Biomedical subjects
Publications and source records attributed to V Innao.
Nineteen cases of dysplasia epiphysealis hemimelica are presented. Eleven were single and 8 were multiple. The writers illustrate the clinical and radiographic aspects of this condition, and stress the importance of surgical treatment as soon as the first clinical symptoms appear.
Mesenchymal chondrosarcoma of bone and soft tissues treated at the Istituto Ortopedico Rizzoli are reviewed. The skeletal locations were prominent in five cases. Only two cases were in the soft tissues. Radiographic picture in the bone shows an aggressive osteolysis, with soft tissues invasion. Histologic picture is the same in bone and soft tissues, and is highly distinctive: islands of well-differentiated chondrosarcoma embedded in undifferentiated mesenchymal cells with high malignancy characteristics. The cases showed a poor prognosis, and no patient survived more than four years.
Thirty cases of pulmonary metastases in osteosarcoma are analysed from the point of view of evaluating the indications for localised excision, and also to report the results obtained. This group is compared with 42 analogous cases in which the metastases were not treated surgically. The results of pulmonary surgery is shown to be effective in the multidisciplinary treatment of osteosarcoma with pulmonary metastases.
Maffucci's syndrome is a rare condition which is not hereditary. It is manifested by multiple chondromata associated with subcutaneous angiomata. Up to now only 109 cases have been reported in the literature. Malignant degeneration is reported in about 15% of cases. The authors present 3 more cases, in one of which sarcomatous degeneration occurred in one of the chondromata.
Pigmented villonodular synovitis of the hip is a very rare condition. The authors report 9 cases out of a total of 139 cases of pigmented villonodular synovitis of joints observed at the Rizzoli Institute in the last 35 years. They describe the clinical, radiological and pathological aspects, and discuss the problems of differential diagnosis. In particular, they discuss the indications for surgery (total synovectomy or arthroprosthesis) and the post-operative regime.
The Authors consider the surgical treatment of 122 patients (125 operations) with metastatic lesions of the skeleton. They outline the most commonly used surgical techniques (arthro- and endoprostheses, endomedullary implants, plates). Operations need to be planned with special standards and methods since the bone tissue is undergoing serious structural changes and the patients need rapid rehabilitation. To this end, the utility is emphasized of the substitution with prostheses even of extensive skeletal segments and the use of acrylic cement is recommended to replace loss of substance caused by neoplastic osteolysis. The results obtained are classified as good, fair and bad according to the degree of solidity of the synthesis obtained, disappearance or relief of pain and recovery of function. The complications are discussed and the incidence of survival.
The authors report the results obtained in the treatment of twenty-four cases of transolecranal dislocation (anterior dislocation of the elbow accompanied by fracture of the olecranon). Follow up examinations were performed after one to eight years. Discussion of the types of dislocation is followed by a description of the operations necessary to reduce and stabilise the individual lesions. In the light of the results obtained the authors still consider it advisable for the elbow to be immobilised in plaster for three weeks to allow the capsulo-ligamentous lesions caused by the dislocation to cicatrize.
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A radiographic study of femoral bone tissue remodeling around hip arthroplasty was carried out simultaneously in two series totalling 224 cementless and 77 cemented prostheses. Remodeling was analyzed by detailed visual evaluation of the radiographic assessment. The results show that the phenomenon of bone remodeling is still evolving more than 5 years after surgery. Bone demineralization of the proximal femur is more evident in cementless prostheses than in those stabilized with acrylic cement (24% vs. 12%). The preoperative state of mineralization significantly influences bone remodeling.
Four cases of supracondylar process of the humerus are presented. Two of the patients were asymptomatic and in one of these the supracondylar process was fractured. In a third there was median nerve compression and in the last there was ulnar nerve entrapment. The anatomical features, clinical symptoms and therapy are described. Good results were obtained after resection of the supracondylar process; neurological symptoms regressed one month after surgery.
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