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Biomedical subjects

D Tigani

Publications and source records attributed to D Tigani.

18 recordsLinked to original sources
PubMed1991

Recurring osteoblastoma initially presenting as a typical osteoid osteoma. Report of two cases.

Two patients each underwent inadequate excision of an osteoid osteoma and some months later developed a large tumor in the same location showing the radiographical and histological features of osteoblastoma. This rare occurrence again suggests that osteoid osteoma and osteoblastoma are closely connected benign neoplasms. Indeed some authors in the past have suggested classification as a single tumor showing different clinical and radiographical patterns.

Adult↗
PubMed1991

Grosse-Kempf nailing in fractures of the tibia.

A series of 136 tibial fractures treated with locked Grosse-Kempf nailing is reviewed, evaluating the results according to rapidity of healing, functional recovery, and complications. Locked nailing proved so reliable that immediate mobilization was possible. There was only a 6% incidence of delayed union, including infections (3 cases, 2%) and nail breakage (2 cases, 1.5%). Several details of the operative technique that were decisive in the final result are discussed.

Adolescent↗
PubMed1989

Problems related to blocked nailing in fractures of the proximal femur.

The modern treatment of fractures of the proximal femur in the adult usually involves surgery. Open plating has proved to be reliable, but often involves a high percentage of complications: axial deformity, delayed union, breakage of the plate and/or screws (the risk of which increases in relation to the degree of comminution). At this site, in fact, the plate is submitted to strong flexion stress. It therefore becomes essential to associate cancellous grafts (as proposed by the AO School) (Muller et al., 1981) or a homoplastic cortical craft (as in our experience) (Zinghi and Masetti, 1982). Furthermore, open osteosynthesis is time consuming and this means considerable blood loss and a risk of infection. There are thus many reasons for preferring closed surgery, but effective stabilisation can only be obtained with blocked nailing; in fact, only metadiaphyseal screwing is capable of neutralising the rotation or axial stresses which cause deviation, instability or telescoping of the fracture (Kempf et al., 1978; Tigani et al., 1986; Zinghi et al., 1984). Osteosynthesis with Grosse-Kempf nailing is thus an effective alternative to open nailing, particularly in those fractures which would require additional bone grafting with this method. The purpose of our study was to verify the effectiveness of intramedullary osteosynthesis with Grosse-Kempf blocked nailing, in particular analysing the problems encountered in the use of this method.

Adolescent↗
PubMed1989

A comparison between delayed and immediate intramedullary nailing in the treatment of comminuted and open fractures (grade 1) of the tibia.

The authors studied a group of 215 comminuted or open (Grade 1) fractures of the tibial diaphysis in order to compare two methods successively adopted at the 1st Clinic and 3rd Division of the Rizzoli Orthopaedic Institute. We at first chose to delay nailing in these two types of fracture for 4 weeks (131 cases) and obtained good results in terms of consolidation, but only fair results in terms of functional recovery of ankle and subtalar movement and axial alignment of the tibia. Successively, we used immediate osteosynthesis with a screwed nail (84 cases), the results of which were better for all the parameters considered. The criteria for delaying intramedullary osteosynthesis in grade 1 open fractures are still valid, particularly when there are problems which necessarily delay operative treatment within 8 hours of injury. However, immediate treatment is essential in these fractures when they are associated with vascular lesions or in patients with multiple injuries. Finally, the authors express their preference for intramedullary nailing as compared with external fixation for the treatment of these open fractures with limited exposure.

Adult↗
PubMed1989

Breakage of the Grosse-Kempf nail: causes and remedies.

Eleven cases of breakage of the Grosse-Kempf nail were observed in a series of 297 operations performed at the Rizzoli Orthopaedic Institute in Bologna. Seven of the 9 femoral nails were not the latest available model, which is capable of supporting more stress because areas of less resistance have been eliminated. However, breakage is still a possibility as a result of errors of technique and incorrect planning of weightbearing.

Adolescent↗
PubMed1988

Vertebral osteosarcoma.

