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Biomedical subjects

R Capanna

Publications and source records attributed to R Capanna.

At least 127 records · Page 7Linked to original sources
PubMed1982

Long term results of centralising intertrochanteric osteotomy in Legg-Calvé-Perthes' disease. (Report on 60 cases).

The writers propose a new classification of Legg-Calvé-Perthes' disease into three degrees of increasing gravity. Grade 1 includes hips with minimal or no flattening of the epiphysis, normal relations between the head of the femur and the acetabulum, and a normally orientated epiphyseal cartilage. Grade 2 comprises hips with slight epiphyseal flattening (one third or less), the epiphyseal growth cartilage is horizontal, the femoral head is partly uncovered due to epiphyseal subluxation, but becomes normal in the abduction test. Grade 3 hips show severe epiphyseal flattening (more than one third), the epiphyseal growth cartilage is horizontal, and the epiphyseal subluxation persists even in the abduction test. In our opinion, the advantage of this classification, which is not dependent on a determination of the extent of the necrosis, is that it is less subjective, and can be applied more easily and immediately, as compared with Catterall's classification. The results in sixty cases of intertrochanteric centralising osteotomy were constantly satisfactory in grades 1 and 2, but unsatisfactory in grade 3. The writers consider that surgical intervention is unnecessary in patients with hips in grade 1, while femoral osteotomy is contra-indicated in grade 3 cases. In the latter event, surgical intervention, if considered necessary, should be a pelvic osteotomy or cheiloplasty of the femoral epiphysis. Centralising osteotomy is the operation of choice in patients of grade 2. The results were better in patients who were less than six years of age at the time of operation.

Adult↗
PubMed1979

Malignant degeneration in fibrous dysplasia (presentation of 6 cases and review of the literature).

Malignant degeneration of fibrous dysplasia is rare. It occurs with similar frequency at all ages and in both sexes. It is more frequent in cases of polyostotic than in monostotic fibrous dysplasia. In cases of fibrous dysplasia that do show malignant degeneration it is common to find that a high level of alkaline phosphatase persists in the serum, even in adults. Previous radiotherapeutic treatment appears to me a predisposing factor. Osteosarcoma is the most frequent neoplasm, followed at some distance by fibrosarcoma and chondrosarcoma. The tumour is most often localised in the femur; it is not unusual to find it in the tibia, maxilla and mandible. The treatment and prognosis are the same as those of the involved malignant neoplasm.

Adolescent↗
PubMed1979

"Atypical" eosinophil granuloma (description of two cases).

Two cases of histiocytosis X are reported. One affected a single bone, the other several bones. Both had the usual radiographic appearances, but a somewhat alarming cytological picture. The differential diagnosis between benign proliferative conditions and those possessing malignant or pseudo-malignant characteristics therefore demanded very careful consideration. After discussion of the radiological and histiocytological data, the diagnosis off histiocytosis X was arrived at, and in view of the favourable results, we are inclined to the view that these were atypical cases of eosinophilic granuloma.

Bone Neoplasms↗
PubMed1979

Results of surgical treatment of idiopathic pes plano-valgus by means of Grice's operation combined with reconstruction of the glenoid (accessory plantar) ligament and anterior transposition of tibialis posterior. (A review of 90 cases).

After an average follow up of six years, the writers reviewed the results of ninety operations for idiopathic flat foot treated by Grice's operation combined with reconstruction of the glenoid ligament and anterior transposition of the tibialis posterior. Eleven parameters (clinical, plantographic and radiographic) were used for objective assessment of the initial and residual deformity, a numerical code being given to each. The results were excellent or good in 88 per cent of the patients. The initial severity of the condition and the presence of ligamentous laxity either generalised or localised to the ankle joint, had an adverse effect on the results. The technique of Grice's operation is extremely important. The results are always excellent or good when the sinus tarsi is widely opened up and the bone graft correctly placed. Anterior transposition of the tibialis posterior improved the results in 26 per cent of cases: elongation of the Achilles tendon was only rarely necessary. The type of graft had no effect on the results: homoplastic grafts are therefore preferable since they cause less inconvenience. Surgical intervention before the age of four years is a mistake: the best results are obtained between nine and thirteen years.

Adolescent↗
PubMed1979

The surgical treatment of lumbo-sacral coccygeal agenesis.

