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Biomedical subjects

N Maffulli

Publications and source records attributed to N Maffulli.

At least 217 records · Page 12Linked to original sources
PubMed1992

Inter- and intratester reliability of radiographic measurements of spondylolisthesis.

Thirteen radiographic methods to measure spondylolisthesis were assessed to determine: 1. whether or not the different methods were correlated with each other; 2. their precision in detecting vertebral displacements; 3. inter- and intra-measurer reliability among six orthopedic surgeons performing radiographic measurements. Several methods were found to be correlated with each other in detecting spondylolisthesis on radiographs. However, on simulated displacements only three of them showed good correlation (r greater than or equal to 0.95, p less than 0.01). Intra- and intergroup correlations among the orthopedic surgeons were equally good (r greater than 0.90; p less than 0.01).

Humans↗
PubMed1991

Pseudoarthrosis of the ulna in neurofibromatosis. A report of four cases.

Four children suffering from neurofibromatosis with ulnar pseudarthrosis and progressive reabsorption of the middle and distal thirds of the ulna are reported. None had any pain or sensory loss, but all had progressive deformity of the forearm. Instability of the elbow and wrist were present in three cases, while one case showed good stability and function. A cross-union of the ulna with the radius to produce a one-bone forearm was accomplished using screw fixation and iliac bone grafting, and a one-bone forearm was achieved in three cases. Non-operative management was decided on in the patient with slow ulna reabsorption. The creation of a one-bone forearm is more likely to produce sound union, thus avoiding the need for further operations, while conservative management should be reserved for patients with a slowly progressive condition.

Bone Resorption↗
PubMed1991

Glove perforation in hand surgery.

A survey of glove perforation in 100 consecutive hand surgery operations was undertaken. A total of 397 pairs of gloves were tested for punctures after the operation. Evidence of perforation was found in 19% of the gloves used, and only in 12 cases did the surgeons actually realize that a perforation had occurred. With a perforation rate of 43%, the surgeons were significantly more at risk of glove perforation than the other members of the operating team.

Gloves, Surgical↗
PubMed1991

Transient entrapment neuropathy of the posterior interosseous nerve in violin players.

Eleven white male right handed violin players complained of transient muscular deficit of the extensor compartment of the left forearm during and after prolonged playing. This was associated with paraesthesiae and pain. Relief was achieved keeping the wrist and the elbow flexed, with the supinated forearm held by the contralateral hand. An anatomical study showed changes of the relationship of the posterior interosseous nerve with its surrounding structures with pronation and supination of the forearm. On the basis of the clinical features, the anatomical studies and the response to a simple physiotherapeutic regime, it is suggested that prolonged pronation of the forearm may cause transient entrapment of the nerve.

Adult↗
PubMed1991

Glove perforation in foot surgery.

A total of 391 pairs of gloves were tested for punctures after 100 consecutive foot surgery operations to assess the rate, site, procedure, and maneuver during which glove puncture accidents took place. Evidence of perforation was found in 23% of the gloves used. The surgeons are significantly more at risk of glove perforation than the other members of the operating team.

Equipment Failure↗
PubMed1991

Chronic stress injuries of the elbow in young gymnasts.

The radiological changes of chronic stress injuries of the elbow in 19 adolescent elite gymnasts are reported. The principal abnormalities were avascular necrosis of the capitellar epiphysis (Panner's disease) (one patient), post-traumatic subarticular necrosis (osteochondritis dissecans) of the capitellum (six patients) and the medial articular eminence of the distal humerus (one patient). Flattening and anterior depression of the radial head epiphysis with an underlying metaphyseal notch associated with an epiphyseal cleft (three patients), which, in one patient who continued training, developed into a chronic Salter Type IV stress fracture. A further patient, post-epiphyseal fusion, showed osteochondritis dissecans of the anterior aspect of the radial head. Seven patients exhibited a spectrum of olecranon changes from fragmentation of the epiphysis to chronic Salter Type I stress fractures of the growth plate. A follow-up survey found that, of those who responded to a questionnaire, nearly all the patients with articular surface damage failed to continue with competitive gymnastics whereas those with olecranon abnormalities were able to continue gymnastics at the same level. The mechanism of injury and the pathological changes are discussed.

Adolescent↗
PubMed1991

Fibular hypoplasia with absent lateral rays of the foot.

We describe 11 children with fibular hypoplasia and three- or four-ray feet, two bilaterally. This deformity is a less severe form of the better known congenital short tibia with absent or dysplastic fibula. If the leg-length discrepancy is minor, no treatment or a simple orthosis are used. Epiphysiodesis or leg lengthening by callotasis is appropriate for mild to moderate discrepancy. If the foot is non-functional, or the projected leg-length discrepancy is too great, early amputation and a prosthesis are advised.

Child, Preschool↗
PubMed1991

Horizontal pelvic osteotomies for bladder exstrophy. A preliminary report.

We have treated 11 patients aged three days to 15 years with bladder exstrophy by horizontal osteotomies of the innominate bones. The operation was originally used for older patients with severe deformity or failed previous surgery but is now applied as a primary procedure in the first week of life. The osteotomies enable the complex malformations to be corrected in a single operation without turning the patient: the pubic bones can be brought together, the abdominal wall repaired and the bladder closed with reconstruction of the urethra and external genitalia. The early results have been very satisfactory in all cases with only minor complications; we felt that a preliminary report should be made, despite a mean follow-up of only seven months.

Adolescent↗
PubMed1991

Spinal anaesthesia for day case surgery in sportspersons and sedentary patients.

