PubMed Health⌕ Search

Biomedical subjects

J Cañadell

Publications and source records attributed to J Cañadell.

At least 37 records · Page 2Linked to original sources

Posttraumatic ulnar neuropathy versus non-traumatic cubital tunnel syndrome: clinical features and response to surgery.

The outcome of 53 patients operated on either for posttraumatic ulnar neuropathy (PUN) or non-traumatic cubital tunnel syndrome (CTS) was reviewed after 3 years follow-up. Results were analyzed and compared considering the surgical technique used (neurolysis versus anterior transposition or combined) and a variety of clinical features that could influence outcome after nerve release. In the whole series, excellent outcome was obtained in 39 patients (73%). No major differences were found with the different surgical procedures. Slightly better results, but no statistically significant, were found in cases with CTS. As to clinical parameters, patients with CTS had a higher mean age, a shorter duration of symptoms and most were men. The presence of symptoms for more than one year before operation significantly diminished the chance of satisfactory recovery in cases with CTS, but not in those with PUN. For both CTS- and PUN-cases with symptoms for more than one year, neurolysis plus anterior transposition was the more useful technique. Our study shows that CTS and PUN differ to a certain extent in their clinical profile, electrophysiological findings and response to different surgical approaches and hence can be considered as two different clinical entities.

Adolescent↗

Leg lengthening by distraction through the callus of an arthrodesis.

Limb lengthening by means of distraction through the callus of a knee arthrodesis was performed in a 14-year-old boy with congenital hypoplasia of one lower limb. Knee arthrodesis was indicated because of destruction of the distal femoral epiphysis caused by a previous bone lengthening procedure.

Adolescent↗

Long term evaluation of high tibial valgus osteotomy.

We present a long term evaluation of 100 high valgus tibial osteotomies with a mean follow up of 11 years. Knees with slight or moderate osteoarthritis had the best results. Slight overcorrection was beneficial, but gross overcorrection was not. There were few complications and the overall long term results were good.

Activities of Daily Living↗

Secondary repair of ulnar nerve injury. 44 cases followed for 2 years.

A series of 44 patients with complete section of the ulnar nerve was reviewed on average 2 years after secondary repair. The procedures applied were fascicular grafting in 33 cases, epineural suture in 7, and suture in 4. Useful ulnar motor function was restored in 22 cases of fascicular grafting, in all 4 of fascicular suture and in 3 of epineural suture. Sensibility recovered in 23 patients operated on by fascicular grafts and in 10 of 11 treated by epineural or fascicular suture. Cases with unsatisfactory results had other associated severe lesions, i.e., median nerve section, vascular damage or tendon injuries. Early repair of clean-cut nerve sections by fascicular or epineural suture gives a good chance for recovery. Grafting should be performed within 3 months and no later than 1 year after the injury.

Adolescent↗

Paraspinal muscle pathology in experimental scoliosis.

Paraspinal muscle biopsies from ten rabbits with experimentally induced scoliosis and from four healthy controls were analyzed histologically and histochemically. Scoliosis was induced by two different methods: six animals underwent unilateral damage of the dorsal column of the spinal cord (mean curve: 22 degrees) and four costotransversectomy (mean curve: 47 degrees). In eight scoliotic animals myopathic changes were detected on the muscles of the concave side. Only those animals which underwent costotransversectomy showed a neuropathic pattern with cronic denervation changes on the convex side. As regards the fiber type distribution, the control group showed a higher percentage of type-I fibers, which were similar on both sides of the spinal cord. No fiber proportion asymmetry could be detected in the muscles on the concave side in normal or scoliotic rabbits. There was a tendency to depart from normal values, in two different ways, on the convex side of scoliotic animals. Thus, in contrast to the medullary damage group, the muscles of the costotransversectomized rabbits showed an increased proportion of type-I fibers. Taken together, our findings support the hypothesis that myopathic changes as observed in human idiopathic scoliosis are a consequence of the postural deformity. Fiber type distribution does not appear to be related to the curvature in the same way.

Animals↗

Intraoperative radiotherapy in the multidisciplinary treatment of pediatric tumors. A preliminary report on initial results.

