PubMed Health⌕ Search

Biomedical subjects

G L Di Gennaro

Publications and source records attributed to G L Di Gennaro.

At least 19 recordsLinked to original sources
PubMedDate not supplied

Osteosynthesis with percutaneous wiring in fractures of the proximal humerus.

The authors report the preliminary results of osteosynthesis with percutaneous wiring in the treatment of fractures of the proximal humerus. This method which is still described in very few cases, is characterized by several advantages such as its minor invasiveness, and respect for vascularization of the fragments that guarantee good functional results. The application of threaded pins or pins of large diameter guarantees excellent hold with a low incidence of loosening secondary to loss of reduction. The use of a traction device applied to the surgical table simplifies reduction maneuvers and osteosynthesis.

Adolescent↗
PubMedDate not supplied

The chondroepitrochlearis muscle: case report.

An extremely rare muscle disorder in the pectoral region is described. It involves a musculotendinous unit which originates from the pectoralis major and inserts onto the medial epicondyle of the humerus. The authors report a case of an 11-year-old boy, affected bilaterally, who underwent surgical treatment to lengthen the chondroepitrochlearis muscle. There was significant cosmetic and functional improvement.

Child↗
PubMedDate not supplied

Recurrent dislocation of the elbow in children: description of a case.

The authors report a case of recurrent dislocation of the elbow in a boy aged 11 years, surgically treated by reconstruction of the lateral capsuloligamentous structures. After a review of the literature, the need for a diagnostic protocol to establish the main cause of recurrent dislocation is emphasized.

Child↗
PubMedDate not supplied

Femoral shaft fractures during childhood.

The treatment of femoral shaft fractures in the child is influenced by the anatomophysiological peculiarities of the bone in childhood. The authors report a personal series of 51 fractures treated surgically (Kuntschner, Rush, Kirshner, external fixator), and they analyze the most significant aspects of fractures of the diaphyseal segments during childhood: post-fracture lengthening and the ability for post-fracture malalignment to self-correct. Also considered are the different methods of treatment, emphasizing advantages and disadvantages (from an economical point of view, as well), to emphasize the authors' therapeutic orientation. Under 6-7 years: trans-skeletal traction for 5-6 days, reduction in narcosis without expecting to achieve anatomical reduction, pelvipodalic plaster. Over 10 years: surgical indications are more frequent, until they are the same as those for adults aged over 13-14 years. Between 7 and 10 years of age is a no man's land, where indications for surgery must be made based on the individual surgeon's experience.

Adolescent↗
PubMedDate not supplied

Intra-articular deformities of the knee in congenital hypoplasias of the lower limb: an arthroscopic study.

A knowledge of the morphology of the cruciate ligaments in congenital hypoplasias of the lower limb, susceptible to treatment to even the length discrepancy, is of practical importance in the prevention of subdislocation and dislocation of the knee during the distraction phase of femoral and/or tibial lengthening. The authors report their experience with 20 arthroscopies diagnosed in 20 children affected with congenital hypoplasia of the lower limb (shoft congenital femur, longitudinal peroneal hemimelia) performed prior to assembling the Ilizarov external fixator for femoral and/or tibial lengthening. None of the patients had congenital dislocation of the knee or knee with recurvation. In the patients in our study, it is possible to demonstrate that the anatomical cause of instability of the knee in congenital hypoplasias of the lower limb may be constituted by aplasia of one or both cruciate ligaments.

Arthroscopy↗
PubMedDate not supplied

The surgical treatment of inveterate hip dislocation in children affected with cerebral palsy: a preliminary report.

The incidence of hip dislocation in patients affected with cerebral palsy is directly correlated with the degree of neurologic deficit. Surgical treatment aimed at stabilization of the coxofemoral joint relieves pain and avoids the occurrence of changes in the static of the pelvis and vertebral column. The authors report their experience with procedures for the recovery of joint congruency (release of the adductors and psoas, surgical reduction of the dislocated epiphysis, femoral shortening associated with varus-derotation at the osteotomy level, acetabuloplasty) performed in one or more surgical stages, and operations with a purely anthalgic purpose (innominate osteotomy according to Chiari), specifying relative indications in relation to age.

Adolescent↗
PubMedDate not supplied

Blount's disease.

Out of a total of 40 patients affected with Blount's disease treated at the Pediatric Orthopaedic Division of the Rizzoli Orthopaedic Institute between 1965 and 1996, 29 were affected with the infantile type, and 11 with the adolescent type. In the group affected with infantile Blount's disease, the mean age was 5.5 years, 11 were bilateral, for a total of 40 limbs affected, with a mean TMD angle of 24 degrees. All of the patients were treated by valgus osteotomy obtaining a percentage of poor results (insufficient correction or recurrence) equal to 25% according to Schoenecker's criteria. Mean follow-up was 3.6 years. In the group affected with adolescent Blount's disease, mean age was 12.6 years, the affection was always monolateral, the mean TMD angle was 15 degrees. All of the patients except 1 were treated by valgus osteotomy with elevation, and the results were constantly favorable. Mean follow-up was 2 years. The authors believe that the type of osteotomy used must be modulated based on the anatomopathologic findings of compromise in the proximal tibial metaepiphysis.

