RESUMEN
Conjoined fracture-dislocation of the elbow were first described by Marotte in 1982. In this study, a total of 41 patients treated between 1975 and 1995 at the Rizzoli Orthopaedic Institute and 4 patients treated between 1997 and 2000 at the Division of Orthopaedics at the Maggiore Hospital are evaluated. Based on the Marotte classification, the patients are divided into 4 groups, by site of dislocation of the radial capitellum and amount of comminution of the fracture of the ulna. A clinical and radiographic evaluation was made after a mean follow-up of 5.3 years based on Anderson criteria. The results obtained were excellent in 17 patients (37.8%) satisfactory in 13 (28.9%), dissatisfactory in 12 (26.7%); 3 patients were considered to be failures (6.7%), the best results were obtained in type I anterior dislocations.
Asunto(s)
Lesiones de Codo , Fracturas Conminutas/complicaciones , Luxaciones Articulares/complicaciones , Fracturas del Cúbito/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Codo/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas , Fracturas Conminutas/diagnóstico por imagen , Fracturas Conminutas/cirugía , Humanos , Luxaciones Articulares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Radiografía , Factores de Tiempo , Resultado del Tratamiento , Fracturas del Cúbito/diagnóstico por imagen , Fracturas del Cúbito/cirugíaRESUMEN
The Marchetti-Vicenzi elastic nail was used in the osteosynthesis of 15 diaphyseal or metadiaphyseal fractures of the humerus, 14 cases achieved consolidation, 1 resulted in nonunion. Surgical approach was always distal, transtricipital and the nail was always locked distally. In the cases that healed, the mean radiographic consolidation time was 90 days. There were no immediate postoperative complications.
Asunto(s)
Fijación Intramedular de Fracturas , Fracturas del Húmero/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Fijación Intramedular de Fracturas/instrumentación , Humanos , Fracturas del Húmero/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Aparatos Ortopédicos , Cuidados Posoperatorios , Radiografía , Factores de TiempoRESUMEN
Nonunion of the proximal femur is a severe pathology, often provoked by the inopportune or improper use of a therapeutic aid: nonsurgical (primary nonunion), surgical (secondary nonunion). Surgical treatment of this nonunion may thus be characterized by different degrees of difficulty, depending on whether or not it is the sequela of surgery or of nonsurgical treatment. In lax nonunion, with atrophy of the segments and regions of necrotic bone interposed, modeling resection is required to correct the functional axes. The condylar blade-plate may be opposed by a cortical graft--to improve stability of the assembly--protecting the medial wall and providing the screws with excellent hold.
Asunto(s)
Fracturas del Fémur/cirugía , Fracturas no Consolidadas/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , SeudoartrosisRESUMEN
A total of 78 cases of aseptic nonunion of the humeral shaft treated at the third division of the Rizzoli Orthopaedic Institute between 1980 and 1997 were evaluated. There was a mean time of 19 months between trauma and definitive treatment. Surgical treatment consisted in osteosynthesis with a plate and bone grafting in 75 cases, and synthesis with screwed bone grafting alone in 3 cases. Consolidation was obtained in 96% of cases. The bone graft used (homo- or autoplastic) encountered complete osteointegration in a maximum time of 8 months. Postoperative motility of the shoulder and elbow were comparable to the preoperative findings.
Asunto(s)
Fracturas no Consolidadas/cirugía , Fracturas del Húmero/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Acetabular fractures are often associated with dislocation of the proximal femoral epiphysis. The dislocation may be of three types, based on the type of fracture to which it is associated: anterior, central, posterior. In anterior and in central dislocation epiphyseal necrosis of the proximal femur has never been observed, while in posterior dislocation necrosis has been observed in 23% of cases. Diagnosis of posterior dislocation is of essential importance so that it may be reduced immediately, decreasing the risk of necrosis. The authors report a review of 192 fractures of the acetabulum to which dislocation of the femoral epiphysis was associated, treated between 1980 and 1996 at the IIIrd Division of the Rizzoli Orthopaedic Institute.
Asunto(s)
Acetábulo/lesiones , Fracturas Óseas/complicaciones , Luxación de la Cadera/etiología , Acetábulo/cirugía , Adulto , Femenino , Fracturas Óseas/cirugía , Luxación de la Cadera/cirugía , Humanos , MasculinoRESUMEN
Fracture of the pelvis is often caused by high-energy trauma, and for this reason it is frequently associated with fractures in other regions, hemorrhages, or severe lesions of the organs. Based on an analysis of the results, obtained by a review of 68 cases of unstable fracture of the pelvis treated at the IIIrd Division of the Rizzoli Orthopaedic Institute between 1980 and 1995, the authors make several suggestions concerning diagnosis and therapy for the evaluation and treatment of these patients.
Asunto(s)
Fracturas Óseas/complicaciones , Huesos Pélvicos/lesiones , Adolescente , Adulto , Anciano , Niño , Femenino , Fracturas Óseas/epidemiología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
There are specific forms of nonunion secondary to per-inter-subtrochanteric fractures that make surgical planning a critical phase. In cases such as these, it may be useful to transform the center of the nonunion into an osteotomy plane. Because of the anatomotopographical features, course and progression of the lesion, cases such as these constitute a pathology that is difficult to define in terms of a therapeutic protocol. The authors report the surgical technique used in 4 cases of nonunion of the proximal metaphysis of the femur.
