1,721,003 research outputs found
Congenital elevation of the scapula (A review of 69 cases)
No full textThe author have reviewed sixty nine cases of congenital elevation of scapula on whom scapuloplexy was performed. The degree of elevation was classified according to Rigault's criteria (1976). This operation gave excellent or good results in 68 per cent of cases, the improvement being slightly better from the aesthetic than from the functional point of view. The factors adversely influencing the results were: the degree of elevation, scoliosis, "pagoda" deformity, and insufficient surgical lowering. Osteotomy of the clavicle is necessary in the presence of neurological complications. In cases with scoliosis or "pagoda" deformity of the scapula it is desirable also to resect the supero-medial angle. The operation should be carried out before the patient reaches the age of ten years
Results of surgical treatment of idiopathic pes planovalgus by means of Grice's operation combined with reconstruction of the glenoid (accessory plantar) ligament and anterior transposition of tibialis posterior.
No full textAfter an average follow up of six years, the writers reviewed the results of ninety operations for idiopathic flat foot treated by Grice's operation combined with reconstruction of the glenoid ligament and anterior transposition of the tibialis posterior. Eleven parameters (clinical, plantographic and radiographic) were used for objective assessment of the initial and residual deformity, a numerical code being given to each. The results were excellent or good in 88 per cent of the patients. The initial severity of the condition and the presence of ligamentous laxity either generalised or localised to the ankle joint, had an adverse effect on the results. The technique of Grice's operation is extremely important. The results are always excellent or good when the sinus tarsi is widely opened up and the bone graft correctly placed. Anterior transposition of the tibialis posterior improved the results in 26 per cent of cases: elongation of the Achilles tendon was only rarely necessary. The type of graft had no effect on the results: homoplastic grafts are therefore preferable since they cause less inconvenience. Surgical intervention before the age of four years is a mistake: the best results are obtained between nine and thirteen years
Trattamento chirurgico delle agenesie lombo-sacro-coccigee
No full textVertebro-pelvic instability and deformities of the lower limbs are the main therapeutic problems in lumbo-sacral agenesis. The first of these can be solved conservatively with the aid of an orthopaedic corset; patients treated in this way have never reported visceral compression disturbances. In regard to the deformities of the lower limbs it is possible and preferable to perform corrective surgery rather than amputation. However, this is complicated by the possibility of ischaemic attacks as a result of stretching of the neurovascular bundle. Surgical treatment should be commenced at an early stage and be performed in the following order: knees, hips, feet. If the deformity is not long-established, extension of the knees can be achieved by simple posterior capsulotomy and tenotomy of the flexors followed by slow, gradual trans-skeletal traction applied over a period of approximately one month. Relapses, however, must be treated by double osteotomy (supracondylar of the femur and metaphyseal of the tibia) with removal of anterior wedges. Flexion relapses of the knees are common and require further surgery. Correction of the hip deformities is easy and we have never observed relapses of this deformity. When the deformities have been corrected and static function restored to the lower limbs, the patients can walk with elbow crutches and orthopaedic calipers by oscillating the trun
Risultati nel trattamento chirurgico del piede piatto valgo essenziale mediante intervento di Grice, plastica del legamento glenoideo e anteposizione del tibiale posteriore (90 osservazioni).
No full textRisultati nel trattamento chirurgico del piede piatto valgo essenziale mediante intervento di Grice, plastica del legamento glenoideo e anteposizione del tibiale posteriore (90 osservazioni
L'allungamento dell'ulna e del radio nelle ipoplasie asimmetriche dell'avambraccio (presentazione di 7 casi)
No full textSi presentano sei casi di allungamento dell’ulna e uno di allungamento del radio nell’ipoplasia dell’avanbraccio. Si descrivono la tecnica chirurgica e i risultati ottenuti da uno a tre anni dopo l’operazione
Osteogenesis imperfecta: results obtained with the Sofield method of surgical treatment
No full textThe authors report the results obtained in thirteen patients with osteogenesis imperfecta who were treated by the Sofield operation. This operation is indicated both in the congenital and delayed forms of the disease. The results are promising: prevention of deformities and fractures in a high percentage of cases, recovery of the ability to walk in all the patients. The incidence of complications was low, infection being the most serious. Although the use of extending rods reduces the number of reinterventions, it does not appear to improve the results and carries the risk of a greater number of complications. However, the authors have no experience of this particular technique
Long term results of centralising intertrochanteric osteotomy in Legg Calve Perthes disease. (Report on 60 cases)
No full textThe writers propose a new classification of Legg-Calvé-Perthes' disease into three degrees of increasing gravity. Grade 1 includes hips with minimal or no flattening of the epiphysis, normal relations between the head of the femur and the acetabulum, and a normally orientated epiphyseal cartilage. Grade 2 comprises hips with slight epiphyseal flattening (one third or less), the epiphyseal growth cartilage is horizontal, the femoral head is partly uncovered due to epiphyseal subluxation, but becomes normal in the abduction test. Grade 3 hips show severe epiphyseal flattening (more than one third), the epiphyseal growth cartilage is horizontal, and the epiphyseal subluxation persists even in the abduction test. In our opinion, the advantage of this classification, which is not dependent on a determination of the extent of the necrosis, is that it is less subjective, and can be applied more easily and immediately, as compared with Catterall's classification. The results in sixty cases of intertrochanteric centralising osteotomy were constantly satisfactory in grades 1 and 2, but unsatisfactory in grade 3. The writers consider that surgical intervention is unnecessary in patients with hips in grade 1, while femoral osteotomy is contra-indicated in grade 3 cases. In the latter event, surgical intervention, if considered necessary, should be a pelvic osteotomy or cheiloplasty of the femoral epiphysis. Centralising osteotomy is the operation of choice in patients of grade 2. The results were better in patients who were less than six years of age at the time of operation
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