Showing papers by "Giulio Maccauro published in 2002"
TL;DR: Clinical and radiographical outcomes of 21 patients with femoral metastases treated with intramedullar nailing at the Orthopaedics Department of Catholic University of Rome from 1997 to 2000 were analyzed, and survival rate was related to the type of primary tumor, and varied from 3 months to 2 years.
Abstract: Bone metastases are one of the most frequent problems in orthopaedic oncology. Impending fractures require surgical treatment in order to control pain and mechanical disrupture of the bone involved. The femur is the long bone most commonly involved by metastatic carcinoma. Preventive osteosynthesis is considered a good solution in the treatment of femoral metastases, reducing local pain and improving the quality of life. We analyzed clinical and radiographical outcomes of 21 patients with femoral metastases treated with intramedullar nailing at the Orthopaedics Department of Catholic University of Rome from 1997 to 2000. Bone metastases were located in the diaphysis or in the metadiaphysis. The primary tumors were lung in 10 cases, breast in 8 cases and kidney in 3 cases. Proximal or distal localizations constituted the indication for locked nailing. The implants used were: Kuntscher nail in 8 cases, Russel-Taylor nail in 8, Recon nail in 2 cases and proximal femoral nailing in 3 cases when osteolysis involved also the femoral neck. Partial weight-bearing with external support was allowed 3 days postoperatively; full-weight bearing was allowed 20 days after operation except in the cases in which a progression of the primary tumor was observed. No infection or pulmonary embolism was observed. Adjuvant chemotherapy or local radiotherapy was used in all cases. Survival rate was related to the type of primary tumor, and varied from 3 months to 2 years.
6 citations
TL;DR: Radiological and clinical outcome was satisfactory in all but one patient, in whom the closed reduction was insufficient, and percutaneous elastic pinning is an effective treatment of proximal humeral fractures.
Abstract: We present a technique of osteosynthesis of proximal humeral fractures using Kirschner wires, assembled in an elastic manner. We report 29 patients (mean age, 68 years) with types II, III and V fractures, according to Neer's classification, treated with closed or open (seldom) reduction and percutaneous pinning. The pin placement was antegrade: the wires started on the epiphysis and aimed at the diaphysis, with the proximal ends fixed with an external clamp and the distal ends crossed and laying on the endosteal surface. Patients were evaluated with the Constant-Murley scale at the end of treatment. Radiological and clinical outcome was satisfactory in all but one patient, in whom the closed reduction was insufficient. Percutaneous elastic pinning is an effective treatment of proximal humeral fractures. If necessary, it should be associated with open reduction.
5 citations