The effects of spinal anaesthesia were investigated in 67 sportspersons and in 128 sedentary patients (average age 31.8 +/- 6.2 yrs). The most frequent complaint in both groups was mild low back pain (27 cases vs. 58). Postspinal headache was severe and disabling, with an incidence of 13.4% in the sportspersons and 21.1% in the sedentary group. The sedentary group also showed a higher incidence of other postanaesthetic problems. Given the high rate of side effects, the young age of the subjects, and their desire to resume work as soon as possible after the operation, spinal anaesthesia is not the best anaesthetic procedure for this age group.

Absenteeism↗
PubMed1991

Fracture of the humeral diaphysis with extreme rotation.

We report a spiral fracture of the humeral diaphysis with marked rotational deformity complicated by radial nerve neuropraxia in a young girl. Conservative management resulted in fracture healing and full recovery of the radial nerve palsy.

Child↗
PubMed1991

Dorsal dislocation of the distal end of the ulna in a judo player.

A 32-year-old policeman injured his left wrist while engaged in judo training. A distal radio-ulnar dislocation, ulna dorsal, was reduced under general anesthesia, but, as the distal radio-ulnar joint was unstable, a Liebolt's ligamentous reconstruction procedure and a partial excision of the triangular fibrocartilage complex were carried out. The patient could resume his job eight weeks after the operation, and light training after a further six months. The need for proper physical examination and accurate radiographic positioning is stressed.

Adult↗
PubMed1991

Anaerobic threshold and performance in middle and long distance running.

A total of 112 endurance athletes, divided in three groups according to their age, were selected considered in this study. Thirtythree randomly subjects (11 per each age group) were both laboratory--and field--tested for anaerobic threshold (AT) determination. The running speed (RS) and heart rate (HR) at which AT occurred were highly correlated in the two conditions, with R ranging from 0.82 to 0.90, with the highest correlation for the oldest group. All the athletes participated a series of competition races at various distances, and the correlation between RS at AT and actual racing RS was calculated. It was found that RS at AT is highly correlated with racing RS for distances from 5 km and above, with the highest correlation found in the 10 km race for the 12-18 years and the 19-30 years age groups, and for the one hour race for the oldest group. Shorter distances (e.g. 800 m) did not show significant correlation with RS at AT, and this was particularly evident for the oldest group (R = 0.30).

Adolescent↗
PubMed1991

Incidence of glove perforation during caesarean section.

A survey of glove perforation in 200 consecutive Caesarean sections (100 elective and 100 emergency) was undertaken. A total of 1276 gloves were tested for punctures after the end of the operation. Evidence of perforation of one or more gloves was found following 39 elective (234 gloves, 37.2%) and 43 emergency sections (290 gloves, 44.8%) (total 82, 41%). Only in 17 of these cases (20.7%) was it realised that a perforation had actually occurred. The surgeons were found to be significantly more at risk of perforation than the other members of the operating team.

Cesarean Section↗
PubMed1991

[Osteosynthesis with an adhesive in skeletal fractures: an experimental study].

A-cyanoacrylate proves to be an advanced means of osteosynthesis. It is particularly indicated for short bone fragments in the articular and comminuted fractures, where a perfect anatomic reduction is required. It is shown to be non-toxic for bone and surrounding tissues and to be endowed with a remarkable chemical bond. It is easily applied and inexpensive. The results are very interesting and stimulate continuation of the studies. The authors think a-cyanoacrylate (or a derivative) is the future of biological osteosynthesis.

Animals↗
PubMed1991

Arthroscopy wounds: to suture or not to suture.

The arthroscopic wounds of 100 Caucasian patients were either sutured or simply bandaged on a random basis. The patients were reviewed after 2 and 12 weeks to ascertain the outcome of the two techniques. Suturing an arthroscopic wound resulted in an increased incidence of hematomas and superficial abscesses. A sutureless technique probably favors early hematoma draining, thus removing a potential cause of infection.

Abscess↗
PubMed1991

Lateral meniscal cyst: arthroscopic management.

Thirty-six patients underwent arthroscopic cystectomy and partial meniscectomy for a lateral meniscal cyst. In two other patients, an open cystectomy was performed following a diagnostic arthroscopy. The patients were reviewed at an average of 39 months (range 8-82) after the operation, and recurrence was found in four cases. Five patients, all keen sportsmen, were dissatisfied with the operation. Four patients, with arthroscopic signs of early degenerative arthritis, were still experiencing some pain, but were able to lead a normal working and social life. Arthroscopy is safe, giving low morbidity and recurrence. In the cases treated by arthroscopy, a horizontal meniscal tear was always found. The question whether this tear and the resulting meniscal changes are traumatic or degenerative in origin still remains; and, to some extent, neither hypothesis can be readily discarded. This study supports the use of arthroscopy alone in the treatment of lateral meniscal cysts.

Adult↗
PubMed1991

Indices of sustained aerobic power in young middle distance runners.

Sixteen young endurance athletes underwent physiological testing to determine their maximal oxygen uptake (VO2max), lactate threshold (lacAT), ventilatory threshold, and the slope variation point (SVP) of the linear relationship between running speed (RS) and heart rate (HR) both on the treadmill and during a field test, and the onset of blood lactate accumulation point. The RS, HR, VO2, and blood lactate concentration at which the different thresholds occurred were highly correlated, with r ranging from 0.82 to 0.90. The highest correlation was shown by RS at lacAT and RS at SVP during the field test. Various indices of sustained aerobic power in athletic children examined were shown to occur at a percentage of their VO2max similar to adult endurance runners. The tests developed for older athletes can be used in this age group as well.

Adolescent↗