A review of the total number of cases of osteosarcoma referred to the Tumour Centre at the Rizzoli Orthopaedic Institute between 1904 and 1986, revealed 11 cases of the disease localised in the vertebrae, 9 of which were fully documented. We excluded secondary forms of the disease due to irradiation or malignant degeneration in Paget's disease, also metastases from osteosarcoma of the limbs localised in the sacrum. It is extremely important to distinguish osteosarcoma from osteoblastoma; and this problem is even more highlighted by the statistical evidence that both neoplasms have an almost equal probability of being localised in the spine. Treatment has progressed from the initial purely palliative approach to a more aggressive type of surgery which, in association with modern chemotherapy, makes it a more reliable type of treatment from the oncological point of view. To this aim, we emphasize the importance of performing biopsy according to the required criteria.

Adolescent↗
PubMedDate not supplied

The Gamma nail, sliding-compression plate. A comparison between the long-term results obtained in two similar series.

The authors report the results they obtained in a retrospective comparative study conducted on two systems of osteosynthesis used to treat trochanteric fractures: the sliding-compression screw-plate (CHS), and the Gamma nail. Two series were included in the study, each of which was made up of 50 cases; these were comparable in terms of fracture type, age of the patients, associated pathologies, and minimum follow-ups of 6 months. The parameters compared were: surgical trauma, average amount of time before a standing position could be resumed, resumption of motor activity previous to trauma, mechanical behavior of the instrumentation. The results show that both of the means of synthesis are capable of effectively stabilizing pertrochanteric fractures, avoiding the mechanical complications instead observed when more dated instrumentation, such as the screw-plate or nail-plate, are used, systems which are not characterized by a sliding cervico-cephalic screw. The amount of time before walking is resumed is quicker when the Gamma nail is used. There was no significant difference in terms of resumption of motor activity. Surgical trauma was the same in both series when the instrumentation was applied after reduction of the fracture in closed surgery, while blood loss was greater when fracture reduction required by application of the plate was performed in open surgery.

Adult↗
PubMedDate not supplied

Degenerative spondylolisthesis: lumbar stenosis and instability.

Degenerative spondylolisthesis may manifest itself with different clinical pictures depending on the phase of the spondylotic disease. Based on pathophysiological criteria 24 patients affected with degenerative spondylolisthesis were divided into three groups: group I: those with spondylotic instability; group II: those with lumbar stenosis and current or potential segmental instability; group III: those with lumbar stenosis and naturally stabilized spondylolisthesis. Group I was treated by posterolateral fusion; group II by laminectomy, removal of the medial portion of the facets and posterolateral fusion; group III by laminectomy and removal of the medial portion of the facets. Long-term results were positive in 100% of the cases in group I, 90% in group II and 83% in group III, with no statistically significant differences between groups, because of the limited series of cases. The authors conclude that surgery for the treatment of degenerative spondylolisthesis must be based on age, symptoms, and the phase of the disease, and that when these indications suited to the clinical-radiographic picture are taken into account, good results may be obtained with different operations.

Adult↗
PubMedDate not supplied

Tricalcium phosphate and hydroxyapatite ceramics in the surgery of bone tumors: preliminary results.

The authors report their preliminary experience in the use of substitutive bone compounds in order to fill the bone cavity after curettage. The material used is constituted by a biphasic compound, made up of tricalcium phosphate and hydroxyapatite. Twenty-one patients were submitted to surgery because of the presence of a benign or low-grade malignant tumor. After removing the neoplastic tissue the residual cavity was filled with: tricalcium phosphate/hydroxyapatite (5 cases); tricalcium phosphate/hydroxyapatite plus autogenous bone (8 cases); tricalcium phosphate/hydroxyapatite plus bone allografts (8 cases). A radiological evaluation obtained 12 months after treatment showed that the incorporation of the compound in granular form was nearly complete in most of the cases, while the blocks revealed partial remodelling which was more evident in the angles. Finally, bone resorption in the site of the compounds used was not observed.

Adolescent↗
PubMedDate not supplied

Grosse-Kempf nailing in the elderly.

The authors report on 30 fractures of the femur and tibia treated with the Grosse-Kempf locked nail in patients aged more than 60 years. Neither nonunion nor severe complications were observed; surgical trauma was well sustained. Functional results were particularly satisfactory; most patients began walking within the first week after fixation.

Age Factors↗