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Biomedical subjects

G F Zinghi

Publications and source records attributed to G F Zinghi.

At least 19 recordsLinked to original sources
PubMed1988

Fractures of the lower end of the humerus in the adult.

The authors report their experience in the treatment of 34 fractures of the lower end of the humerus treated surgically over the last 6 years. The fractures are divided into four types in assessing the functional results; open and closed; those involving and not involving the joint. Satisfactory clinical results were obtained in 22 of the 34 cases (64%). Complications were directly related either to the severity of the lesion (comminuted and open fractures) and/or inadequate surgical technique.

Adolescent↗
PubMed1988

The role of osteosynthesis in the treatment of fractures of the humerus.

Rigid osteosynthesis is widely indicated in fractures of the humeral diaphysis because it abolishes the need for external immobilisation and thereby facilitates early functional recovery. In simple fractures, osteosynthesis was used according to the principles of the Swiss AO school (rigid fixation in axial compression). In complex fractures we added a homoplastic cortical graft on the opposite side to the plate. A follow-up survey of 74 patients was carried out (minimum 8 months, maximum 10 years). There were two cases of complete paralysis of the radial nerve, which quickly regressed. There was one severe infection which resulted in pseudarthrosis, but this was due to an error of judgement because this was an open fracture with exposure of the fragments. This complication aside, the functional results were excellent, and completely justify this method of treatment.

Adolescent↗
PubMed1987

The treatment of fractures of the acetabulum involving both anterior and posterior columns.

Over a period of 20 years, 35 cases of fracture of the acetabulum involving both columns were treated by operation in our unit. These were followed up after a minimum of 8 to a maximum of 20 years. The Iselin approach, even when extended forwards by partial disinsertion of the gluteal muscles, allowed good reduction only when there was little or no displacement of the ilio-pubic column. In the other cases, it was necessary to use a combined anterior and posterior approach, or the Letournel approach, but the latter was reserved for cases with very severe displacement or comminution of the fragments when it is essential to have access and control of the iliac and acetabular complex in its entirety. The clinical and radiographic results of fractures involving both columns are not unlike those observed in other complex fractures of the pelvis: good reduction and osteosynthesis is synonymous with good function even in the long term.

Acetabulum↗
PubMed1986

The Grosse-Kempf blocked nail in the treatment of diaphyseal and metadiaphyseal fractures of the tibia.

The use of the Grosse-Kempf nail in the treatment of fractures of the tibia is limited for two reasons: (1) the medullary canal may be too narrow to permit adequate reaming to accommodate the instrumentation; (2) complex or comminuted fractures rarely occur without severe soft tissue involvement or exposure of the fracture. The authors report 24 cases treated since 1981. They describe the radiographic features, indications for treatment, time for union, and programme of rehabilitation. These are practically identical to those found in a previous report on femoral shaft fractures. In the present series, the only complication was a false aneurysm of the posterior tibial artery which was successfully treated surgically with no loss of function.

Follow-Up Studies↗
PubMed1986

The surgical treatment of inveterate fractures of the acetabulum.

Any fracture of the acetabulum which is not adequately treated within 3 weeks poses a considerable surgical problem. Reduction is difficult, callus has already begun to form between the displaced fragments, and the risks of complications are therefore increased. Our material consists of 35 cases, subdivided into 18 fractures submitted for treatment between 3 and 12 weeks after injury, and 17 fractures submitted for treatment beyond the 12 week limit. In the first group the incidence of complications (ischaemic necrosis, arthrosis, infection) was high; satisfactory results were obtained only when the fracture was of the simplest type. In the second group, malunion had to be accepted, and treatment was concerned solely with improving function by correcting malposition and relieving or eliminating pain. The surgical methods adopted depended on the circumstances: corrective osteotomy, arthrodesis or total prosthetic replacement.

Acetabulum↗
PubMed1986

Transverse fractures of the acetabulum.

From a total case material of 356 fractures of the acetabulum we have been able to analyse in depth 188 fractures treated surgically--77 transverse, 21 T-fractures and 90 transverse associated with posterior rim fractures. These lesions, although sharing certain anatomical and radiographic features, have peculiar characteristics which are important to define for purposes of treatment. Posterior dislocation of the femoral head is frequently associated with posterior rim fractures and central dislocation with transverse and T-fractures. Traumatic arthritis as a late complication was studied with particular reference to the quality of reduction of the fracture. When this results in an irregular articular surface early arthritis is the usual outcome; when it results in an acetabular cavity wider than the diameter of the femoral head, arthritis is delayed usually for more than 10 years, and subsequently progresses very slowly.

Acetabulum↗
PubMed1985

Surgical treatment of infected pseudarthrosis of the humerus.

The authors report 16 cases of infected lesions of the humerus with delayed consolidation or pseudarthrosis. The treatment consisted of radical surgical debridement, freshening of the bone fragments with removal of all necrotic tissue, and stabilisation with a Hoffmann-Vidal external fixation device. Healing occurred between 3 and 6 months after operation. The one case of failure was attributable to inappropriate technique (inadequate resection of the ends of the fragments).

