Archivio "Putti" di chirurgia degli organi di movimento最新文献

The authors report a case of massive osteolysis of the right shoulder in a woman aged 53 years, characterised by progressive evolution with spontaneous arrest 8 months after onset. The diagnosis of Ghoram's syndrome was based on a histologic examination revealing evident vascular neoformation, radiographic and clinical evolution.

At the Orthopaedic Clinic of the University of Perugia from 1973 to 1984, 28 fractures of the neck of the radius were treated with open reduction in children aged between 4 and 15. Follow-up evaluation showed a high percentage of poor results (33.3%) frequently associated with a deficit of pronation and supination. Clinical results were related both to the severity of the displacement and to the radiographic results at follow-up. Open reduction is essential in highly displaced fractures, but it can be avoided in those with minor displacement.

The author reports his experience with arthroscopy under local anesthesia for the diagnosis of affections of the knee. He emphasises the criteria that must be used to guide the surgeon in his choice, illustrates the method commonly used, and reports the positive results obtained in a group of patients. The author concludes by suggesting that arthroscopy under local anesthesia for joint pathology of the knee is a safe and indispensable method to be used by knee surgeons.

The recent studies, related in medical literature, indicate a reduced activity of fibrinolysis in patients with low back-pain caused by multiple factors (lumbar disc disease, post-laminectomy, post myelography) and suggest a new pathogenetic hypothesis of this disease and new therapeutic implications. The authors conducted a research based on the study of fibrinolysis in patients affected by post-surgical lumbar adhesive syndrome, with the aim of finding, eventually, a relationship between reduced fibrinolytic activity and clinical symptoms. The results are referred and discussed.

With reference to 21 cases the authors describe the clinical, radiological and anatomo-pathological findings of multiple exostoses disease. The indications for the surgical treatment are discussed; they are, however, the same to the solitary osteochondroma.

Examination of the infant hip with real time ultrasonography is spreading and affirming in these last years. It allows accurate and reliable investigation of the anatomic structures which are not visualized on a radiograph, so that it appears of great interest in the early screening of congenital dislocation of the hip (CDH). In this paper, the authors examine and discuss some particular features of the sonograms which are usually employed for the investigation of neonatal hips, attempting to dissolve some doubts and perplexities which commonly come out in the first approach to a new diagnostic image technique. The systematic examination of infant hips with real time ultrasonography promises a decisive improvement in the problem of the early diagnosis of CDH.

Drepanocytosis is a hereditary hemoglobinopathy which is particularly common in Blacks; in its homozygote form there is constant general involvement of the osteoarticular system with clearly recognisable clinical and radiographic pictures. Microdrepanocytosis (double heterozygotosis) is instead more difficult to recognise. Based on their observations the authors report several specific aspects of the disease of orthopaedic interest.

Between May 1981 and May 1987, 250 isoelastic hip prostheses were implanted. The first 180 (from May '81 till May '86) were called for a visit. 130 (72%) came and were assessed with a minimum review time of 1 year. We ignore the reasons for which 28% of the patients did not turn up (death or others). 81% of the patients had good or very good results after surgery. Three patients developed infections (2.3%); none of these was revised. Four developed loosening of the femoral component; two of these underwent revision surgery and are doing well now. We did not notice any loosening of the acetabular component. The recommended period of gait support was of 2 months of no weight bearing with two canes and of two months of partial weight bearing with one cane. No component had broken. We had 1 femoral fracture incurred during surgery which healed with routine management. These early results are very encouraging, but the effectiveness of this prosthesis will require longer follow-up data to be confirmed.

On the basis of material taken from Padua's Institute of Clinical Orthopedics (25 operations performed according to the Papineau method between 1980 and 1986), the authors give particular attention to some little-known histological facts: a) about granulation tissue, and b) about cancellous tissue nestled in the infection sites in bone.