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J D Aquerreta

Publications and source records attributed to J D Aquerreta.

9 recordsLinked to original sources

Complications of bone lengthening.

Bone lengthening is a surgical method which requires meticulous technique, continuous attention, and satisfactory cooperation on the part of the patient. The absence of common criteria makes it difficult both to classify the complications which arise, and to compare them with those of other authors. We report the complications in a group of 61 patients who were studied prospectively. Disorders of the lengthening callus accounted for 45% of all complications, and a further 33% arose in the joints. The remainder occurred in the bone, the apparatus and the soft tissues, of which the most common were stiffness of the joints, axial deviations and loosening of the pins, while articular subluxation, fractures with angulation and delayed consolidation occurred less frequently. In our study, the overall number of complications per lengthening process was 2.1. In bilateral lengthening, the rate was 1 per segment, while in unilateral cases the mean was 2.7. Problems which we defined as severe, requiring that the lengthening had to be halted, occurred in 1.8% of the total complications. The aetiology of the length discrepancy has an important role in the complications which occur in each segment. Over twice as many problems occur in asymmetrical lengthening procedures as in patients where lengthening is symmetrical.

Bone Lengthening

Splenic embolization prior to myelosuppressive treatment in hepatocarcinoma and active chronic hepatitis.

In the treatment of active chronic hepatitis and hepatocellular carcinoma some effective drugs can produce myelosuppression. Hypersplenism may considerably limit the dosage of such drugs. Splenectomy is an effective treatment for hypersplenism, although it is not without complications. Partial splenic embolization is a good and safe procedure; 15 patients were treated in order to achieve higher platelet and leukocyte counts. Embolization has been performed with gelfoam with local and systemic antibiotics (Spigos' protocol) and 50-75% of the splenic parenchyma was infarcted. All patients could be treated for the underlying hepatopathy with adequate dosages of interferon or chemotherapeutic drugs.

Aged

The open-ended guidewire as superselective catheter for intraarterial chemotherapy: experience in 190 procedures.

With intraarterial infusion, high levels of chemotherapeutic agents can be achieved in the tumoral area. We present our experience with open-ended guidewire (OEGW) associated with steerable guidewires (SGW) as superselective catheters for intraarterial chemotherapeutic infusion and embolization. This technique was used successfully in 62 patients (190 procedures) over 15 months.

Antineoplastic Agents

Indications for epiphyseal preservation in metaphyseal malignant bone tumors of children: relationship between image methods and histological findings.

We compared several image methods in the evaluation of the possible physeal effect in 47 osteosarcomas and 18 Ewing's sarcomas in children. The minimal follow-up was 3 years (range, 3-17). In the histological study, the physis was affected in 53% of the cases. We correlated the histological findings and the findings from the different image methods. There were more false-positive than false-negative results, and in the computed tomography and magnetic resonance imaging (MRI) studies, there were no false negatives. The accuracy of MRI (predictive positive value plus predictive negative value) was the best (90.3%), and it is the technique that we prefer. According to these findings, we can safely preserve the epiphysis in cases of metaphyseal tumors showing no contact between the tumor and the growth plate in the MRI images. If the tumor shows contact with part of the physis, it is also possible to preserve the epiphysis.

Adolescent