Vertebro-pelvic instability and deformities of the lower limbs are the main therapeutic problems in lumbo-sacral agenesis. The first of these can be solved conservatively with the aid of an orthopaedic corset; patients treated in this way have never reported visceral compression disturbances. In regard to the deformities of the lower limbs it is possible and preferable to perform corrective surgery rather than amputation. However, this is complicated by the possibility of ischaemic attacks as a result of stretching of the neurovascular bundle. Surgical treatment should be commenced at an early stage and be performed in the following order: knees, hips, feet. If the deformity is not long-established, extension of the knees can be achieved by simple posterior capsulotomy and tenotomy of the flexors followed by slow, gradual trans-skeletal traction applied over a period of approximately one month. Relapses, however, must be treated by double osteotomy (supracondylar of the femur and metaphyseal of the tibia) with removal of anterior wedges. Flexion relapses of the knees are common and require further surgery. Correction of the hip deformities is easy and we have never observed relapses of this deformity. When the deformities have been corrected and static function restored to the lower limbs, the patients can walk with elbow crutches and orthopaedic calipers by oscillating the trunk.

Abnormalities, Multiple↗
PubMed1979

Dedifferentiated chondrosarcomas.

The authors report twenty five cases of dedifferentiated chondrosarcoma, illustrating the principal clinical, radiographic and histological features. The prognosis is particularly grave in this neoplasm: the only correct therapy is radical removal of the tumour by amputation or disarticulation.

Adolescent↗
PubMed1978

Congenital elevation of the scapula (a review of 69 cases).

The author have reviewed sixty nine cases of congenital elevation of scapula on whom scapuloplexy was performed. The degree of elevation was classified according to Rigault's criteria (1976). This operation gave excellent or good results in 68 per cent of cases, the improvement being slightly better from the aesthetic than from the functional point of view. The factors adversely influencing the results were: the degree of elevation, scoliosis, "pagoda" deformity, and insufficient surgical lowering. Osteotomy of the clavicle is necessary in the presence of neurological complications. In cases with scoliosis or "pagoda" deformity of the scapula it is desirable also to resect the supero-medial angle. The operation should be carried out before the patient reaches the age of ten years.

Age Factors↗
PubMed1978

Plasmocytoma (a study of 222 cases).

In a review of 222 cases of plasmocytoma, the author demonstrates that solitary plasmocytoma is not rare and has a different localization in bone as compared with the multiple type. The prognosis is influenced by the number of lesions, the level of the anemia, calcemia and hypoalbuminaemia, and the type and level of the paraproteins. In solitary plasmocytoma, the prognosis is also conditioned by the sex of the patient and the site of the primary localization. Proteinaemia was increased in only 40 per cent of cases and electrophoresis was negative in 20 per cent. The treatment of choice for plasmocytoma is radiotherapy associated with Malphalan.

Adult↗
PubMedDate not supplied

Prognostic significance of serum lactic acid dehydrogenase in Ewing's tumor of bone.

Pretreatment serum lactic acid dehydrogenase (LDH) levels were examined in 82 patients with Ewing's tumor of bone (23 metastatic and 59 localized). The percentage of patients with increased serum LDH levels was significantly higher in the metastatic group than in the group of patients with localized disease (87 vs. 45%). After treatment with combined therapy, in this latter group the recurrence rate was significantly higher in patients with elevated serum LDH levels at admission than in those with normal serum LDH levels (50 vs. 9%). Of the 16 patients with localized disease who relapsed, 13 (81%) had elevated serum LDH levels at the time of recurrence. These results indicate that in Ewing's tumor serum LDH levels may serve as useful prognostic markers and could be valuable in monitoring the effectiveness of combined therapy.

Adolescent↗
PubMedDate not supplied

[KMFTR (Kotz Modular Femur Tibia Reconstruction System) modular tumor endoprosthesis system for the lower extremity].

206 patients with tumorendoprosteses of the KMFTR-type at the lower extremity were operated at the Institute Rizolli Bologna and at the University Clinic of Vienna. The minimum follow up was 2 years (mean 3.2, max. 8 years). In order to bridge the defect caused by tumor resection the proximal femur was replaced in 42 cases, the distal femur in 119 cases and in 6 patients a total femur prosthesis was used. The proximal tibia was replaced in 35 cases and in 4 cases a total knee prosthesis was implanted. Clinical evaluation according to Enneking revealed 71.6% excellent and good results. In 83.4% the radiological score was higher then 20. We saw deep infections in 8.2% (17 patients), breakage of the prosthesis in 6.8% and aseptic loosening in 5.8%. 3 patients had to be amputated due to infection. In the remaining cases of infection in 66% of the patients healing was observed. All cases of aseptic loosening or breakage could be revised successfully by an exchange of the prostheses and therefore salvage of the leg was achieved.

