PubMed Health⌕ Search

Biomedical subjects

J de Pablos

Publications and source records attributed to J de Pablos.

At least 19 recordsLinked to original sources
PubMed1998

Progressive opening-wedge osteotomy for severe tibia vara in adults.

Five patients with tibia vara were treated with progressive opening-wedge osteotomy. The maximum varus deviation of the mechanical axis of the tibia varied from 20 degrees to 12 degrees. The minimum postoperative follow-up was 26 months. Complete correction of the deformity was achieved without any major complications. Progressive opening-wedge osteotomy offers several advantages over conventional osteotomy in adults. First, fibular osteotomy is unnecessary. Second, knee mobility is only slightly restricted immediately following surgery. Third, it is possible to adjust correction postoperatively, and finally, progressive opening-wedge osteotomy does not induce shortening of the lower limb. The most significant disadvantage is the need for prolonged external fixation. This technique should be reserved for patients with severe deformities (minimum of 15 degrees varus) and mild or moderate osteoarthrosis.

Aged↗
PubMed1997

Bone remodeling in malunited fractures in children. Is it reliable?

Fracture malunion is not a rare phenomenon in children due to the frequent use of closed reduction treatments. In this article, the processes of bone remodeling in cases of angular and rotational deformities, overriding of bone fragments, and overgrowth are addressed. Critical analyses of the mechanisms to correct these deformities, function of the physis and periosteum, and other related factors are given. The acceptable deformities for complete remodeling to be successful vary at different ages and locations.

Bone Remodeling↗
PubMed1995

Progressive opening-wedge osteotomy for angular long-bone deformities in adolescents.

We report the treatment in 17 patients of 27 angular deformities of the long bones by progressive opening-wedge osteotomy. The technique consists of percutaneous osteotomy and progressive angular correction using a modified Wagner distractor. Ten patients (20 bone segments) had adolescent bilateral idiopathic tibia vara with a mean angular deformity of 12 degrees varus (10 to 16). Seven other adolescent patients had secondary angular deformities either at the distal femur or the distal tibia. One of the femoral deformities had an associated 5.5 cm of shortening which was treated simultaneously. The patients with idiopathic tibia vara achieved a final mean angular correction of 15 degrees (mechanical axis from 12 degrees varus to 3 degrees valgus). In patients with secondary angular deformities the mean angular correction was 17 degrees. The Wagner device was removed in an average period of 12 weeks (9 to 27), and no major complications were observed. Progressive opening-wedge osteotomy is an alternative to conventional osteotomies for the treatment of angular deformities of the long bones in adolescent patients, and has the advantage of requiring less invasive surgery, allowing progressive and adjustable correction with bone lengthening if needed.

Adolescent↗
PubMed1994

Large experimental segmental bone defects treated by bone transportation with monolateral external distractors.

Monolateral frames were applied to five dogs and ten lambs for treatment of large segmental bone defects (LSBD) surgically induced in one of their femoral diaphyses. Reconstruction was attempted by bone transport, as developed by Ilizarov. Monolateral frames were used to minimize the draw-backs of Ilizarov's circular device. Radiographic, computed tomographic, and histologic studies were performed. The skin and soft tissues were not a major obstacle for the longitudinal migration of the screws during bone transport. Four months after the operations, healing and remodeling of the bone defect was always satisfactory. Histologically, the repair of the lengthened segment followed an intramembranous ossification pattern in its central areas and in the periphery as well. At the end of the experiment, the new induced bone had a virtually normal diaphyseal bone appearance. Bone transport for the treatment of experimental LSBD can be completed in monolateral frames.

Animals↗
PubMed1993

Treatment of adolescent tibia vara by asymmetrical physeal distraction.

We have treated 12 adolescent patients with idiopathic tibia vara by asymmetrical physeal distraction using a modified Wagner external fixator. There were no major complications and a mean correction of 13 degrees was achieved. The main advantages of the technique are that no osteotomy, internal fixation or bone graft is needed, and that the operation can be performed on both tibiae simultaneously. No shortening is produced and lengthening can be added to angular correction if required.

Adolescent↗
PubMed1992

Delayed distraction in bone lengthening. Improved healing in lambs.

We compared delayed distraction (DD) with immediate distraction (ID) in bone-lengthening. Open femoral diaphyseal osteotomy was performed on 24 three-month-old lambs, and external distractor fixators were applied. In the ID group (n 12), distraction commenced on the first postoperative day; in the DD group (n 12), distraction was delayed until the tenth day after surgery. In all the animals, the femur was lengthened by 2 cm at the rate of 1 mm/day. The animals were killed 1, 2, and 3 months postoperatively. Radiography and densitometry of the lengthened callus showed that DD, compared with ID, improved the quality of the callus with quicker, denser, and more homogeneous bone formation.

Animals↗
PubMed1992

Correction of angular deformities by physeal distraction.

Physeal distraction is an alternative to more conventional treatments for the correction of angular deformities of the long bones. Twenty deformities of the femur and tibia, nine of which also involved associated shortening, were partially or completely corrected. In eight cases, there was physeal bony bridge. Complete correction of the angular deformity was achieved in 17 patients, and in seven patients, more than 80% correction was achieved. There were complications in four patients that hindered complete correction of the deformity, or shortening, or both. The external control of the correction until consolidation occurs is progressive and fairly noninvasive. The method allows external control of the correction until consolidation; it acts at the site of the deformity itself and permits lengthening and angular correction during therapy. In deformities with a physeal bony bridge, correction can be achieved with physeal distraction alone, prior resection of the bridge is not unnecessary. The technique is indicated in cases of angular deformities in patients nearing skeletal maturity and particularly in subjects in whom there is associated shortening.

