Biomedical subjects
Publications and source records attributed to L Valdiserri.
After reviewing the literature, the authors report 19 patients affected with post-injective contracture of the quadriceps muscle observed by them between 1971 and 1983. Clinical evaluation, indications for surgery and the results of surgery are discussed.
The authors review 31 cases of fracture of the intercondylar tibial eminence in children and adolescents. In view of the constant relationship observed between the initial clinical and radiological findings and the final results, they advise that a clinical examination in narcosis be done in all cases in order to ascertain the existence or otherwise of ligamentous laxity, which is the determining factor in the end result. After emphasizing the differences as compared with these fractures in adults, the principal surgical techniques are reviewed, including the role of arthroscopy.
The authors reviewed 26 hips in 21 patients treated by triple osteotomy of the pelvis for the sequelae of congenital dysplasia or congenital dislocation of the hip. The minimum follow-up was 3 years, maximum 6 years. The clinical condition remained constant over this period. Pain, if present before operation, was either improved or disappeared. The Trendelenburg limp was either unchanged or improved. Reduction of range of hip movement was very rare. There was 0.5 cms lengthening of the leg compared with the pre-operative state. The post-operative radiographic parameters were unchanged over the follow-up period. These included the acetabular roof angle (C.E. angle), Hilgenreiner's roof angle, the neck/shaft angle, and anterior coverage of the femoral head. In about one third of the cases, however, there was deterioration in centralization.
The authors describe the technique of the operation of proximal radio-ulnar arthrorisis, used in the treatment of supination deformity in children affected by obstetrical paralysis of the brachial plexus. The results obtained in 19 cases are discussed.
The authors carried out a study of 15 patients with congenital aplasia of the tibia, 12 total and 6 partial. The clinical and radiographic characteristics of this severe deformity are discussed in relation to the classification and indications for treatment. The authors, whose preference is towards reconstructive surgery, had good results in the partial forms whilst in the total form reconstruction of a new knee joint gave functionally worthwhile results in exceptional cases.
Seventeen children between the ages of 6 and 12 years with fractured femoral shafts were treated by Küntscher nailing. They were followed up clinically and radiographically to ascertain if nailing had any long term adverse effects. The following radiographic parameters were considered: --valgus, varus angle; --distance between lesser trochanter and acetabulum; --width of the neck of the femur; --distance between greater trochanter and acetabulum; --intertrochanteric distance. On analysing the results it was found that Küntscher nailing did not give rise to any adverse effects provided it is carried out after 8-9 years of age.
Triple pelvic osteotomy (or triradiate osteotomy) enables a Salter innominate osteotomy to be performed in older children, or even in adults. The displacement of the acetabular fragments is made possible by a double osteotomy near the symphysis in the anterior pelvic girdle. After the age of seven to eight years, the lack of elasticity in the symphysis pubis makes it technically difficult to perform a classic Salter osteotomy. On the basis of a study of the first twenty cases in which the operation was performed, the authors discuss the indications and describe the surgical technique for this operation, which enables excellent acetabular roof cover to be provided in dysplastic hip joints in which the femoral head can still be centered.
Three children presented with recurrence of aneurysmal bone cyst. In two of these patients the lesion was localized in the superior metaphyses of the tibia and humerus respectively. Total resection was performed followed by the introduction of autoplastic transplants of cortical and spongy bone. In the third case prosthetic substitution of the upper fourth of the ulna was preferred. Healing was obtained in all cases. The indications, operative technique and the final results are discussed.
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