Biomedical subjects
Publications and source records attributed to Q Mollica.
The authors report their experience in treating angular and rotational deformities of the lower limb by an original method consisting of corticotomy and gradual distraction with an external fixator on the opposite side of the limb as the deformity. The Castaman angular and Monticelli-Spinelli circular external fixators were employed (Castaman, 1983; Monticelli and Spinelli, 1983, 1986, 1987).
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The authors report their experience in surgical treatment of the arthritic varus knee. After a comparative study of the most commonly used osteotomy techniques, they describe the results of their first cases of metaphyseal tibial corticotomy and angular distraction using an external fixator (25 cases).
The authors report their experience in the reconstruction of the anterior cruciate ligament using the Leeds-Keio ligament in 12 patients, 7 by open arthrotomy and 5 by an arthroscopic technique. The biological evolution of the new ligament was studied macroscopically and histologically in the first 6 cases treated by open arthrotomy. Arthroscopic monitoring and biopsy was carried out 4 to 10 months after operation. In 5 cases the new ligament appeared to be intact and histologically vital, with proliferation of new tissue along the new ligament. There were broken filaments of dacron hanging from the intercondylar cavity in only one case. The first macroscopic, histological and ultrastructural results show that despite a few limitations the Leeds-Keio ligament has the features required for replacement of the anterior cruciate ligament, although it will be necessary to wait 4 or 5 years before fully evaluating the durability and function of the ligament and the best operative method.
Following a review of current knowledge on the anatomical, histological and biomechanical aspects of fracture healing, the authors present an original method for the measurement of relative interfragmentary deformation in diaphyseal fractures of the lower extremity stabilised by flexible intramedullary nailing. The first data obtained is reported. In the examples reported, the authors have determined the precise amount of relative interfragmentary deformation in diaphyseal fractures of the lower extremity stabilised by flexible intramedullary nailing. The first data obtained is reported. In the examples reported, the authors have determined the precise amount of relative interfragmentary deformation in each case, using accurate digitizer measurement on the radiographs with and without loading. This method makes it possible to measure relative interfragmentary deformation and monitor it over a period of time. The authors conclude that relative interfragmentary deformation is beneficial to the healing of fractures provided it is kept within the limits of the "strain-tolerance" of the various types of callus which succeed one another during fracture healing.
The excellent results obtained in the stabilization of lateral and subtrochanteric fractures of the neck of the femur by the use of Ender nails have encouraged us to extend this method, with some technical modifications, to shaft fractures of the femur. It is proposed to be an alternative in the surgical treatment of such fractures. We propose to use this alternative when local conditions counterindicate, or the risk factor in other surgical techniques is too high. This method is simple, easily executed and assures a rapid and functional recovery. Ender intramedullary nailing achieves a dynamic stabilization controlled by the elasticity of the nails, muscle tone and weight bearing. The stabilization allows slight interfragmentary movements and produces the formation of periosteal bone callus.
In cases presenting with abdominal pain in which the clinical findings and investigations are negative there is often associated dorsolumbar pain. The pathology in such cases often resides in the posterior apophyseal spinal joints, which should therefore be investigated as follows: a) Clinical. The abdomen is examined for areas of hypoaesthesia. The level of vertebral anomaly and related referred pain are determined using the Maigne test. b) The affected area of the spine is investigated by standard and dynamic radiographs and CT scan for evidence of transitional anomalies or signs of instability. Is should be noted that in many cases these tests are negative. Local infiltration of the posterior joints has given satisfactory results, as also has manipulation in some cases. The temporary use of a lumbar support and physiotherapy is advised to prevent recurrence.
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The writers first describe the main features of the pathological anatomy and clinical characteristics of Dupuytren's contracture. They classify the lesions by Tubiana's method, which is eminently objective and practical. This classification divides the lesions, according to their severity, in five stages: 0, 1, 2, 3, 4. The surgical technique of total aponeurectomy used by the authors is described. The total case material is thirty patients, with thirty-three hands operated on. By comparing the state of the hand before and after operation, the degree of improvement was calculated as a percentage derived from Tubiana's method of classification. A careful evaluation of the results confirms the validity of the therapeutic approach adopted. The indications and prognosis depend on the severity of the initial lesions. In general the chances of cure are good up to stage 3; but once this stage has been passed, and especially if hyperextension of the terminal phalanx is present, there is a high probability of recurrence and failure. In these cases they advise against corrective surgery and consider arthrodesis or amputation a more suitable alternative.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.