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Biomedical subjects

G Rollo

Publications and source records attributed to G Rollo.

At least 19 recordsLinked to original sources
PubMed2000

Sister chromatid exchanges and ion release in patients wearing fracture fixation devices.

The quantification of sister chromatid exchange (SCE) during mitosis is a useful index for evaluating genotoxic effects in subjects occupationally or incidentally exposed to potentially toxic substances. The authors investigated the hypothesis that ions released by corrosion from prosthetic components of fracture fixation devices are associated with change in SCE incidence. In the present study, ten patients with implants were examined, and fifteen subjects with no implants were used as controls. SCE and high frequency cell (HFC) numbers were evaluated in circulating lymphocytes. In addition, nickel (Ni) and chromium (Cr) ion values in the serum were measured because, after iron, these metals are major components of stainless steel. A significant increase in SCE numbers was observed in patients compared to the control population (4.9 +/- 1.3 vs. 3.5 +/- 1.4). Ni concentration was 1.71 +/- 1.49 ng/mL in patients and 0.72 +/- 0.52 ng/mL in control subjects; Cr concentration was, respectively, 1.01 +/- 0.77 ng/mL and 0.19 +/- 0. 27 ng/mL. The increase of serum Cr and Ni was statistically significant. No correlation was found between the increased Cr concentrations and SCE number while Cr ion levels were found to be significantly correlated to HFC. An inverse correlation between Ni level and SCE numbers was observed. Our findings suggest that Cr release by stainless steel implants could have a genotoxic effect; thus it would be useful to carefully monitor implanted subjects with regard to serum ion dosage, SCE analysis, and HFC evaluation. In any case, it would be appropriate to remove the implant when fracture fixation is reached.

Adolescent↗
PubMed2000

Sister chromatid exchange in patients with joint prostheses.

The evaluation of sister chromatid exchanges (SCE) is used to establish the cytogenic damage in subjects exposed to toxic substances. The test is considered to be 1 of the most sensitive and accurate indicators of damage and responds to toxic chemicals at low doses. We evaluated the incidence of SCE in peripheral lymphocytes of patients with articular prostheses. Subjects with prostheses made of titanium-aluminium-vanadium alloys presented a significantly higher SCE number than the control population (6.3+/-2.3 vs 4.4+/-1.3; P = .0128), whereas subjects with prostheses made of chrome-cobalt alloy or mixed prostheses presented a higher SCE value than the controls but not significantly different. The presence of high-frequency cells was alarming only in 5 patients, 4 of whom had titanium alloy prostheses, whereas none belonged to the control group. The number of SCE was not affected by the presence of bone-cement used in prosthesis fixation or by the implant duration. The indication of possible cytogenic damage in patients with titanium alloy prostheses that emerged from this study should be considered carefully, even though the sample population was small.

Adult↗
PubMed1997

Surgical treatment of isolated forearm non-union with segmental bone loss.

Twenty-four isolated radius and ulna non-unions with segmental bone loss were operated on. Nine non-unions were in the radius, 15 in the ulna. The surgical technique consisted of removal of the necrotic bone, filling of the bone defect with an intercalary bone graft and internal fixation with a cortical bone graft fixed opposite to a plate. The average length of bone defect after freshening of the bone ends was 3.6 cm (range 2-10.5 cm). The average length of follow-up was 90 months. In 23 cases union was achieved. In three cases a postoperative infection developed. Resolution of the infection after surgical debridement was achieved in two of these patients, while recurrent infection caused failure of the treatment in the third patient. Statistical analysis revealed a shorter healing time (p = 0.031) in the ulna non-unions (12.5 +/- 3.0 weeks) compared with the radius non-unions (16.4 +/- 4.2 weeks). Functional results were classed as excellent in 10 patients, satisfactory in six, unsatisfactory in seven and failure in one.

Adolescent↗
PubMed1997

[Traditional radiology in the assessment of posttraumatic carpal instability].

