1,721,010 research outputs found
Parafocal osteotomy and Ilizarov method in the treatment of femoral pseudarthrosis. Case report
No full textThe case presented is that of a man aged 54 years,with hypertrophic pseudarthrosis shortening by 3 cm and a femoral mechanical axis measuring 13 degrees varus. Parafocal osteotomy according to Paltrinieri was carried out with the aim of correcting the varus femur, the shortening and,secondarily, of obtaining recovery from the pseudarthrosis. Osteosynthesis was achieved by the Ilizarov apparatus. Axial correction and lengthening were obtained after 33 days. The fixator was removed after 5 months and 10 days, during wich the nonunion appeared healed
Sindrome del Tunnel carpale e algodistrofia. Giornale Italiano di Ortopedia e Traumatologia, 2008; 34:
No full textWe report a case of algodystrophie after a operation for a carpal tunnel syndrome. The patient was reoperated with hypothenar fat flap for median nerve coverage. The result was a complete functional impotence of the han
Comparison of percutaneous intramedullary Kirschner wire and interfragmentary screw fixation of displaced extra-articular metacarpal fractures.
No full textBackground and aim of the work: the management of the displaced extra-articular metacarpal fractures is still a subject of debate in the literature. The purposes of this study were to report the outcomes of unstable extra-articular metacarpal fractures treated by using intramedullary Kirschner wires or inter-fragmentary screws and to determinate which techniques provide better clinical and radiographic results. Methods: we retrospectively reviewed a series of 49 consecutive patients operated for 53 closed, unstable metacarpal fractures. The fractures were divided into two groups, according to the fixation method used: the percutaneous intramedullary K-wire fixation group and the interfragmentary screw fixation group. The injuries were classified on the basis of fracture level and type. Assessment of patients was carried out according to the Mayo Wrist and Dash Scoring systems. Finally, radiographic and clinical outcomes of both groups were assessed and compared. Results: there were no significant differences between the two groups related to follow-up, hospitalization days, operating time, and Mayo Wrist and Dash Scores. Bone union was achieved within 6 weeks in all patients. Nine cases of malunion were found, with a mean angular deformity of 8.33° (range, 5°-15°), of which 8 were patients treated with K-wires (mean 8.125°) and 1 with screws (10°). Conclusion: our results indicate that both procedures are effective in the treatment of displaced extra-articular metacarpal fractures. However, we believe K-wires represent the gold standard of treatment for displaced fractures of the metacarpal neck. Instead, screws are more effective for spiroid shaft fractures, while displaced fractures of the base may be treated with either screws or wires
La sostituzione protesica nelle fratture prossimali d'omero nell'anziano.
No full textVengono presentati i risultati ottenuti in 50 fratture prossimali di omero trattate con sostituzione protesica (33 protesi parziali e 17 protesi totali), in pazienti anziani (età media 78 anni). I controlli sono stati eseguiti con il Constant score. I risultati si possono considerare buoni con entrambe le protesi per quanto concerne il dolore. Sono migliori i risultati nel recupero dell’articolarità con le protesi totali
Aseptic nonunion and delay in consolidation in the tibia: treatment by intramedullary nailing and using the Ilizarov method
No full textThe authors present a clinical-radiographic study on two groups of patients affected with aseptic nonunion and delays in consolidation of the tibia treated by intramedullary nailing (24 cases) and Ilizarov method (29 cases). Nailing was locked in 12 cases and associated with resection of the fibula in 15 (in 8 locked nailing). Autoplastic bone grafts were applied in 3 cases of atrophic nonunion. The Ilizarov method was used with different procedures: standard assembly in 23 patients, of whic 6 with application of autoplastic grafts for atrophic nonunion. En bloc resection of the atrophic nonunion was carried out in 6 patients followed by removal (4 cases) or lengthening (2 cases). Parafocal osteotomy according to Paltrinieri was reserved for closed hypertrophic nonunion with severe varus and procurvatum. The data for this study allow the authors to conclude that intramedullary nailing is preferable in delays in consolidation and in hypertrophic nonunion without angular defects or hypometria, while the Ilizarov method is more indicated in atrophic nonunion with hypometria and angular defect
La metodica di Ilizarov nel trattamento delle neoplasie maligne di tibia
Full text linkA total of 3 malignant neoplasms of the tibia are presented: 1 is a mesenchymal chondrosarcoma of the tibial pylon (male aged 14 years), and 2 are cases of squamous skin carcinoma of the leg with tibial infiltration (1 male and 1 female aged 32 and 64 years, respectively). The resections carried out (16.5 cm on the average) were treated by bone transport. Simple transport was used in the first patient, double in the other two. At the end of transport a second surgical stage involving astragalotibial arthrodesis was performed in the first case, and revision of the junction site of bone segments transported with application of autoplastic bone grafts was performed in the other two. The regenerate obtained was slowly corticalized in the first patient, submitted to various cycles of chemotherapy during the course of distraction. In the other two cases, which were not treated by chemotherapy during distraction, corticalization occurred over a shorter amount of time. Follow-up was obtained after 10 years in the first case, and after 2 years in the other 2 patients. There was no long-term recurrence
PLATING IN DIAPHYSEAL FRACTURES OF THE FOREARM
No full textBackground and aim of the work: Currently, open reduction and internal plate-screw fixation is generally accepted as the gold standard treatment of diaphyseal forearm fractures. The purpose of this retrospective study was to evaluate the clinical and radiographic outcomes of open reduction and internal fixation by using the Locking Compression Plate (LCP) implant system of radial, ulnar or combined shaft fractures of a skeletally mature patients group treated at our institution.
Methods: We examined 47 patients, 44 men and 3 women, mean age 35 years (range 14–74) operated for diaphyseal fractures of the forearm. Overall 64 segments were treated: 32 ulnar and 32 radial. All patients received 3.5-mm titanium LCPs (Locking Compression Plates) with “combi-holes”. Follow-ups included standard X-rays and clinical assessment according to Anderson's criteria and the DASH questionnaire.
Results: Mean follow-up was 11 months (range 6-39). The number of the patients who achieved complete consolidation was 43 with a union rate of 91.5%. They showed 37 excellent results and 6 satisfactory results according to Anderson criteria, while non-union occurred in 4 out of 64 segments (2 ulnar and 2 radial) with a non-union rate per patient of 8,5%. The mean score of the DASH scale was 13.5 (range 0-46.7).
Conclusions: Our data show that internal plating gives good functional outcomes in the treatment of forearm diaphyseal fractures, as long as the surgical technique is perfect and carried out by expert surgeons. However, further research is desirable to better identify fracture types for which LCPs should be used
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