Adolescent↗
PubMedDate not supplied

Fracture of the patella in children and adolescents.

Fractures of the patella in childhood and adolescence are a rare occurrence, and they are differentiated from those occurring the adult. Between 1975 and 1995, 76 cases of fracture of the patella in patients aged under 15 years were treated at our institute. A mean clinical-radiographic follow-up of 2 years was available for all of the patients; 18 patients were followed-up after a considerable amount of time (mean 18 years). After analyzing the specific features that distinguish there fractures when they affect a subject who is still growing, the authors report the results obtained and the short and long-term complications observed.

Adolescent↗
PubMedDate not supplied

Fracture of the lesser trochanter.

Isolated fracture or detachment of the lesser trochanter is an infrequent occurrence. In most cases the event is part of a complex of fractures involving the femoral neck and the greater trochanter. Isolated fracture caused by direct trauma is rare because of the anatomical location of the lesser trochanter which is protected anteriorly and posteriorly by large muscular masses, superiorly by the head and the neck of the femur, laterally by the femur itself, and medially by the ilio- and ischio-public branches of the pelvis. Trauma is usually indirect, caused by sudden traction by the iliopsoas muscle on the femoral tendinous insertion. The highest frequency is observed in young patients who are still growing where there is an imbalance between muscular strength and resistance of the osteochondral plate of the tendinous insertion. Particularly affected are adolescent athletes of male sex aged from 13 to 17 years. Similar overloading of traction in an adult would probably produce only muscular stretching. Diagnosis is based on radiographic ascertainment, obtained with the thigh in extra-rotation, supported by rather typical clinical findings such as acute pain in the inguinal region and in Scarpa's triangle, limping, passive movement of the hip in all directions with pain in maximum extension and relief when seated. Nonsurgical treatment with the limb resting in flexion, further confirmed by the case presented in this study, still remains the treatment of choice in most cases, obtaining excellent functional results. The authors believe that it was of interest to report this clinical case because of the rareness of the pathology observed and because of the specific features of its etiology.

Adolescent↗
PubMedDate not supplied

Trochanteric arthroplasty in the treatment of sequelae after septic arthritis of the hip in infancy.

The authors describe 17 patients submitted to trochanteric arthroplasty between 1979 and 1999 at the Division of Pediatric Orthopaedics and Traumatology of the Rizzoli Orthopaedic Institute. There were 9 females and 8 males aged from 1 to 8 years (mean of 4) affected with the sequelae of septic arthritis of the hip with complete destruction of the epiphysis and of the femoral neck (types IVB and V according to the Hunka classification system). Mean follow-up was 9 years (minimum 1, maximum 23). Surgery is described and indications are discussed: this is the only type of treatment that may be offered in place of conservative treatment.

Child↗
PubMedDate not supplied

Injection-induced contractures of the quadriceps during childhood.

A total of 8 cases affected with injection-induced contractures of the quadriceps occurring in 7 patients were followed-up at the Division of Pediatric Orthopaedics at the Rizzoli Orthopaedic Institute. Mean age was 8 years (minimum 5, maximum 9). Surgery involved arthromyolysis according to Judet whether or not associated with distal reconstruction of the quadriceps. Mean follow-up was 9 years (3-17). Mean increase in passive flexion of the knee was 70 degrees, while deficit in active extension was observed in 50% of cases. The clinical aspects indispensable for diagnosis, the therapeutic choices, the surgical method reported in the literature and the results obtained using this method are all discussed.

Child↗
PubMedDate not supplied

Scoliosis in Escobar syndrome (multiple pterygium syndrome). Description of two cases.

The authors report two cases of scoliosis in Escobar syndrome. Both of the patients were submitted to surgical treatment. A fair amount of correction was obtained in the first case, simple stabilization of the deformity was obtained in the second. Our experience confirms the fact that scoliosis may progress considerably in Escobar syndrome, requiring early surgical treatment.

Abnormalities, Multiple↗
PubMedDate not supplied

The treatment of congenital hip dysplasia.

The authors take into consideration the different phases of the treatment of congenital hip dysplasia (CHD) as it is related to age and natural development. Within the first year of age three objectives must be aimed at: reduction of the epiphysis, its retention and immobilization, maturation of the hip. After three years of age, once the epiphysis has been reduced, reconstructive and stabilizing surgery must be performed (acetabuloplasty and femoral osteotomy) in order to correct the modified joint parameters. After ten years of age and until the end of growth the degree of dysplasia influences treatment, as intervention is justified (preferably with biological reconstruction of the acetabulum) in forms of severe dysplasia caused by the definite occurrence of pain at an early age. We emphasize the importance of adapting treatment to the specific phase of evolution of the hip understood to be dynamic reality.

Age Factors↗