INTRODUCTION: Carpal instability is a painful posttraumatic syndrome with early or late loss of the normal alignment of the carpal bones, which can be caused by a variety of injuries, from minor sprain to major fracture-dislocation of the carpal-wrist complex. If the trauma causing instability is a fracture, a severe dislocation or a fracture-dislocation, the radiographic diagnosis is not particularly difficult. The morphologic and dynamic complexity of the carpal region represents, instead, a major obstacle in the radiologic diagnosis of mild or moderate sprains because the morphologic alterations on standard static views are minimal or absent in these conditions. MATERIALS AND METHODS: We reviewed 214 injuries causing posttraumatic carpal instability including both the cases classified by the Data Analysis Center of the Istituto Ortopedico Rizzoli as carpal dislocations and fracture-dislocations from January, 1975, to July, 1996, and the more recent cases directly observed at our Casualty Clinic. In the former cases, we reviewed only the available images, while our patients were examined with comparative standard and under stress or dynamic views. RESULTS: Of 214 lesions causing posttraumatic carpal instability, 43 along the great arch were classified as severe because they were easily detectable on standard films and 171 along the small arch were classified as mild because slight/no abnormalities were detected on standard static views. Only dynamic imaging showed posttraumatic carpal instability demonstrating the integrity of the ligaments and of the carpal hinges, as well as gaps or asymmetry not detected on static views. CONCLUSIONS: We suggest the systematic use of dynamic imaging in the cases where static findings are negative or poor, in the patients with a painful wrist after an apparently minor sprain. Missed or delayed diagnoses are thus reduced, as well as the consequent joint incongruity and/or chronic subluxation which may severely impair these patients.

Carpal Bones↗
PubMed1995

Composite bone grafting and plate fixation for the treatment of nonunions of the forearm with segmental bone loss: a report of eight cases.

Between June 1986 and December 1991, eight aseptic isolated severe forearm segmental bone losses were treated. The average age of the patients was 26 years. Three cases involved the radius and five the ulna. The average time between the onset of trauma and the final surgical intervention was 9 months. The surgical technique consisted of complete removal of necrotic bone, filling of the bone defect with an intercalary autogenous bone graft, and stable internal fixation, which required combining a plate and an opposite cortical bone allograft. The average bone loss length after freshening the bone ends was 7 cm (range 4-11). The average follow-up was 48 months (range 24-80). In all eight cases union and recovery of forearm function was achieved. The proposed surgical technique proved to be effective in obtaining results with no major complications.

Adolescent↗
PubMed1994

[Percutaneous computed tomography-guided biopsy in spinal diseases].

The use of percutaneous spinal biopsy (PSB) is on the increase in the field of interventional radiology. From July 1990 to December 1992 in the Department of Radiology in the Istituto Ortopedico Rizzoli, 74 patients (50 men and 24 women, mean age: 47 years old) underwent CT-guided spinal biopsy. This study was aimed at evaluating the diagnostic capabilities and accuracy of CT-guided percutaneous biopsy, which is considered as a simple, reliable and definitive method for histopathologic diagnosis. In our case histories, the total average accuracy rate, which varies according to the involved segment and to the kind of lesion to be examined, was 86%; in 14% of cases the excised tissue proved insufficient for histologic diagnosis. By allowing the histopathologic diagnosis to be made, CT-guided PSB proves a valuable technique to plan the treatment of primary/secondary neoplastic lesions or of inflammatory and dysmetabolic processes.

Biopsy, Needle↗
PubMed1992

SEM and chemical micro-analysis in a failed total knee prosthesis.

Authors performed SEM and EDS analyses in a cemented removed knee prosthesis demonstrating the average values of mineral elements in the bone surrounding the prosthesis. The composition of the metallic prosthesis surface in different microareas was also studied.

Alloys↗
PubMedDate not supplied

Inveterate fractures of the acetabulum.

The authors reviewed 44 inveterate fractures of the acetabulum treated surgically by internal osteosynthesis. The definition of inveterate fracture concerns lesions that are treated from 21 to 90 days after trauma. Based on an analysis of this series several features of a prognostic and therapeutic nature may be determined. In particular, it may be observed just how difficult it is to standardize therapeutic strategies in relation to polymorphism and anatomopathologic progression of the lesions.

Acetabulum↗
PubMedDate not supplied

Osteosynthesis with percutaneous wiring in fractures of the proximal humerus.

The authors report the preliminary results of osteosynthesis with percutaneous wiring in the treatment of fractures of the proximal humerus. This method which is still described in very few cases, is characterized by several advantages such as its minor invasiveness, and respect for vascularization of the fragments that guarantee good functional results. The application of threaded pins or pins of large diameter guarantees excellent hold with a low incidence of loosening secondary to loss of reduction. The use of a traction device applied to the surgical table simplifies reduction maneuvers and osteosynthesis.

Adolescent↗
PubMedDate not supplied

The surgical treatment of nonunion of the proximal metaphysis of the femur.

Nonunion of the proximal femur is a severe pathology, often provoked by the inopportune or improper use of a therapeutic aid: nonsurgical (primary nonunion), surgical (secondary nonunion). Surgical treatment of this nonunion may thus be characterized by different degrees of difficulty, depending on whether or not it is the sequela of surgery or of nonsurgical treatment. In lax nonunion, with atrophy of the segments and regions of necrotic bone interposed, modeling resection is required to correct the functional axes. The condylar blade-plate may be opposed by a cortical graft--to improve stability of the assembly--protecting the medial wall and providing the screws with excellent hold.