Adolescent↗
PubMedDate not supplied

Direct cortisone injection in eosinophilic granuloma of bone: a preliminary report on 11 patients.

Eleven patients, between 3 and 16 years of age (average 6.5 years), with eosinophilic granuloma of bone were treated with direct injection of methylprednisolone acetate. Methylprednisolone acetate was used at the dilution of 40 mg/ml. Each single injected dose varied from 1 to 4 ml, depending on the sizes of the radiolucent defect and the soft tissue mass. One patient had four separate injections, one had three injections, five had two injections, and four had a single injection. All 11 patients healed without complications. This method of management is recommended.

Adolescent↗
PubMedDate not supplied

Latissimus dorsi pedicled flap applications in shoulder and chest wall reconstructions after extracompartimental sarcoma resections.

AIMS AND BACKGROUND: In sarcomas of shoulder and of chest wall, latissimus dorsi muscle gives the opportunity to solve any plastic problem without recourse to free flaps. The authors report their experience in the use of latissimus dorsi pedicled flap as adjuvant procedure in the surgery of bone and soft tissue sarcoma. METHODS: The latissimus dorsi pedicled flap was used in seventeen patients to reconstruct composite tissue defects after sarcoma resection of the shoulder or of the chest wall. Three groups were recognized. The eight patients of Group I received the flap to close the chest cavity after a multiple rib resection performed to remove a tumor of the chest wall. In Group II four patients had the latissimus dorsi transported to reconstruct the soft tissue coverage over a proximal humerus prosthesis previously applied after bone tumor resection. The five patients of Group III had the flap performed at the same time of the resection of a tumor arising in the shoulder area (1 bone and 4 soft tissue sarcoma). RESULTS: Two patients of the Group II presented a recurrent skin failure. A satisfactory coverage without any flap complication was provided in all the other 15 patients (88%). CONCLUSIONS: Latissimus dorsi pedicled flap represents a reliable and effective technique to reconstruct large chest wall or shoulder soft tissue defects.

Adolescent↗
PubMedDate not supplied

Bizarre parosteal osteochondromatous proliferation (Nora's lesion). Description of six cases and a review of the literature.

The authors report their experience with 6 cases of bizarre parosteal osteochondromatous proliferation (BPOP) observed in 4 patients in its typical site (distal ends of the limbs), and in 2 patients where it was instead atypically localized in the humerus and femur. The histories of the patients revealed that 50% reported previous trauma in the site of lesion. Five patients were submitted to surgical exeresis, while the remaining patient refused to undergo any type of treatment because he was asymptomatic. At a mean follow-up of 36 months 1 patient presented with recurrence (20%). BPOP is a rare pseudotumorous lesion with typical radiographic and histopathologic findings similar to to those of other benign and malignant tumor forms. A review of the small amount of literature in existence is used to analyze the elements that may lead to accurate differential diagnosis.

Adolescent↗
PubMedDate not supplied

Rotationplasty in segmental resections of the femur.

The authors report 26 cases of high-grade malignant tumors of the distal femur (23 osteosarcomas, 3 Ewing's tumors) submitted to rotation-plasty. The five-years actuarial survival rate (in the 23 cases of osteosarcoma) was 69% and there was no incidence of local recurrence. The following complications were observed: wound dehiscence (6 cases), arterial thrombosis (in 2 patients submitted to resection and vascular termino-terminal suturing), paralysis of the sciatic nerve (2 cases), delay in consolidation (2 cases), traumatic fracture of the neo-femur (3 cases). All of the complications were resolved favorably, 5 of these requiring surgical treatment (33%). Satisfactory functional results were obtained in all of the cases, except in one patient who had limitation of the ankle joint subsequent to vascular compartmental syndrome. On the basis of the oncological, functional and biomechanical results reported in this study and in the literature, the authors discuss current indications for rotation-plasty.

Adolescent↗