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Biomedical subjects

G Rollo

Publications and source records attributed to G Rollo.

18 recordsLinked to original sources
PubMed1997

Surgical treatment of isolated forearm non-union with segmental bone loss.

Twenty-four isolated radius and ulna non-unions with segmental bone loss were operated on. Nine non-unions were in the radius, 15 in the ulna. The surgical technique consisted of removal of the necrotic bone, filling of the bone defect with an intercalary bone graft and internal fixation with a cortical bone graft fixed opposite to a plate. The average length of bone defect after freshening of the bone ends was 3.6 cm (range 2-10.5 cm). The average length of follow-up was 90 months. In 23 cases union was achieved. In three cases a postoperative infection developed. Resolution of the infection after surgical debridement was achieved in two of these patients, while recurrent infection caused failure of the treatment in the third patient. Statistical analysis revealed a shorter healing time (p = 0.031) in the ulna non-unions (12.5 +/- 3.0 weeks) compared with the radius non-unions (16.4 +/- 4.2 weeks). Functional results were classed as excellent in 10 patients, satisfactory in six, unsatisfactory in seven and failure in one.

Adolescent↗
PubMed1997

[Traditional radiology in the assessment of posttraumatic carpal instability].

INTRODUCTION: Carpal instability is a painful posttraumatic syndrome with early or late loss of the normal alignment of the carpal bones, which can be caused by a variety of injuries, from minor sprain to major fracture-dislocation of the carpal-wrist complex. If the trauma causing instability is a fracture, a severe dislocation or a fracture-dislocation, the radiographic diagnosis is not particularly difficult. The morphologic and dynamic complexity of the carpal region represents, instead, a major obstacle in the radiologic diagnosis of mild or moderate sprains because the morphologic alterations on standard static views are minimal or absent in these conditions. MATERIALS AND METHODS: We reviewed 214 injuries causing posttraumatic carpal instability including both the cases classified by the Data Analysis Center of the Istituto Ortopedico Rizzoli as carpal dislocations and fracture-dislocations from January, 1975, to July, 1996, and the more recent cases directly observed at our Casualty Clinic. In the former cases, we reviewed only the available images, while our patients were examined with comparative standard and under stress or dynamic views. RESULTS: Of 214 lesions causing posttraumatic carpal instability, 43 along the great arch were classified as severe because they were easily detectable on standard films and 171 along the small arch were classified as mild because slight/no abnormalities were detected on standard static views. Only dynamic imaging showed posttraumatic carpal instability demonstrating the integrity of the ligaments and of the carpal hinges, as well as gaps or asymmetry not detected on static views. CONCLUSIONS: We suggest the systematic use of dynamic imaging in the cases where static findings are negative or poor, in the patients with a painful wrist after an apparently minor sprain. Missed or delayed diagnoses are thus reduced, as well as the consequent joint incongruity and/or chronic subluxation which may severely impair these patients.

Carpal Bones↗
PubMed1995

Composite bone grafting and plate fixation for the treatment of nonunions of the forearm with segmental bone loss: a report of eight cases.

Between June 1986 and December 1991, eight aseptic isolated severe forearm segmental bone losses were treated. The average age of the patients was 26 years. Three cases involved the radius and five the ulna. The average time between the onset of trauma and the final surgical intervention was 9 months. The surgical technique consisted of complete removal of necrotic bone, filling of the bone defect with an intercalary autogenous bone graft, and stable internal fixation, which required combining a plate and an opposite cortical bone allograft. The average bone loss length after freshening the bone ends was 7 cm (range 4-11). The average follow-up was 48 months (range 24-80). In all eight cases union and recovery of forearm function was achieved. The proposed surgical technique proved to be effective in obtaining results with no major complications.

Adolescent↗
PubMed1994

[Percutaneous computed tomography-guided biopsy in spinal diseases].

The use of percutaneous spinal biopsy (PSB) is on the increase in the field of interventional radiology. From July 1990 to December 1992 in the Department of Radiology in the Istituto Ortopedico Rizzoli, 74 patients (50 men and 24 women, mean age: 47 years old) underwent CT-guided spinal biopsy. This study was aimed at evaluating the diagnostic capabilities and accuracy of CT-guided percutaneous biopsy, which is considered as a simple, reliable and definitive method for histopathologic diagnosis. In our case histories, the total average accuracy rate, which varies according to the involved segment and to the kind of lesion to be examined, was 86%; in 14% of cases the excised tissue proved insufficient for histologic diagnosis. By allowing the histopathologic diagnosis to be made, CT-guided PSB proves a valuable technique to plan the treatment of primary/secondary neoplastic lesions or of inflammatory and dysmetabolic processes.

Biopsy, Needle↗
PubMed1992

SEM and chemical micro-analysis in a failed total knee prosthesis.

Authors performed SEM and EDS analyses in a cemented removed knee prosthesis demonstrating the average values of mineral elements in the bone surrounding the prosthesis. The composition of the metallic prosthesis surface in different microareas was also studied.

Alloys↗
PubMedDate not supplied

Inveterate fractures of the acetabulum.

The authors reviewed 44 inveterate fractures of the acetabulum treated surgically by internal osteosynthesis. The definition of inveterate fracture concerns lesions that are treated from 21 to 90 days after trauma. Based on an analysis of this series several features of a prognostic and therapeutic nature may be determined. In particular, it may be observed just how difficult it is to standardize therapeutic strategies in relation to polymorphism and anatomopathologic progression of the lesions.

Acetabulum↗
PubMedDate not supplied

The surgical treatment of cervical disc herniation.