Asunto(s)
Fracturas no Consolidadas/cirugía , Fracturas de Cadera/cirugía , Osteoartritis de la Cadera/cirugía , Osteotomía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Fracturas no Consolidadas/etiología , Fracturas de Cadera/etiología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Two groups of 24 patients each who had been submitted to osteosynthesis for the treatment of fracture of the acetabulum were evaluated. The first group was submitted to rehabilitation treatment according to the protocol used in the Division of Physiotherapy at the Rizzoli Institute; the second group did not use this protocol. Clinical-radiographic follow-ups were obtained after 1 month, 3 months, 6 months, and 1 year postsurgery. The results of the evaluations carried out showed the usefulness of specific physiokinesitherapy in obtaining more rapid and best possible functional recovery.
Asunto(s)
Acetábulo/lesiones , Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Acetábulo/cirugía , Adolescente , Interpretación Estadística de Datos , Femenino , Fracturas Óseas/epidemiología , Fracturas Óseas/rehabilitación , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The authors present 15 unstable fractures of the wrist treated by external fixation. The fractures were classified based on the AO system, while results were evaluated clinically (Gartland and Werley method modified by Sarmientio) and radiographically. In two cases stabilization with metal wiring was used in addition to external fixation. Results were excellent in 4 cases, good in 9, unsatisfactory in 2 (1 fair, 1 poor). Intraoperative complications included a compound fracture of the second metacarpus, and late complications included a case of algodystrophy.
Asunto(s)
Fijadores Externos , Fracturas Óseas/cirugía , Traumatismos de la Muñeca/cirugía , Anciano , Anciano de 80 o más Años , Femenino , Fracturas Óseas/diagnóstico por imagen , Humanos , Complicaciones Intraoperatorias , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Radiografía , Fracturas del Radio/diagnóstico por imagen , Fracturas del Radio/cirugía , Traumatismos de la Muñeca/diagnóstico por imagenRESUMEN
The authors report the preliminary results they obtained using the Wagner technique for revision of the prosthetic stem by transfemoral access. Between January 1992 and June 1993 a total of 20 patients were treated by reimplantation of the prosthetic stem according to the Wagner technique. At minimum 12-month follow-up, based on the Harris Score System, results were excellent, good and fair in 16 cases. Results were not satisfactory in 4 cases after sinking of the prosthesis exceeding 2 cm or due to mid-distal pain with loading.
Asunto(s)
Cabeza Femoral/cirugía , Prótesis de Cadera , Anciano , Femenino , Cabeza Femoral/diagnóstico por imagen , Estudios de Seguimiento , Prótesis de Cadera/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Falla de Prótesis , Radiografía , Reoperación/métodos , Reoperación/estadística & datos numéricosRESUMEN
The authors report the preliminary results of the surgical treatment of unstable fractures of the pelvic ring. Between 1989 and 1993 a total of 12 unstable fractures were treated by internal fixation. Short-term radiographic and functional results were satisfactory. The authors attribute an essential role to preoperative planning by conventional radiographic assessment and CT scan with multiplanar reconstructions, associated with carefully performed internal osteosynthesis.
Asunto(s)
Fijación Interna de Fracturas , Fracturas Óseas/cirugía , Huesos Pélvicos/lesiones , Adolescente , Adulto , Estudios de Evaluación como Asunto , Femenino , Fracturas Óseas/diagnóstico por imagen , Humanos , Luxaciones Articulares/cirugía , Masculino , Persona de Mediana Edad , Huesos Pélvicos/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
The authors describe a case of traumatic monolateral dislocation of L5 on S1. It is a very rare lesion which involves serious diagnostic and therapeutic problems. Surgical treatment constituted by reduction and stabilization alone can obtain stable correction of the deformity and complete functional recovery.
Asunto(s)
Luxaciones Articulares/diagnóstico por imagen , Vértebras Lumbares/lesiones , Sacro/lesiones , Fracturas de la Columna Vertebral/diagnóstico por imagen , Accidentes de Tránsito , Adulto , Femenino , Humanos , Luxaciones Articulares/cirugía , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugía , Traumatismo Múltiple/diagnóstico por imagen , Traumatismo Múltiple/cirugía , Sacro/diagnóstico por imagen , Sacro/cirugía , Fracturas de la Columna Vertebral/cirugía , Tomografía Computarizada por Rayos XRESUMEN
8 femoral heads removed in 4 patients operated on by bilateral total hip replacement for osteoarthritis were evaluated. 3 patients were treated with Calcitonin between the first and the second operation. X-ray powder diffractometry analysis showed an improvement of bone crystallinity in the Calcitonin treated patients.
Asunto(s)
Calcitonina/farmacología , Fosfatos de Calcio/análisis , Cabeza Femoral/efectos de los fármacos , Hidroxiapatitas/análisis , Osteoartritis/metabolismo , Calcitonina/uso terapéutico , Calcio/farmacología , Calcio/uso terapéutico , Durapatita , Cabeza Femoral/química , Cabeza Femoral/patología , Prótesis de Cadera , Humanos , Microscopía Electrónica de Rastreo , Osteoartritis/tratamiento farmacológico , Osteoartritis/patología , Osteoartritis/cirugía , Vitamina D/farmacología , Vitamina D/uso terapéutico , Difracción de Rayos XRESUMEN
Authors performed SEM and EDS analyses in a cemented removed knee prosthesis demonstrating the average values of mineral elements in the bone surrounding the prosthesis. The composition of the metallic prosthesis surface in different microareas was also studied.