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Biomedical subjects

A Andrisano

Publications and source records attributed to A Andrisano.

At least 19 recordsLinked to original sources
PubMed1990

The correction of valgus knee by temporary epiphyseal stapling.

Unilateral temporary epiphysiodesis with Blount staples is a surgical method used to gradually correct axial deviations of the knee, slowing down the growth of one side of the conjugate cartilage. The authors analyse the results obtained with this method in the treatment of infantile valgus knee, in an attempt to determine an average monthly value of angular correction, based on which it is possible to plan the best time to perform this type of surgery. They affirm the effectiveness of the procedure, the success of which nonetheless appears to be related to the correct choice of the site of application and the number of staples used.

Adolescent↗
PubMed1990

The Steindler method in the treatment of paralytic elbow flexion.

Based on an average follow-up of 8.6 years, the authors analyse the functional results obtained in 16 patients submitted to Steindler flexoroplasty of the elbow between 1975 and 1986. The absence of active flexion of the elbow produces a severe deficit in the upper limb even when there is good function of the shoulder and hand. Since 1921, the year in which Steindler published a report on his surgical method, numerous surgical methods have been described for the treatment of paralytic elbow. Clark (1946), Merle d'Aubigné et al. (1956), Brook and Sendon (1959) propose transposing pectoralis major by suturing it to the tendon of the biceps muscle. Le Coeur (1953) instead isolates pectoralis minor and then transposes it on the biceps tendon. Bunnel (1951) describes two methods: the first consists in isolating the sternocleidomastoid by lengthening it with the fascia lata and inserting it into the tendon of the biceps, the second proposes anteriorly transposing the distal triceps tendon. Hovnanian (1956) and Zancolli and Mitré (1973) transpose the latissimus dorsi by inserting it distally on the distal biceps tendon, while Axer et al. (1973) transpose part of the same muscle. It is the purpose of this study to report the experience obtained using the Steindler method in 22 patients affected with paralysis of the flexor muscles of the elbow.

Adolescent↗
PubMed1989

Post-injective quadriceps contracture.

After reviewing the literature, the authors report 19 patients affected with post-injective contracture of the quadriceps muscle observed by them between 1971 and 1983. Clinical evaluation, indications for surgery and the results of surgery are discussed.

Child↗
PubMed1988

Orthotopic knee grafts in rats: a model for growth plate transplantation.

A model for orthotopic whole knee transplantation in syngeneic Lewis rats is presented. The donor knee was isolated on the femoral vessels 1 cm superior and inferior to the knee joint. A minimal muscle cuff was left attached to ensure adequate circulation to the graft via the popliteal vessels. The graft was transplanted to the recipient animal and secured in an orthotopic position by two intramedullary Kirschner wires. The graft pedicle was anastomosed to the recipient's femoral vessels and the muscular elements sutured. Preliminary results are reported, and future implications on growth plate autograft transplantation are discussed.

Anastomosis, Surgical↗
PubMed1988

A critical review of the surgical treatment of infantile fibrous dysplasia.

A critical review of the surgical treatment of 65 cases of infantile fibrous dysplasia demonstrated that "circumscribed" forms of the disease generally do not require any type of surgical treatment, while "extended" forms, as well as Albright's syndrome, require early surgical treatment aimed at preventing the development of skeletal deformities which are difficult to correct. Prophylactic intramedullary nailing with nails of suitable calibre most effectively achieves this goal.

Adolescent↗
PubMed1988

Arthromyolysis of the elbow in arthrogryposis.

The authors discuss the indications and describe the technique of arthromyolysis of the elbow in arthrogryposis and report 17 operations performed on 10 patients followed up after an average of 4.5 years. Their results show that this type of operation considerably improves passive mobility of the elbow and is capable of conferring adequate function on the limb, even without recourse to subsequent muscle transposition into the paralysed biceps.

Activities of Daily Living↗
PubMed1987

Congenital proximal radio-ulnar synostosis: clinical and anatomical features.

A new radiographic classification is proposed based on a study of 31 cases of congenital proximal radio-ulnar synostosis in which close correlation was observed between the clinical and radiographic pictures. The authors attempt to clarify some aspects of the pathogenesis of this rare disease.

Child, Preschool↗
PubMed1986

Epiphyseodesis of the great trochanter.

