Biomedical subjects
Publications and source records attributed to C Iacobellis.
The results of a multicentric review are reported using the extensimetric instrumentation applied to the Ilizarov device. This clinical trial the follows same theoretical and experimental preliminary studies, outlines the advantages and current limits of the method, and sets the bases for further clinical and experimental research.
This study reports the results of a computerized baropodometric analysis of the function of primary valgus pronated flat foot submitted to talocalcanear arthrodesis according to the Grice-Green method (Grice, 1952; 1955) as modified by Vigliani et al., (1978). Our purpose was to document any anomalies in the behaviour of such feet, which up until now have been based on conventional evaluation (plantar imprints, podoscopy, etc.), which are much less sensitive than those of modern electronic systems.
A study of plantar loading has a place in orthopaedic literature today thanks to the studies conducted by various authors (Stott et al., 1973; Braun et al., 1980, Corvi et al., 1985; Salsano et al., 1986; Pisani, 1987). It is the purpose of this study to report the results obtained by using the baropodometer to study the static and dynamic functions of the foot in patients who were submitted to arthrodesis of the knee 15 or more years ago.
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.
The authors report a case of bifocal instability of the cervical spine (C2-C3) emphasizing the rarity of the lesion, particularly as the instability at C4-C5 became evident a few months after the first operation involving surgical reduction and stabilisation at C2-C3 with a metal loop.
Explore the source record for details and available documents.
The 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 which the nonunion appeared healed.
Ruptures of the long head of the biceps brachii are mostly of degenerative nature, secondary to subacromial impingement and morphological changes in the bicipital groove. Clinical findings are typical. Treatment is controversial, as it may either be surgical or non-surgical. The authors considered only those cases in which tendinous rupture was the first manifestation of pathology caused by wearing, with typical deformity of the profile of the arm. The favorable results of surgical treatment in 14 patients aged from 38 to 70 years, followed-up after an average of 10.9 years, are reported. Among surgical methods used, tenodesis at the bicipital groove currently constitutes the method of choice.
After reporting the most significant data in the literature, the authors present 5 cases of vascular leiomyoma of the limbs (1 in the upper limb, 4 in the lower limb) in subjects of both sexes. In all of the patients, diagnosis was only possible thanks to histological examination, confirmed by an immunohistochemical examination. In none of the cases was there recurrence of neoplasm after surgical exeresis.
The 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 which 6 with the 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 nonunions and in hypertrophic nonunions with hypometria and angular defects.
The results of the treatment of 18 cases of nonunion of the tibial pylon using the Ilizarov method are presented. The level of the nonunion was divided into A (epiphyseal, 2 cases), B (from 1 to 4 cm from the joint rima, 7 cases), and C (from 4 to 7 cm from the rima, 9 cases). Nonunion was atrophic in 12 cases, hypertrophic in 2, and infected in 4. Bone grafts were applied in 8 atrophic cases, while bone resection with transport or resection-shortening was performed in the 4 cases with infection, or resection-shortening and then lengthening in 2 cases. Consolidation was always achieved. Range of movement was very compromised in 9 cases, of which 5 initially presented with joint fracture, while another 4 had had septic complications after fracture.
A 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.
Occipito-cervical fusion for congenital and post-traumatic anomalies of the axis was used to treat 5 patients; the results obtained are analyzed. The authors also discuss the advantages of using autoplastic bone graft which remains stable in time, without creating disabling sequelae in the patient.
Two cases of monolateral voluntary hip dislocation in Down's syndrome are reported. No surgical procedure was permitted by the family in either case, thus showing the natural evolution of the joint morphology. In the case observed a year after the onset of hip dislocation CT Scan already showed an initial smoothing of the posterior acetabular wall. In the other case, after a 9 year follow-up, the voluntary hip dislocation was followed by progressive subluxation and fixed dislocation at the end. This suggests that only early surgical treatment can prevent this outcome.
The authors report 3 cases of rare spondylocostal dysplasia (Jarcho-Levin syndrome) associated with multiple visceral anomalies (V.A.C.TE.R.L. syndrome). The difficulty encountered in treating the disease because of the complexity and multiplicity of the visceral anomalies, and the extent and type of associated vertebral deformities is emphasized. The cases described revealed a moderate amount of progression, and were able to be treated non-surgically. It is also emphasized that even when there is moderate scoliosis associated costal deformities may cause anti-cosmetic thoracic gibbosity.