The authors reviewed 61 cases of cervico-brachialgia due to posterolateral disc herniation treated at the Rizzoli Orthopaedic Institute between 1975 and 1985. Results were positive in 69.3% of the cases, partially negative or negative in 30.7%. An analysis of the results reveals a high correspondence between clinical diagnosis and surgical findings (82%): but the percentage of error in clinical diagnosis (18%) cannot be overlooked. For this reason the clinical diagnosis must be confirmed by CT and/or MRI. In our experience, the posterior approach has proven to be suited to resolving most cervico-brachial pain syndromes due to posterolateral disc herniation.

Adult↗
PubMedDate not supplied

Intra-articular fractures of the knee: arthroscopic diagnosis and treatment.

Fifteen intra-articular fractures of the knee were treated by reduction under arthroscopic monitoring and osteosynthesis, and followed-up after an average of 24 months. The authors expose the principles of surgery and discuss the advantages and the disadvantages as compared to traditional surgery.

Arthroscopy↗
PubMedDate not supplied

The Ilizarov method for the treatment of infected pseudarthrosis of the tibia: our experience in cases with severe lesion of the soft tissues.

Between 1985 and 1990 a total of 35 cases of infected pseudarthrosis of the tibia were treated by radical resection of the pseudarthrosis and corticotomy-distraction-compression. In 5 patients there was severe lesion of the soft tissues with extensive loss of substance. It is the purpose of the present study to evaluate the effects of the use of this method on lesions of the soft tissues in these 5 patients.

Adolescent↗
PubMedDate not supplied

[Study of torsion defects of the lower limbs using computerized tomography].

January, 1990, to July, 1993, the torsional defects of the lower limbs were studied at the Department of Radiology of the Istituto Ortopedico Rizzoli, Bologna. Ninety-three patients were examined, all of them affected with congenital or acquired (posttraumatic and/or iatrogenic) torsional defects. The torsional angles, i.e., the anteversion acetabulum angle, the anteversion femoral neck angle and the tibial torsion angle, were measured as follows: the patients were laid supine with their limbs either in intrarotation with the patella perpendicular to the table (62 patients) or in neutral rotation with the feet in the pace position (31 patients). The images were always analyzed at the console by two different radiologists in the following days. The electronic lines for measuring torsional angles were drawn by the two radiologists ex novo on the previously acquired CT images. No statistically significant differences were observed between the two groups of patients. The measures were independent of limbs position and the interobserver differences were bigger in children and in the measurement of femoral neck anteversion angle; however, these differences decreased by about 50% with better console use. CT, thanks to its feasibility, has replaced conventional (direct or indirect) radiology to study the torsional defects of the lower limbs. Moreover, CT is extremely useful not only for early disease diagnosis (location, rotation degree and associated joint deformities), but also for treatment planning, be it surgical or conservative.

Adolescent↗
PubMedDate not supplied

Lumbosacral monolateral dislocation.

The authors describe a case of traumatic monolateral dislocation of L5 on S1. It is a very rare lesion which involves serious diagnostic and therapeutic problems. Surgical treatment constituted by reduction and stabilization alone can obtain stable correction of the deformity and complete functional recovery.

Accidents, Traffic↗
PubMedDate not supplied

Internal fixation in unstable fractures of the pelvis. Preliminary notes.

The authors report the preliminary results of the surgical treatment of unstable fractures of the pelvic ring. Between 1989 and 1993 a total of 12 unstable fractures were treated by internal fixation. Short-term radiographic and functional results were satisfactory. The authors attribute an essential role to preoperative planning by conventional radiographic assessment and CT scan with multiplanar reconstructions, associated with carefully performed internal osteosynthesis.

Adolescent↗
PubMedDate not supplied

Revision of the femoral prosthetic component according to the Wagner technique.

The authors report the preliminary results they obtained using the Wagner technique for revision of the prosthetic stem by transfemoral access. Between January 1992 and June 1993 a total of 20 patients were treated by reimplantation of the prosthetic stem according to the Wagner technique. At minimum 12-month follow-up, based on the Harris Score System, results were excellent, good and fair in 16 cases. Results were not satisfactory in 4 cases after sinking of the prosthesis exceeding 2 cm or due to mid-distal pain with loading.

Aged↗
PubMedDate not supplied

Lesions of the sciatic nerve in fractures of the acetabulum.

Between 1982 and 1992 a total of 211 fractures of the acetabulum were operated. There was lesion of the sciatic nerve in 21 cases, the pathogenesis and evolution of which were studied. Clinical follow-up was obtained at least 2 years after occurrence of neurological deficit and supported in 13 cases by electromyography. Based on an analysis of the literature and of these series it is observed how spontaneous recovery of paralysis is not rare, even if it requires a long period of time. The presence of various levels of lesion, which are not easily diagnosed, and which are not easily attacked surgically, calls for a prudent attitude with regard to neurolysis.

Acetabulum↗
PubMedDate not supplied

Aseptic nonunion of the tibia treated by intramedullary osteosynthesis.

The authors report 52 cases of aseptic nonunion of the tibia treated by intramedullary osteosynthesis. The means of synthesis used were the Küntscher nail, the Eiffel Tower Rush nail, and the Grosse-Kempf nail. Which means of synthesis was used depended on the site and the features of the nonunion. Healing occurred in all of the cases after an average of 5 months. Mean follow-up was 4.5 years.

Adolescent↗
PubMedDate not supplied

The external fixator for the treatment of wrist fractures.

The authors present 15 unstable fractures of the wrist treated by external fixation. The fractures were classified based on the AO system, while results were evaluated clinically (Gartland and Werley method modified by Sarmientio) and radiographically. In two cases stabilization with metal wiring was used in addition to external fixation. Results were excellent in 4 cases, good in 9, unsatisfactory in 2 (1 fair, 1 poor). Intraoperative complications included a compound fracture of the second metacarpus, and late complications included a case of algodystrophy.

Aged↗