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Biomedical subjects

D Saragaglia

Publications and source records attributed to D Saragaglia.

47 records · Page 3Linked to original sources
PubMed1986

[Butel's hip screw-plate in osteosynthesis of fractures of the upper end of the femur. Apropos of 241 osteosyntheses (100 true cervical fractures and 141 fractures of the trochanter)].

Butel's hip plate was used for osteosynthesis of 241 fractures of upper end of femur (100 true cervical - 141 trochanteric and subtrochanteric fractures). Results for true cervical fractures were assessed as satisfactory in 89.5% of cases, with only 3 pseudarthroses and 4 cases of femoral head necrosis (2 septic, 2 aseptic), a total complication rate of 7.5%. These clinical results confirm the value of screw fixation at several cephalic anchorage sites (demonstrated biomechanically) in true cervical fractures. Results in trochanteric and subtrochanteric fractures were rated as satisfactory in 86.9% of cases, complications including 2 ruptures of plate, 1 sepsis and 4 early loosening of plate. The latter sequela was avoided by an improved choice of indication for the procedure and by substitution of this compound material (screw-plate) for a monobloc piece ("anti-loosening cervicocephalic screw apparatus"), in compound fractures of trochanter.

Adult↗
PubMed1986

[Latarjet's surgery in recurrent anterior dislocations of the shoulder. 117 cases with an 8-year follow-up].

One hundred and seventeen shoulders in 113 patients were treated surgically for recurrent anterior dislocation of the shoulder by the Latarjet procedure - transplantation of the coracoid process to the anterior border of the glenoid fossa. 67 p. 100 of the patients engaged in sport and 33 p. 100 did not. The usual lesions found at operation were separation of the capsule from the anterior rim of the glenoid in 59 p. 100, a lesion of the glenoid labrum in 65 p. 100 and damage to the glenoid fossa short of a fracture in 18 p. 100. Postoperative complications were rare and usually mild, except in two cases of osteoporosis of the coracoid transplant and two fractures of the bone block. There was slight limitation of lateral rotation in 48 p. 100, of abduction in 14 p. 100 and of medial rotation in 4 p. 100. The results at follow-up were rated as excellent in 68 p. 100 (72 cases), good in 21.7 p. 100 (23 cases), with slight pain and limitation of lateral rotation of less than 20 p. 100 and fair in 6.6 p. 100 (7 cases). In these cases, the Latarjet procedure had been performed for postoperative recurrence after a previous surgical procedure. There were 4 poor results.

Adult↗
PubMed1986

[Fractures of the lower end of the humerus in adults: influence of per- and postoperative tactics on results. Apropos of 70 osteosyntheses].

Results in 70 cases of osteosynthesis of lower end of humerus in adults were analyzed as a function of the fracture line, and the operative (approach route, type of support, attitude towards ulnar nerve transposition) and postoperative (with or without plaster immobilization) tactics. Best results were obtained in simple joint fractures (condyles, capitellum, Hahn Steinthal) with a good outcome in 89% of cases, while prognosis was poorer (68.5% of delayed good results) in more or less comminuted supra- or inter-condylar fractures (41 cases). Results are better in these latter types of fracture when an extra-articular trans-olecranon posterior approach is used. Ulnar nerve transposition was performed 43 times without adverse effects and osteosynthesis by 2 posterior screw plates (one on external and one on internal column) in 50% of cases. Valid comparison of results with or without postoperative plaster immobilization was not possible since only 8 patients were not plastered.

Adolescent↗
PubMed1985

[Role of intermediate sealed prostheses in the treatment of fractures of the trochanter major in the elderly. Apropos of a continuous series of 110 prosthesis].

Between January 1980 and July 1983, 265 fracture of the trochanteric region in elderly patients were treated in Prof. J. Butel's department. Prior to 1980, 75% of the cases were treated with Ender's pin. However, the high failure rate of this procedure (especially in the case of complex fractures) led the authors to select the indications for this operation much more carefully. In the present series of 265 cases, there were: 110 intermediate sealed prostheses, 136 Ender's pin 19 direct osteosyntheses. At the present time (and for the last 2 years) the indications are distributed in the following way: 50% intermediate sealed prostheses, about 40% Ender's pin and 5 to 10 direct osteosyntheses. The ideal indication for intermediate sealed prosthesis is a unstable fracture of the greater trochanter (complex trochanteric fractures, fractures with a large 3rd fragment separating the lesser trochanter, trochantero-diaphyseal fractures) in autonomous elderly patients over the age of 75. This operation allows immediate weight-bearing and the operative mortality is barely more than with other techniques (21%) with very satisfactory results (more than 80 of good and very good results).

