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Biomedical subjects

S Turra

Publications and source records attributed to S Turra.

At least 19 recordsLinked to original sources
PubMed2004

Sonographic assessment of clubfoot.

PURPOSE: This study was performed to develop a standardized methodology for the sonographic assessment of clubfoot at birth and at the end of both conservative treatment and surgical correction. METHODS: Forty-two congenital clubfeet and 42 normal feet were examined sonographically in the position of spontaneous alignment and during passive manual correction. Scans along 4 planes provided information relevant to the assessment: sagittal posterior, sagittal anterior, coronal lateral, and transverse. RESULTS: Sagittal posterior sonograms demonstrated the progressive gain of dorsiflexion ability during the different steps of treatment for clubfoot. Sagittal anterior sonograms could not demonstrate the normal alignment of the navicular in clubfeet because of the bone's medial displacement. On transverse sonograms, the talar head and the medially displaced navicular may lie on the same plane, depending on the severity of the deformity. Coronal lateral sonograms provided for estimation of the relationships between the calcaneus and cuboid, which were described by the calcaneal-cuboid angle. CONCLUSIONS: Sonography is a promising technique for assessment and monitoring of clubfoot during treatment. The method described here yields accurate and reproducible information about the anatomy of the nonossified clubfoot, helping the orthopedic team decide on appropriate treatment steps.

Ankle Joint↗
PubMed2000

Spinal involvement in Pyle's disease.

BACKGROUND: Pyle's disease is a rare skeletal dysplasia involving the metaphyses of long bones. To date, spinal involvement has been only rarely described in the literature. OBJECTIVE: To show that spinal changes, which are an expression of the same growth defect of the long bones, are an important and constant sign of the disease in the families studied. MATERIALS AND METHOD: The radiographic skeletal changes in five patients have been observed. RESULTS: The pathognomonic metaphyseal widening of tubular bones (known as the 'Erlenmeyer flask sign') was associated with the spinal changes in all cases. Radiographic findings in the spine varied from moderate platyspondyly to the bodies having the appearance of a biconcave lens. This may be attributed to two main causes: (1) a defect in the modelling process of the vertebrae (comparable to that observed in the metaphyses) and (2) chronic pathological fractures secondary to osteoporosis (a typical feature of Pyle's disease). CONCLUSIONS: The finding of platyspondyly of varying severity widens the spectrum of radiographic findings in this disease and can assist in diagnosis.

Adolescent↗
PubMed1998

Comparison of technetium-99m-MDP, technetium-99m-WBC and technetium-99m-HIG in musculoskeletal inflammation.

UNLABELLED: This study compared three radionuclide techniques in distinguishing musculoskeletal infection from noninfectious inflammation. METHODS: Thirty-five orthopedic patients with suspected musculoskeletal infection were examined using three radionuclide techniques in sequence: triphasic bone scintigraphy, 99mTc radioleukocytes (99mTc-WBC) scintigraphy and 99mTc human immunoglobulin (99mTc-Hig) scintigraphy. Two "early" and "late" acquisitions were performed, at 4-6 hr and 20-24 hr postinjection, respectively. Patients who were diagnosed as suffering from noninflammatory lesions became the controls. We calcu"late"d for all studies one index of inflammation (Infl) as the ratio between counts in the uptake area and counts in an equal area of normal tissue. RESULTS: The "early" radiolabeled leukocytes and "late" Hig scintigraphy allowed the greatest ability to distinguish between infections and noninfectious inflammations (p < 0.011 and p < 0.016) with a sensitivity of 96.6% and 96.5% and specificity of 71% and 100%, respectively. Hig and radioleukocytes allowed distinguishing infections from noninflammatory diseases at both examinations. CONCLUSION: The "early" radioleukocyte scintigraphy allowed us to separate infections from noninfectious inflammations. In contrast, the same result can be obtained only with the "late" scan in the Hig study, but Hig mapped the spread of the inflammation into soft tissues better. Hig might be an alternative to radioleukocytes because of its simple preparation, similar accuracy and safety.

Adult↗
PubMed1995

Prevalence of unsuspected myopathy in infants presenting for clubfoot surgery.

The objective of this study was an evaluation of the prevalence of myopathies in paediatric patients scheduled for orthopaedic surgery (clubfoot) performed under regional anaesthesia. Seventeen infants scheduled for lower limb orthopaedic surgery were studied to verify coexisting neuromuscular disorders with electromyography and muscle biopsy during surgery. All surgical procedures were performed under caudal block or spinal anaesthesia, associated with light general anaesthesia. No major cardiorespiratory, neurological or malignant hyperthermic complications (muscle rigidity, arrhythmias, hyperpyrexia) were observed. Combined neurological, electromyographic and biopsy studies showed a high rate of myopathic changes (70%). Performance of clubfoot surgery under light general anaesthesia with regional techniques was free from any problems. The high rate of myopathic changes (70%) observed in the muscle biopsies suggests that precautions should be taken with paediatric patients for clubfoot surgery and a regional anaesthesia technique with adequate monitoring may be helpful to prevent possible malignant hyperthermia related problems.