Adolescent↗
PubMed1991

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↗
PubMed1990

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↗
PubMed1990

Experimental physeal distraction in immature sheep.

An experimental study on physeal distraction was carried out in the distal femur of 45 two-month-old lambs for the purpose of identifying the basic mechanism of lengthening as well as assessing growth cartilage viability after lengthening. The animals were divided into three groups, each with three subgroups, according to the distraction rate employed (2 mm/day, 1 mm/day, 0.5 mm/day) and the time at which the animals were killed (end of lengthening, 1.5 months postlengthening, and at six months of age). Another group of three animals whose femurs were lengthened at a rate of 0.5 mm/day was killed ten days postoperatively. Roentgenologic, specimen measurements, and histologic studies were performed on all animals. The results obtained showed that the basic mechanism for lengthening is the production of a physeal fracture between degenerative and calcified layers; this finding was consistent. It was also observed that the lower the rate of distraction employed, the greater was the short- and long-term viability of the growth cartilage. More specifically, optimal viability was observed when a distraction rate of 0.5 mm/day was employed.

Animals↗
PubMed1986

Bone lengthening by physial distraction. An experimental study.

Experimental physial distraction was carried out in the distal part of the femur in 45 two-month old lambs in order to study the basic mechanisms of lengthening as well as the viability of the growth cartilage after using this method. The animals were divided into three groups (A, B and C), and each group into three subgroups (1, 2 and 3) according to the rate of distraction used (2 mm/day, 1 mm/day, 0.5 mm/day) and the time of sacrifice. The results obtained show that the basic lengthening mechanisms consists, firstly, in the production of a fracture between the metaphysis and the epiphysis and, secondly, that the lower the distraction speed employed, the greater is the short-term and long-term viability of the growth cartilage. Optimum viability was observed at a distraction rate of 0.5 mm/day. On this basis we conclude that in clinical practice physical distraction could be indicated for children at an early stage of skeletal growth and repeated later provided that the rate of distraction is kept within reasonable limits.

Animals↗
PubMed1986

Discitis due to Clostridium perfringens.

Diagnosis of the infectious process of the intervertebral disc is often delayed due to the lack of specifity of the clinical picture. This delay in diagnosis and consequently in treatment can lead to severe neurologic sequela. In these cases, punction biopsy of the intervertebral disc is of special value. The authors found no mention in the literature concerning Chlostridium perfringens discitis verified by aspiration and fluid culture extracted by intervertebral disc puncture.

Adult↗
PubMed1985

Breaking bony bridges by physeal distraction. A new approach.

Physeal distraction for breaking bony bridges and the late treatment of long bone deformities in children near maturity, has been used in our Department since June, 1983. In all cases (4 bones in 3 patients) a deformity was present at the extremity of a long bone due to a bony bridge caused by a previous injury to the growth cartilage. The results were excellent and in our opinion there are advantages over other methods. The operation itself is not extensive and very little damage is done. There is no need for internal fixation or bone grafts. It is possible to obtain lengthening and to adjust the angular correction during treatment. We conclude that it is possible to correct angular deformities and bone shortening due to bony bridges by physeal distraction without the need for resection of the bony bridge. At present we recommend this method in children near skeletal maturity, especially in those cases with bone shortening.

Adolescent↗
PubMed1982

Chronic lateral instability of the ankle.

The authors present 14 cases of chronic lateral instability of the ankle in 13 patients, in whom we performed ligamentoplasty using peroneus lateral brevis. The importance of careful preoperative evaluation of clinical findings as well as stress-roentgenograms and arthrographies is emphasized and a simple surgical technique is presented. We also realize an assessment of the results obtained which are very encouraging at the present.

Adolescent↗
PubMedDate not supplied

Longitudinal growth pattern of the radius after forearm fractures conservatively treated in children.

In a 3-year prospective study, the growth pattern of the radius following fracture was analyzed in 64 children < 15 years old with forearm fractures treated by conservative methods. Comparative radiographic studies of the fractured and the uninjured radius were carried out in all patients at 3, 6, 12, and 18 months after fracture. Only 40 patients, 28 boys and 12 girls, with an average age of 9 years, completed the follow-up period. The series included 19 buckle fractures of the radius, 11 green-stick, and 10 complete fractures. Fracture of the ulna was associated in 11 cases. Maximal average radial growth rate was observed from age 9 through 12 years. Overall, the length discrepancy between the fracture and the healthy radius at the end of the follow-up period averaged 0.03 cm (range -0.50 to +1). In nine cases (21%), the fractured radius showed an average overgrowth of +0.44 cm. In 10 other patients (25%), a radial shortening could be detected (average discrepancy -0.29). Five of the nine cases with radial overgrowth had an associated fracture of the ulna. This association was not found in any of the 10 patients with radial shortening. These observations allow us to reconsider the classic etiopathogenic theories concerning overgrowth in the long bones of children following fracture. Factors other than the increased vascularity of the growth plate--as is postulated for the femur and tibia--must be investigated further to explain the frequent absence of radial overgrowth following fracture.

Adolescent↗