Debridement↗
PubMed1985

The role of osteotomy in the treatment of pseudarthrosis of the neck of the femur in younger patients.

The authors discuss 34 cases of pseudarthrosis of the neck of the femur that were subjected to two different types of osteotomy, namely the support osteotomy of Putti and the valgising osteotomy of Pauwels. The following conclusions were reached: both methods produced good healing of the pseudarthrosis; with regard to the functional result, valgising osteotomy associated with a degree of lateralisation must be the operation of choice because it compensates for the shortening and prevents the Trendelenburg gait.

Adolescent↗
PubMed1984

The transtibio-fibular graft in the treatment of pseudarthrosis of the tibia with loss of bone substance.

The transtibio-fibular graft is the treatment of choice in pseudarthrosis of the tibia with significant loss of bone, particularly in the presence of infection or potential infection. A personal series of 28 cases is reported. The method consists of stabilizing the pseudarthrosis, usually after radical surgical cleansing, by applying the grafts through healthy tissues from a postero-lateral approach. The authors stress that this operation is only called for when the amount of bone loss is substantial. In the less severe cases the operation restores sufficiently strong union to prevent future fatigue fractures, whilst even in cases of more extensive bone loss it still offers an excellent prospect of avoiding such possible future complications.

Adolescent↗
PubMed1983

Pathogenesis and treatment of certain fatigue fractures of the neck of the femur.

During the unipedal phase of walking, it has been shown (Fischer, Fick & Pauwels) that the forces acting on the hip obey the fundamental laws of mechanics and can be calculated and graphically recorded fairly precisely. In these circumstances, the bones, muscles and tendons act reciprocally in such a way as to achieve the best possible motor unit, a complex machine designed to achieve the maximum work with the minimum material and the minimum expenditure of energy. This explains why, if the bones undergo changes in form or structure, complicated pathogenetic mechanisms are invoked which are interdependent and therefore give rise to disabling symptoms and/or fatigue fractures. This is illustrated in the cases presented in the present report.

Adult↗
PubMed1981

Pseudarthrosis of the forearm bones. (Clinical and radiographic survey of 112 operated cases).

There are two aims in the surgery of pseudarthrosis in the forearm; consolidation of the fracture, and restoration of function as nearly normal as possible in a part of the musculo-skeletal system which is mechanically controlled by extremely delicate, interdependent, structural units. These aims are, of course, the same as those in the treatment of fresh fractures. The following conclusions emerge from a clinical and radiographic study of 112 operated cases: (a) Sherman's plate has been shown to be an ideal means of synthesis, because of its metallurgical and physical qualities, which enable it to adapt excellently to an irregular bone surface. (b) Plate fixation is supplemented by an appositional cortical transplant. This also plays a definite mechanical role, both because of the firm grip that it affords to the screws when the bone stumps are atrophic, which they often are, and because it is isoelastic with the recipient's tissue. Two cortical grafts are sometimes used instead of a plate and graft. (c) The best functional results are obtained when the leverage of the forearm has been anatomically restored.

Adolescent↗
PubMed1980

Osteosynthesis with Rush's double nail by the "Eiffel Tower" method in pseudarthrosis impacted in good position and retarded union.

The "Eiffel Tower" method of nailing has not attracted the interest in Italy that it deserves, both because its utilisaton in fractures is difficult when closed reduction of the fragments is difficult, and because the attention of surgeons has been progressively directed towards osteosynthesis by open reduction. Our experience over many years, however, has convinced us that, in the diaphysis, only the intramedullary nail can provide the quick recovery that is not always forthcoming in the case of plating. We need only think of comminuted fractures, where the possible necrosis of one or more fragments demands a certain amount of prudence in allowing direct weight bearing. Therefore, in adopting the double Rush system, we extended its application to the intramedullary osteosynthesis of metaphyseal fractures. It was a short step from this to the surgical treatment of pseudarthrosis impacted in good position or retarded union, the results of which were encouraging, as demonstrated by the eighty-one cases reported in this paper.

Bone Nails↗
PubMed1979

The treatment of trochanteric fractures of the neck of the femur by Ender's nail.

The authors report the clinical and radiographic results obtained in the treatment of 138 patients with pertrochanteric fractures of the neck of the femur by Ender's elastic nail. This extremely simple method of treatment, which is within the scope of all surgeons, permits early recovery of function in the elderly patient and, even more important, early mobilisation in the upright stance, thereby preventing many of the surgical complications that can affect elderly patients.

Aged↗
PubMed1977

Delayed closed endomedullary osteosynthesis in complicated fractures of the femur and tibia.

The results obtained with delayed closed endomedullary osteosynthesis in 230 cases are considered. This method greatly extends the use of endomedullary nailing to open fractures and those in which controindications of a mechanical nature (multiple fractures, or at several levels) rule out the immediate use of implants. The techniques proposed (osteosynthesis with triflanged nail in fractures of the diaphysis and osteosynthesis with double Rush nails in metaphysio-diaphysis fractures) have two advantages. Due to the non opening of the fracture focus there is minimal risk of infection and early restoration of function.

Adult↗