Anesthesia, Conduction↗
PubMed1993

Monoarticular juvenile chronic arthritis of the shoulder. Report of a case and review of the literature.

In 20% of the cases Juvenile Chronic Arthritis (JCA) has a monoarticular onset. Usually the inflammatory process spreads out to other joints with pauciarticular or polyarticular course. Very rarely the disease persists in one joint only and this is in about 70% of the cases, the knee. We describe a case of Monoarticular JCA with isolate and persistent involvement of the shoulder never reported in the literature. The clinical, pathologic features and different diagnoses are discussed.

Arthritis, Juvenile↗
PubMed1992

Adriamycin in hyperthermic perfusion for advanced limb sarcomas.

From February 1989 to April 1991, 12 hyperthermic limb perfusions (HLP) with adriamycin (ADR) were performed in 12 patients with high grade soft tissue sarcomas (9 in the leg and 3 in the arm); two were at A.J.C. stage IIb, eight stage IIIb and two stage IV. ADR (0.7-1.5 mg/kg) was administered in bolus at a mean temperature of 41.5 degrees C and perfused for 60 min. No systemic toxicity was reported; seven patients had grade II locoregional toxicity, another four grade III and one grade IV. Tumor necrosis (radiological evaluation) was less than 25% in two patients, 25% to 50% in two, 50% to 75% in five and greater than 75% in three. Limb sparing surgery was feasible in ten patients. At present eight patients are alive; three had local recurrence and four distant metastases.

Adult↗
PubMed1991

[Plate osteosynthesis in complex fractures of the tibial plateau].

The authors report their experience in the treatment of complex fractures of the tibial plateau (epi-metaphyseal and comminuted bicondylar and spinotuberosity fractures) using the Kerboull epiphyseal plate and autogenous cancellous bone grafts if sinking occurs. It is not always possible to perfectly restore joint anatomy and stability. Plate fixation ensures solidity by not exposing the load-bearing axis, eliminating the risk that the tibial plate will later give way and thereby allowing early mobilization and rapid functional recovery of the knee. The authors emphasize the importance of both consensual treatment of possible ligament tears and preservation, when possible, of the meniscus. They claim that the frequent complications can only be prevented by careful preliminary assessment of general and local conditions which may absolutely or relatively contraindicate this type of surgery.

Adult↗
PubMed1991

[Ultrasonography in the study of lesions of the menisci and the collateral ligaments of the knee. Findings in 48 surgically treated patients].

The authors report the results of the study of 48/112 patients who underwent US examination of the knee for gonalgia. Meniscopathy or capsular-ligamentous lesions were clinically suspected. US results were compared with arthroscopic or athrotomic findings; the latter two methods were considered as the reference gold standard. US exhibited 81.2% overall diagnostic accuracy, thus confirming its limitations, more evident than those of arthroscopy and arthrography, CT and MR imaging. Major limitations of US were its failed recognition of meniscal tears smaller than 5-6 mm, and its failed distinction of degenerative meniscopathies from common meniscal fractures (with the exception of 2 cases). Moreover, US did not allow cruciate ligament lesions to be demonstrated; however, in all these cases, US did demonstrate increased capsular thickness (greater than 3 mm at the lower margin of femoral condyle). This indirect sign, together with roudness of parameniscus and capsular-ligamentous limitans (at the hemirhyme), and the direct sign of inhomogeneous hyperechogenicity of the meniscal triangle (normally hypoechoic) contributed to raising overall diagnostic accuracy of US to 89.9%. In the 5 patients with a suspected lesion of the medial collateral ligament examined within 48 hours from trauma, US gave 2 false-positive results in 2 cases where forced abduction test was also positive. Massive edema and swelling of adjacent structures prevented the correct evaluation of ligament limitans. In these 2 cases, a lesion in the anterior cruciate ligament was found at surgery; one of them was associated with a meniscal lesion already diagnosed at US. Both parameniscal and popliteal cysts were correctly diagnosed with US. Due to the well-known limitations of clinics in the diagnosis of knee pain, US could be suggested as the examination of choice to evaluate suspected meniscopathy or ligamentous lesions, thanks to its low cost and short execution time. The use of US could also spare the patients more invasive examinations--e.g., arthroscopy and arthrography--and more expensive ones--e.g., CT and MR imaging.

Adolescent↗
PubMed1990

Long-term follow-up results after surgical repair of esophageal atresia.

Fiftytwo of 55 children, surviving surgical repair of tracheo-esophageal fistula between 1975 and 1985, were reviewed in relation to birth weight and Waterston's risk group after a mean follow-up of 7.5 years. The long-term results of esophageal atresia patients seem good in 30% of the follow-ups. Esophageal dysfunctions and respiratory difficulties were found respectively in 23 (44.2%) and 26 (50%) of the children; all the patients were improving after the first years of life. Scoliosis affected 27 children (51.9%) and its incidence increased with growth. Waterston's classification was a poor prognostic guide, but children weighing less than 2500 g at birth remained of relatively lower weight. The frequent development of scoliosis with age leads to continue evaluations after that respiratory and alimentary problems which might occur in the early years have been overcome.