The authors report 9 cases of congenital or acquired coxa vara due to abnormalities of the epiphyseal growth cartilage, treated by epiphyseodesis of the great trochanter. The operations were performed on children between the ages of 4 and 8 years. The follow-up was a minimum of 6 months and a maximum of 2 1/2 years. A constant correlation was established between a negative preoperative A.T.D. index (height between tip of trochanter and roof of acetabulum) and a Trendelenburg gait. Both these parameters were markedly improved after operation. The conditions treated comprised congenital coxa vara, osteochondrosis following reduction in C.D.H., septic arthritis and Perthes disease type 3.

Child↗
PubMed1985

Long term results in Osgood-Schlatters disease.

The authors were able to establish a relationship between high patella (alta) and Osgood-Schlatter's disease. In a long-term study this was found in 38% of cases. There was also evidence of abnormalities of femoro-patellar relationship in 57% of cases, although only 14% of these had symptoms at the time of follow-up. Two alternative hypotheses on the pathogenesis of the disease are put forward, depending on whether the radiographic changes observed at follow-up were of a pre-existing constitutional type, or the direct result of the disease. This question can be resolved if in future cases a precise radiographic examination is carried out on both knees at the onset of the disease, using the exact technique described so that the relevant parameters can be determined.

Adult↗
PubMed1983

Late sequelae of Perthe's disease (long-term follow-up of 34 hips).

The long-term results were studied in 31 patients (34 hips) with Perthe's disease. The patients were divided into two groups (above and below 25 years of age) in order to study the time at which the late complications become clinically and radiologically evident. The incidence of painful hip and radiological arthrosis is reported in each group in relation to age and initial grade of the disease. The significant prognostic factors were the initial severity of the disease (Types 1-3), the age at which it appeared, and the shape of the femoral head as assessed by the method of Mose. Treatment had been so varied that it was excluded as a factor in our analysis. The development of painful hip and radiological arthrosis (not always painful) only appeared to a significant extent in patients over the age of 25 at follow-up, and both were directly related to the initial grade of the disease.

Adolescent↗
PubMed1982

Osteogenesis imperfecta: results obtained with the Sofield method of surgical treatment.

The 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.

Adolescent↗
PubMed1982

Results in the late treatment of congenital dislocation of the hip.

The results obtained in the treatment of seventeen cases of long established (more than six years) congenital dislocation of the hip are reported. They were followed up for one to five years after operation. The writers consider osteotomy to correct leg length discrepancy to be unnecessary. Triradial osteotomy of the pelvis ensures optimal epiphyseal coverage and permits moderate lengthening of the limb. In the writers' experience, osteochondrosis is not related to the type of osteotomy, nor to operations to produce leg lengthening; it can be avoided by the use of prolonged post-operative traction.

Adolescent↗
PubMed1982

Surgical treatment of metatarsus varus during the growth period.

The writers describe their experience in the treatment of congenital metatarsus varus. They describe an original technique for anterior transfer or shortening of peroneus brevis which they consider to be indicated when the varus deformity is less than 15 degrees and is correctable manually. They also describe Heyman's technique and give their results in twenty-five cases. They consider that this operation is indicated only for varus deformity of the forefoot exceeding 15 degrees which is correctable manually. In both these techniques it is essential that the hindfoot should be in the correct midline axis. Where manual correction of the hindfoot is not possible they advise Dillwyn Evans' operation. In varus deformity of the 1st metatarsal exceeding 15 degrees, and not correctable manually, they suggest osteotomy of the base of this bone, displacing it the correct degree and fixing it with a wedge of homoplastic bone inserted into the gap.

Child↗
PubMed1982

Long term results of centralising intertrochanteric osteotomy in Legg-Calvé-Perthes' disease. (Report on 60 cases).

The 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.

Adult↗
PubMed1979

Results of surgical treatment of idiopathic pes plano-valgus by means of Grice's operation combined with reconstruction of the glenoid (accessory plantar) ligament and anterior transposition of tibialis posterior. (A review of 90 cases).

After 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.

Adolescent↗
PubMed1979

The surgical treatment of lumbo-sacral coccygeal agenesis.

Vertebro-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 trunk.

Abnormalities, Multiple↗