From September 1984 to July 1987, 33 children received intraoperative radiotherapy as part of a multidisciplinary tumor treatment. Their age ranged from 2 to 17 years. Tumors types: Ewing's sarcoma (n = 11), osteosarcoma (n = 8), soft tissue sarcomas (n = 5), Wilms' tumor (n = 3), neuroblastoma (n = 3), malignant pheochromocytoma (n = 1), Hodgkin's disease (n = 1), and optic nerve glioma (n = 1). In 25 patients the disease was localized while 8 had distant metastases. Intraoperative radiotherapy was used in 26 previously untreated patients as part of a radical treatment program and in 7 cases as an effort to rescue local failures (5 in previously irradiated areas). The intraoperative radiation field included the surgically exposed tumor or tumor bed, and the single doses ranged from 10 to 20 Gy, with 6-20 MeV electrons. Patients with osteosarcoma and recurrent tumor in a previously irradiated area did not receive postoperative external beam radiotherapy. With a median follow-up time of 10 months (1 to 31 + months) 24 out of 33 patients are alive without local recurrence and 9 have died from tumor (5 with local disease progression). Intraoperative radiotherapy seems to be a feasible treatment which might promote local control in pediatric tumors.

Adolescent↗

Scoliosis induced by medullary damage: an experimental study in rabbits.

To date, there have been no reports of experiments designed to induce scoliosis by direct damage of different areas of the spinal cord. In a series of rabbits with medullary damage, the authors attempted selectively to interrupt the pathways that mediate proprioceptive input. Unilateral lesion of the dorsal column and posterior horn of the spinal cord was performed using three different techniques: coagulation with laser, stereotaxic microcoagulation, and longitudinal electrocoagulation. Of 32 operated rabbits, 17 developed scoliosis, exhibiting clear pathologic damage of the spinal cord. Electrophysiologic study, including EMG and analysis of the tonic -- vibratory reflex, was performed on 10 rabbits with medullary damage (scoliotic and non-scoliotic) and 12 matched controls. The data suggest disturbance of the sensory afferences that control the postural tone and consequent muscular imbalance, expressed as reduced activity in the muscles of the convex side. This work supports the view that loss of proprioceptive neural impulses caused by medullary damage can induce scoliosis.

Animals↗

The place of intertrochanteric osteotomy in the treatment of idiopathic necrosis of the head of the femur.

The authors present their experience of the use of intertrochanteric osteotomy for the treatment of idiopathic necrosis of the head of the femur. The results obtained from 102 osteotomies performed on 81 patients with the disease are analysed. The mean follow-up is 4.2 years. The results show a statistically significant clinical improvement after operation. Patients presenting with Ficat and Arlet Stage II involvement fared much better than those with more severe changes. Better results were also seen in those with a necrosis angle of less than 200 degrees. No radiological improvement was seen although a high percentage showed no deterioration. The choice of treatment for the condition is discussed in the light of these results.

Adult↗

Aseptic diaphyseal pseudarthrosis: treatment by rigid internal fixation.

The authors define their concepts with regard to nonunion of fractures and study the possible causes of aseptic diaphyseal pseudarthrosis in the 182 cases in their casuistics. They have found that the indication for osteosynthesis was incorrect in 34% of the cases and when it was correct, the technique was poor in 58%. The authors conclude that the risk of nonunion in fractures and nonconsolidation of pseudarthrosis can be minimished if there is: (1) correct indication with respect to type and level of fracture or pseudarthrosis; (2) choice of an appropriate internal fixation method; and (3) good achievement of the selected osteosynthesis.

Femoral Fractures↗

New plate for lateral translation in valgus intertrochanteric osteotomy (CUN plate).

A new plate is presented for internal fixation of valgus intertrochanteric osteotomy. This plate enables a controlled translation, permits dynamic compression of the osteotomy line and eludes some of the complications involved in the use of other double-angle plates. The morphological characteristics of the plate as well as its technical and surgical aspects are described. A follow-up study of 63 patients operated on between January 1978 and June 1980 has been carried out, underlining some of the mistakes that can affect the healing time.

Femur Head Necrosis↗

[The influence of age on the end-results of the total surgical replacement of the hip].

A revision of the first 700 total hip prostheses (operated on in the period 1969-1980) is carried out with the purpose to establish the influence of the age on the evolution of the arthroplasty. The results are very satisfactory but it is younger patients that complications related to loosening are more frequent. This fact can be explained by a longer period of evolution and a major prosthetic stress in these patients. By this reason, we do not use actually cement to fix the implants in those patients younger than sixty.

Adult↗