Adolescent↗
PubMed1990

A 20-year follow-up study of a case of surgically treated massive osteolysis.

Massive osteolysis of the humerus occurred in a 19-year-old male. The lesion was successfully treated with an autogenous fibular shaft transplant. During the 20-year follow-up period, humerus function was restored. Roentgenograms showed incorporation of the graft without any recurrence of the disease. This experience and reports in the literature show that only predominantly cortical autogeneic bone grafting has been successful. This could be due to the intrinsic characteristic of cortical bone. In fact, it seems that cortical bone shows greater resistance to erosion than cancellous bone to the lymphangiomatous osteolytic tissue. Therefore, autogenous bone grafting could be considered as a reasonable alternative to radiotherapy, particularly in young people with monostotic disease localized in bones that are easily operable and have no soft-tissue involvement.

Adult↗
PubMed1989

The treatment of fractures of the surgical neck of the humerus by osteosynthesis with Kirschner wires.

Seventy-one patients treated for fracture of the surgical neck of the humerus by osteosynthesis with Kirschner wires inserted percutaneously were followed up. The method is described in detail, and its indications and limitations are discussed. The clinical and radiographic results were extremely positive, with minimal complications and a much reduced work load on the part of the surgical team.

Adolescent↗
PubMed1989

[Torsional defects of the lower limb: an evaluation of the reliability of the results obtained by CT].

The torsional angle was calculated goniometrically of 9 femurs and 2 tibio-peroneal groups, and then compared to the values obtained from CT scans of the corresponding bones. The results show how the methods adopted up to now have been inaccurate and have yielded only gross definitions of the axis of the femoral neck. As far as this feature is concerned, an error of +/- 6.5 degrees can be estimated, with limits of confidence of 95%, after applying a more accurate system of measurement to the images and considering statistical interferences. After pointing out the advantages of this method, we suggest that the test performed in vivo be systematically proposed to all those patients in whom a more accurate diagnosis would lead to a different medical/surgical therapy considering that: 1) the inevitable error such a measurement bears can be contained between acceptable limits; 2) the radiation dose sufficient to distinguish the bone from the other surrounding tissues is much reduced with respect to the dosage necessary to perform a common CT of the inferior limbs. It comprises one topogram and four tomograms, with a total dose to the patient of approximately 10-20 mGy.

Cadaver↗
PubMed1987

[Anesthesia and nanism. Apropos of 2 cases].

The authors describe the favourable outcome of general anaesthesias in a female patient with achondroplastic dwarfism and in another patient with dystrophic dwarfism. In the first patient the gall-bladder was removed and a plastic reconstruction of the diaphragm was carried out. In the second patient a Girdlestone's operation was performed. The difficulty of intubation of the dystrophic dwarf due to stiffness of the cervical spine suggested a procedure of intubation under fibroscopy. The doses of agents and the size of the tracheal tubes were calculated on the basis of the patients weight and the controlled ventilation was carried out after determining the current volume and the respiratory frequency in the awaken patient.

Achondroplasia↗
PubMed1985

Osteochondritis dissecans of the talus. A report on 7 cases.

The clinical and radiological findings in 7 cases of osteochondritis dissecans of the talus indicate that this is a potentially progressive condition. Surgical treatment was carried out in 4 cases while the remaining 3 were treated conservatively. Surgery produced good clinical and radiological results. The conservative treatment consisted of immobilisation and abstention from weight-bearing. This was unsuccessful in 2 adult patients but in a 9 year old girl it led to a virtually complete recovery in 3 months.

Adolescent↗
PubMed1978

Surgical treatment of congenital club foot. (Comparison of the results of Codivilla's operation with those of Turco's modification).

The purpose of this paper is to compare the results of the classical Codivilla operation with those obtained from the same operation as modified by Turco. The authors have assessed ninety one feet in sixty eight patients treated between 1968 and 1975. The severity of each foot was assessed before and after corrective treatment according to the classification of Manes et al., 1975. The results were determined according to the classification of Mastragostino et al., 1976, based on the clinical, radiographic and functional findings. In this connection, the authors attached particular importance to the dorsiflexion test. Based on their findings in this survey, the authors assert that Turco's modification of the classical Codivilla operation enhances the results.

Age Factors↗
PubMedDate not supplied

Macrodactyly of the foot associated with plexiform neurofibroma of the medial plantar nerve.

A case of macrodactyly of the foot associated with plexiform neurofibroma of the digital branches of the medial plantar nerve is reported. The purpose of this article is to investigate the nature of the association of the rare localization of macrodactyly with a pathognomonic feature of von Recklinghausen disease. The case was approached by semiconservative surgical treatment. Two-year follow-up has shown no relapse of the deformity. These facts suggest that this case of macrodactyly was sustained by an underlying disorder, namely, a "forme fruste" of neurofibromatosis, implying the existence of a still unknown pathogenetic mechanism.

Child, Preschool↗
PubMedDate not supplied

[Analysis of a preventive health service].

This paper reports the experience and organization of an Occupational Health Service for health-care workers, in order to improve the effectiveness of the unit. The Authors describe the activities of the unit, its organization, and evaluate the amount of working time spent in the different activities.

Health Personnel↗