Aged↗
PubMed1985

[Trochanteric fractures in the elderly: Ender nails, prostheses or direct osteosyntheses. Apropos of a continuous series of 265 cases].

The results of 265 trochanteric fractures in the elderly treated between 1980 and 1983 have been analysed. Among them, 136 were treated by Ender's nailing, 110 by prostheses and 19 by internal fixation. In an earlier study, Ender's nailing had been used in 75 p. 100 of cases. The conclusions were that the increasing use of a prosthesis has brought about an improvement in the results-80 p. 100 satisfactory in the present series compared with 54 p. 100 in the preceding one. The mortality rate was comparable after Ender's nailing and prostheses. Ender's nailing is indicated in stable fractures and, in unstable fractures, internal fixation is indicated in very active persons, Ender's nailing in non-ambulatory patients and prostheses in elderly patients with sufficient walking ability.

Aged↗
PubMedDate not supplied

Surgical treatment of bi- and trimalleolar ankle fractures: should the medial collateral ligament be sutured or not?

In Weber type A, B, and C fractures there is no census or whether or not to suture the ruptured medial collateral ligament. From May 1990 to December 1994, operations were performed on 48 patients with such lesions. Thirty-three cases were reviewed, 29 males and four females, with an average age of 39 years (range, 15-73 years). In 22 cases there was an isolated fracture of the lateral malleolus, and in 11 cases the fracture was associated with a posterior malleolus fracture. There were tibiotalar dislocations in nine cases. Fifty-eight percent of the injuries were caused by sports activities and 27% by an ordinary fall. After a preoperative external reduction, the lateral and posterior (if necessary) fractures were anatomically and rigidly fixed (plate, pins, and wire) without any suture of the medial ligament. Medial tibiotalar and tibiofibular diastasis were totally reduced as shown during intraoperative radiographs. The follow-up at time of review was 27 months on average (range, 9 months-5 years). Functional results were excellent and good in 82.5% of cases, with a return to sports activities at a mean time of 4.3 months. X-rays were considered as normal in 73% of cases, with an anterior impingement syndrome in 15% and calcifications of the medial collateral ligament in 12%. Stress radiographs in valgus talar tilt (n = 24) were normal in all cases. The authors suggest new surgical guidelines in ankle fractures with a medial collateral rupture, based on fracture stabilization, with ligament tears left unexplored (medial, tibiofibular, and syndesmotic ligaments), and early mobilization.

Adolescent↗
PubMedDate not supplied

[A.L.J. external fixation. Indications and results in 59 cases].

The authors report their results in 59 cases of external fixation with A.L.J. type devices inserted from November, 1984, to November, 1988, in 57 patients (2 cases of bilateral injuries). These included 49 cases of "recent" traumatology, 4 cases of "second-hand" traumatology, and 6 orthopaedic cases (tibiotarsal arthrodesis for degenerative lesions). Among the recent traumatic injuries, 38 were fractures, most often compound fractures (stages II and III), and 11 serious soft tissue lesions, for which the external fixation was used temporarily for stabilization until the wound was healed. The older traumatological lesions were 4 infected pseudarthroses. The results based on 52 cases (6 were lost to follow-up and 1 is a peculiar case) include 45 healed injuries (ie. 86.5%) and 7 failures. The soft-tissue lesions have all healed within 2 to 4 months. Among the bony lesions, some knit primarily without an additional graft (20 of 37 cases, ie 54 percent), the others after 1, 2 or 3 grafts (10 of 37 cases, ie. 27 percent). The union also occurred without any problem for all 6 tibiotarsal arthrodeses. The 7 failures occurred in cases where no additional bone graft had been performed. The discussion evidences the advantages and drawbacks of the A.L.J.

Adult↗
PubMedDate not supplied

[Posterior dislocation of the hip associated with fracture of the neck of the femur. Apropos of 3 cases].

Three patients with posterior dislocation of hip associated with fracture of neck of femur were treated by early sanguineous reduction and osteosynthesis. This therapy was very effective since necrosis did not develop either in the short or long-term follow up (1, 3 and 4 years). These findings combined with documented data are in favor of anatomic reconstruction of upper end of femur by stable and solid osteosynthesis, at least in young adults. Early operation, an irreproachable operating tactic (orthopedic table, ventral decubitus, posterior approach), an immediate stable and solid synthesis and a deferred load bearing (beyond 6 months) should reduce the risk of femoral head necrosis to a minimum.

Adult↗