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Biomedical subjects

J de Pablos

Publications and source records attributed to J de Pablos.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Surgical management of nerve injuries of the upper extremity in children: a 15-year survey.

In a 15-year retrospective study, the results of 37 surgically treated nerve lesions of the upper extremity in 33 children were reviewed after a mean follow-up of 2 years. Children ranged in age from 4 to 15 years. There were 19 ulnar, 12 median, and 6 radial nerve injuries. Discontinuity of the nerve trunk was found in 23 patients operated by interfascicular grafting (18 patients) or epineural suture (5 patients). The other 14 lesions were treated by decompressive external neurolysis. Useful sensory function (S4-S3) assessed at the autonomous zone was restored in 31 patients (84%). Satisfactory motor recovery was achieved in 25 patients (67%). Independent of the type of lesion, the median nerve showed the best ability to regain complete motor and sensory function. In lesions with continuity of the nerve trunk, those affecting the radial nerve had a worse prognosis regarding motor function recovery. Unfavorable prognosis was mainly related to a time interval of more than 1 year between nerve damage and surgery.

Adolescent↗
PubMedDate not supplied

["Internal lengthening" for the treatment of large segmental bone defects. An experimental study].

Ilizarov's idea of treating large segmental bone defects (LSBD) by transporting bone along the length of the defect is to us extremely interesting. However, the circular external distractor employed, unlike monolateral frames in cumbersome, transfixing and difficult for both placement and postoperative management. A research project has been carried out at our experimental surgery laboratory to assess the reliability of monolateral frames in the treatment of LSBD following Ilizarov' idea. For this experiment we selected five 6 to 12 month-old dogs, five 6 month-old lambs and five 12 month-old lambs, the latter being skeletally mature. All animals were male. The experiment consisted in an attempo of reconstructing a LSBD of 4-5 cm of the animal's femoral diaphysis by means of Ilizarov' method but using monolateral devices. The evaluation of the results was made by X-rays, muscle and bone histology and measurement of the specimens. On the basis of the results obtained it is concluded that treatment of LSBD by the Ilizarov method can be successfully accomplished by using monolateral external fixator-distractors. The advantages of the monolateral frames include a marked minimization of some the most outstanding drawbacks of Ilizarov's circular device, while keeping the advantages of his original concept.

Animals↗
PubMedDate not supplied

[Elongation of the lower extremities. Experience at the University Clinic of Navarre].

The objective of this paper is to explain how and why bone lengthening techniques developed in the Department of Orthopaedic Surgery and Traumatology of the University Clinic of Navarra. We gave up on bone stimulation methods because they were unpredictable and almost not effective; also we abandoned the one-step lengthening methods because they are particularly prone to complications. Now we use almost always progressive lengthening methods among which we prefer bone lengthening by means of metaphyseal percutaneous osteotomy with delayed distraction. Indications for this late method include bone lengthening regardless the age, except for congenital shortening, and correction of angular deformities in mature patients. Physeal distraction would be indicated for bone lengthening in congenital shortening and correction of angular deformities always in immature patients.

Age Factors↗
PubMedDate not supplied

Treatment of adolescent Blount disease by asymmetric physeal distraction.

An alternative treatment is presented for late-onset Blount disease in a 14-year-old boy. The technique consists of asymmetric physeal distraction of the proximal tibial growth plate by using a modified Wagner fixator-distractor device that allows progressive angular correction. The patient had a 23 degrees varus deviation of the left tibia, and no physeal bone bridges were detected. Once the fixator was assembled, distraction started 24 h after surgery at a rate of 1.5 mm/day (2 x 0.75). Complete correction was achieved in 25 days. No osteotomy of the fibula was required. The Wagner device was removed in the outpatient clinic 10 weeks postoperatively. After a 4-year follow-up, there was no loss of correction, showing a satisfactory alignment of the operated-on lower extremity. As compared with acute conventional osteotomies, asymmetric physeal distraction entails several advantages for treatment of Blount disease such as less invasive surgery, progressive and adjustable correction taking place at the apex of the deformity, and the possibility of bone lengthening if needed. Furthermore, physeal distraction does not require a second surgical step for bonegraft harvesting or for removal of the internal fixation.

Adolescent↗