ABSTRACT
The results obtained in the surgical treatment of massive lesions of the rotator cuff are quite often inferior to what is expected, because prognosis is not respected. To demonstrate that the quality of the results obtained is directly proportional to the preoperative prognostic factors a retrospective study was conducted on 28 patients submitted to massive lesion repair of the rotator cuff between 1990 and 1996; the criteria of inclusion was: a) patients aged under 65 years; b) preoperative radiographic findings with acromiohumeral distance not less than 6 mm; c) degeneration of the tendons not greater than a Goutallier stage 2; d) absence of inveterate pseudoparalysis of the limb involved; e) absence of anterosuperior subdislocation of the humeral head. The results obtained with a mean follow-up of 5 years revealed a mean Constant score of 85 points (minimum 79, maximum 91) that may correspond to excellent results, showing how this type of surgery may guarantee good results only when factors of prognosis are respected preoperatively.
Subject(s)
Rotator Cuff Injuries , Rotator Cuff/surgery , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , RuptureABSTRACT
The authors review 30 patients with congenital club foot (CCF) who were treated surgically by a slightly modified Codivilla technique. Clinical morphologic, and functional follow-up was performed an average of 10 years later, and the findings were compared to the radiographic features. The final outcome was rated good in 41% of the cases, fair in 29%, and unsatisfactory in 30%. The authors found a close correlation between the grade of the initial deformity and the final outcome. Some sign of the deformity always remained, even when the functional outcome was excellent.
Subject(s)
Clubfoot/surgery , Child, Preschool , Clubfoot/diagnostic imaging , Female , Follow-Up Studies , Humans , Infant , Male , Radiography , Treatment OutcomeABSTRACT
An 8 year old child was involved in a road accident and sustained a large wound in the left groin; radiographs showed a fracture with loss of the proximal femur. After skeletal traction for 80 days, there was bony regeneration of the proximal femur. At 8 months she was able to walk without support and her left leg was 2 cm only shorter than the right.
Subject(s)
Bone Regeneration , Femoral Fractures/physiopathology , Fractures, Open/physiopathology , Tibial Fractures/therapy , Child , Female , Femoral Fractures/diagnostic imaging , Femoral Fractures/therapy , Humans , Radiography , TractionABSTRACT
The authors report a case of an intraneural ganglion of the peroneal nerve. The cystic material was found to expand the neural sheath, while the neural fasciculi were few and atrophic. A communication between the intraneural cyst and the proximal tibio-peroneal joint was demonstrated. An hypothesis for the pathogenetic basis of intraneural ganglia is presented.
Subject(s)
Popliteal Cyst/pathology , Synovial Cyst/pathology , Child , Humans , Male , Popliteal Cyst/surgeryABSTRACT
A case of severe non-lethal Osteogenesis imperfecta was studied. The patient's cultured skin fibroblasts synthesised a mixed population of type I collagen chains some of which showed abnormal behaviour on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Further analysis revealed that two types of alpha 1(I) chains were synthesised, both an abnormal, slower migrating and a normal species. A small defect in one allele of one of the type I procollagen chains could lead to the larger size of the abnormal chains, probably caused by overmodifications of the triple helical region. CNBr peptide mapping allowed us to localise the defect midway along the triple helix: the defect site could be assigned to the region between the alpha 1(I)CB-3 and CB-7 peptides. The abnormal alpha 1(I) chains synthesised by the patient's cells had a melting temperature which was about 2 degrees C lower than normal chains. The results appear to be in agreement with the defect localisation and the phenotype.
