This study aims to investigate whether tadalafil accelerates fracture healing with an efficiency equal to that of sildenafil. Fracture healing was studied using a rat closed femur fracture model. Forty-eight male Wistar albino rats (mean age 13 weeks; range 12 to 14 weeks) were divided into three groups: 16 received sildenafil (5 mg/kg/day per oral), 16 received tadalafil (1 mg/kg/day per oral), and 16 (control group) received saline daily. After two and five weeks, eight rats from each group were euthanized and bone healing was evaluated using radiographic, histologic, and histomorphometric analyses. At second week, radiologic score of tadalafil group was higher than the sildenafil treated groups and the sildenafil and tadalafil groups both had higher radiographic scores than the control group, all groups had similar scores at fifth week. The sildenafil and tadalafil treated group exhibited smaller callus diameter at the second week comparing to control group but the difference was not statistically significant, while callus diameter was significantly smaller in tadalafil group when compared to the control group in fifth week. Compared with the control group, cartilage percentage of the callus was lower in the sildenafil group at two weeks and lower in both the tadalafil and sildenafil groups at five weeks. There were no differences between the tadalafil and sildenafil groups regarding the radiographic scores, callus size, cartilage and osseous callus percentage, and the qualitative bridging scores at second or fifth week. This study demonstrated that tadalafil accelerates fracture healing by enhancing osseous tissue formation similar to sildenafil.

Joint Diseases and Related Surgery (JDRS), the official journal of the Turkish Joint Diseases Foundation, is an international, peer-reviewed, immediate open access journal. All published articles in JDRS has been free for everyone, without embargo, since 1990.

Renal cell carcinomas (RCCs) commonly cause metastases to the lung, liver, bone and brain but rarely to the skeletal muscles. We describe solitary large masses located in the gluteus maximus and medius muscles in two patients who had a history of RCC treated with nephrectomy. Metastatic RCC must be distinguished from benign primary soft tissue tumors because it requires aggressive surgical resection. An open incisional biopsy revealed RCC metastasis. Both patients underwent complete resection of the large mass with additional local radiotherapy and immunochemotherapy. This incalculable course of RCC suggests the need to perform a thorough postoperative follow-up of such patients.

Objective: The purpose of this study was to evaluate symptomatic bone metastases from urological malignancies and the efficacy of surgical treatment of bone metastases in achieving local tumor control. Methods: This was a retrospective observational study of patients diagnosed with bone metastases from urological malignancies who died from their diseases between 2002 and 2013. Data on clinicopathology, number and sites of bone metastasis, time to first and subsequent metastasis, survival after metastasis, nature of metastasis (blastic, mixed, lytic), type of surgical reconstruction, systemic affections, and visceral organ metastasis for 70 bone metastases from deceased urological malignancies patients (55 male, 15 female) with evidence of bone metastasis were statistically analyzed. Results: Forty-three patients (61.42%) had renal cell carcinoma (RCC), 15 patients (21.43%) had prostate cancer, and 12 patients (17.15%) had bladder carcinoma as primary diagnosis. Osteolytic lesions were most prevalent (n=61; 87%). The most common surgical modality for extremities was wide resection with prosthetic replacement (42 patients), followed by wide resection or wide resection with bone cement application with internal fixation (21 patients); 65 patients were treated with limb salvage procedures, and 2 patients were treated with amputation. Overall median survival was 13 months for RCC, 16 months for prostate carcinoma, and 11 months for bladder carcinoma patients. Conclusion: Detection of bone metastases in patients with urological malignancies influences the treatment strategy. Diagnosis of bone metastases may be delayed in urologic malignities; thus, these patients receive long-term clinical follow-up. DOI: 10.3944/AOTT.2015.14.0340 Özet Amaç: Bu çalışmanın amacı ürolojik malignitelere bağlı semptomatik kemik metastazlarının cerrahi tedavisinin etkinliğini ve lokal kontrol elde edilebilirliğini değerlendirmektir.Çalışma planı: Bu çalışma 2002 ve 2013 yılları arasında ürolojik maliğniteye bağlı kemik metastazlarından ölen hastaların incelendiği retrospektif gözlemsel bir çalışmadır. Ürolojik malignitelere bağlı kaybedilen kemik metastazlı 70 hastanın (55 erkek, 15 bayan) kemik metastazlarının yeri ve sayısı, klinik ve histopatolojik özellikleri, ilk ve ardışık metastazlarının zamanı, metastaz sonrası yaşam süreleri, metastaz natürü (blastik, miks, litik), cerrahi rekonstrüksiyon tipi, sistemik etkileri ve iç organ metastaz durumu istatistiksel olarak analiz edildi.Bulgular: Primer tanılar 43 hastada (%61.42) böbrek hücreli karsinom, 15 hastada (%21.43) prostat karsinom, 12 hastada (17.15) mesane karsinomu idi. Osteolitik lezyonlar daha sık saptandı (n=61 %87). En yaygın uygulanan cerrahi tedavi sırasıyla ekstremitelerde geniş rezeksiyon ile prostetik replasman; geniş rezeksiyon ile ve/veya kemik çimento uygulamaları ile internal fiksasyondu (n=21). 65 hastaya ekstremite koruyucu prosedürler uygulanırken 2 hasta ampute edildi. Ortalama yaşam beklentisi böbrek hücreli karsinom hastalarında 13 ay, prostat karsinomlu hastalarda 16 ay, mesane karsinomlu hastada 11 ay olarak saptandı.Çıkarımlar: Ürolojik maligniteli hastalarda kemik metastazlarının varlığı, primer malignitenin tedavi planını değiştirmektedir. Ürolojik maligniteli hastalarda kemik metastazları geç tanı alabilmektedir. Bu hastaların metastaz açısından uzun yıllar takibi gerekmektedir

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare low-grade, malignant soft tissue tumor that is usually observed in the extremities of adult patients. Magnetic resonance imaging findings for this tumor type have rarely been reported. We report a case involving the distal left femur of a middle-aged man and tumoral invasion of the bone, which, to our knowledge, has been previously described only once. He was treated with distal femoral tumor resection and reconstruction with a modular prosthesis. Histopathologic diagnosis confirmed MIFS. We reviewed literature of the diagnostic imaging and bone invasion findings associated with this tumor type.