., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Indian Orthopaedics Association 2023, corrected publication 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Closed degloving skin lesions of the limbs are uncommon, and diagnosis may be missed at the time of acute trauma. Usually, they are associated with pelvic fractures but may occur in absence of any bony injury. When this closed internal degloving occurs over the greater trochanter, it is known as a Morel-Lavallee lesion. We report a case of unusually delayed presentation of Morel-Lavallee lesion treated successfully by debridement, packing, and delayed closure.