Biomedical subjects
Publications and source records attributed to L Ferrandez.
We recorded the incidence of fractures of the proximal end of the femur in the province of Salamanca, Spain, 1977-88. Based on age-specific survival estimates, the probability of suffering a hip fracture after 50 years of age in women was 7 percent and in men 2 percent, i.e., substantially lower than in Northern Europe or U.S.A.
A retrospective of 216 tibial fractures treated orthopedically was carried out. The aim was to analyze a set of clinicobiological parameters that owing to their assumed action on the physiological model of consolidation can be considered as risk factors to be taken into account in all kinds of orthopedic treatment, because they may lead to a lengthening of the normal consolidation time of the fracture. The variables analyzed were the following: type of immobilization, causative agent of the fracture, location of the focus of the fibular fracture, initial displacement, degree of conminution, type of wound, type of fracture, appearance of radiologically observable callus, commencement of weight-bearing, post-fracture hematoma, secondary displacement, and infection of soft tissues. In the particular case of immobilization by an ischiopedic plaster cast, the following parameters showed a greater degree of prognostic significance: initial displacement, secondary displacement, and age.
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Thirteen cases with loosening of THR treated by a massive prosthesis are reviewed. In previous years, with more conservative surgery, the loss of bone stock was most important. The results after a long follow-up were satisfactory. This was a desperate procedure during a period without a bone-bank. Despite the major problems with failure of this procedure, the author still recommends it in elderly patients who need early mobilization or when the use of a bank-bone is not possible.
Using a series of miniature piezoelectric transducers constructed by the authors, a study was made of the effect of anterior displacement of the tuberosity of the tibia on the distribution of pressures in the patellofemoral joint. Proportionally, the most efficient displacements are those set at 1 cm; after this, and as advancement of the tuberosity is increased, the overall pressure continues to decrease progressively (although more slowly) because there are zones that, according to their situation, receive increased instead of decreased pressures. Consequently, values even higher than those of the original situation are reached. This is the case of the proximal part of the patella, particularly on its lateral facet. This situation can affect the results in cases where the lesion is preferentially located on the proximal part. In these cases it may be enough to advance 1 cm with which overall decompressions close to 50% of the pressure that initially affected the patellofemoral joint are obtained. In very evolved cases or when the lesions are located centrally or distally, it may be worthwhile to advance maximally in spite of the possible complications, seeking the greatest decompression effect that intense advancements can achieve.
Based on Allman's classification, the authors conducted a critical study on the results of treatment of 17 sternoclavicular dislocations, 14 anterior and 3 posterior. They propose conservative treatment for subluxations and operative treatment for total dislocations, particularly when posterior. Tomography was required for precise diagnosis. The advantages of open reduction are stressed and the complication of intra-thoracic migration of crossed Kirschner wires used to stabilise reduction and capsular suturing is described.
A case of pachydermoperiostosis observed over a period of 4 years in a man aged 19 is reported. Its clinical features are described; these place it in the "incomplete" group, according to the classification of Touraine et al.. The authors also discuss the diagnostic criteria and the differential diagnosis from Pierre Marie disease, Ribing's syndrome, van Buchem's syndrome and acromegaly.
Based on an analysis of the authors own patients and observations presented by Suessenbach and Weber, a new, enlarged classification of injuries of the epiphyseal cartilage of the ankle joint was presented which makes it possible to compare the anatomic and functional results of therapy. According to our analysis, the age of the patient seems to be significnat for the success of treatment.
A further case of juxta-cortical chondroma in the first finger-ray of a 61-year-old woman. Periosteal chondroma is an extremely rare benign tumor. Only 34 cases can be found in the literature. The tumor is cured with surgical removal.
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The CT findings observed 6 months and 2 years after chemonucleolysis in 50 and 34 patients are reported. Emphasis is placed on the persistence of the hernia image in nearly 70% of the cases, together with an increase in degenerative intradiscal signs and degeneration of the facet joints; however, this did not lead to poor results 2 years after chemonucleolysis.