Adult↗
PubMedDate not supplied

Valgus-lateralization osteotomy: notes on surgery.

There are specific forms of nonunion secondary to per-inter-subtrochanteric fractures that make surgical planning a critical phase. In cases such as these, it may be useful to transform the center of the nonunion into an osteotomy plane. Because of the anatomotopographical features, course and progression of the lesion, cases such as these constitute a pathology that is difficult to define in terms of a therapeutic protocol. The authors report the surgical technique used in 4 cases of nonunion of the proximal metaphysis of the femur.

Adult↗
PubMedDate not supplied

The surgical treatment of cervical disc herniation.

The authors reviewed 61 cases of cervico-brachialgia due to posterolateral disc herniation treated at the Rizzoli Orthopaedic Institute between 1975 and 1985. Results were positive in 69.3% of the cases, partially negative or negative in 30.7%. An analysis of the results reveals a high correspondence between clinical diagnosis and surgical findings (82%): but the percentage of error in clinical diagnosis (18%) cannot be overlooked. For this reason the clinical diagnosis must be confirmed by CT and/or MRI. In our experience, the posterior approach has proven to be suited to resolving most cervico-brachial pain syndromes due to posterolateral disc herniation.

Adult↗
PubMedDate not supplied

Intra-articular fractures of the knee: arthroscopic diagnosis and treatment.

Fifteen intra-articular fractures of the knee were treated by reduction under arthroscopic monitoring and osteosynthesis, and followed-up after an average of 24 months. The authors expose the principles of surgery and discuss the advantages and the disadvantages as compared to traditional surgery.

Arthroscopy↗
PubMedDate not supplied

The Ilizarov method for the treatment of infected pseudarthrosis of the tibia: our experience in cases with severe lesion of the soft tissues.

Between 1985 and 1990 a total of 35 cases of infected pseudarthrosis of the tibia were treated by radical resection of the pseudarthrosis and corticotomy-distraction-compression. In 5 patients there was severe lesion of the soft tissues with extensive loss of substance. It is the purpose of the present study to evaluate the effects of the use of this method on lesions of the soft tissues in these 5 patients.

Adolescent↗
PubMedDate not supplied

[Study of torsion defects of the lower limbs using computerized tomography].

January, 1990, to July, 1993, the torsional defects of the lower limbs were studied at the Department of Radiology of the Istituto Ortopedico Rizzoli, Bologna. Ninety-three patients were examined, all of them affected with congenital or acquired (posttraumatic and/or iatrogenic) torsional defects. The torsional angles, i.e., the anteversion acetabulum angle, the anteversion femoral neck angle and the tibial torsion angle, were measured as follows: the patients were laid supine with their limbs either in intrarotation with the patella perpendicular to the table (62 patients) or in neutral rotation with the feet in the pace position (31 patients). The images were always analyzed at the console by two different radiologists in the following days. The electronic lines for measuring torsional angles were drawn by the two radiologists ex novo on the previously acquired CT images. No statistically significant differences were observed between the two groups of patients. The measures were independent of limbs position and the interobserver differences were bigger in children and in the measurement of femoral neck anteversion angle; however, these differences decreased by about 50% with better console use. CT, thanks to its feasibility, has replaced conventional (direct or indirect) radiology to study the torsional defects of the lower limbs. Moreover, CT is extremely useful not only for early disease diagnosis (location, rotation degree and associated joint deformities), but also for treatment planning, be it surgical or conservative.

Adolescent↗
PubMedDate not supplied

Lumbosacral monolateral dislocation.

The authors describe a case of traumatic monolateral dislocation of L5 on S1. It is a very rare lesion which involves serious diagnostic and therapeutic problems. Surgical treatment constituted by reduction and stabilization alone can obtain stable correction of the deformity and complete functional recovery.

Accidents, Traffic↗
PubMedDate not supplied

Internal fixation in unstable fractures of the pelvis. Preliminary notes.

The authors report the preliminary results of the surgical treatment of unstable fractures of the pelvic ring. Between 1989 and 1993 a total of 12 unstable fractures were treated by internal fixation. Short-term radiographic and functional results were satisfactory. The authors attribute an essential role to preoperative planning by conventional radiographic assessment and CT scan with multiplanar reconstructions, associated with carefully performed internal osteosynthesis.

Adolescent↗