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ΑΝΑΚΟΙΝΩΣΕΙΣ– ΕΙΣΗΓΗΣΕΙΣ- ΔΙΑΛΕΞΕΙΣ – ΕΠΙΣΤΗΜΟΝΙΚΑ ΕΚΘΕΜΑΤΑ ΣΕ ΕΛΛΗΝΙΚΑ ΣΥΝΕΔΡΙΑ

 

Β. 7

IDIOPATHIC SCOLIOSIS, SURGICAL CORRECTION OF THE CURVE AND DIRECT INCREASE OF THE HEIGHT

A. Christodoulou, Ch. Zidrou, G. Kapetanos, Hip. Hatzokos, P. Givissis, J. Pournaras

Ανακοινώθηκε στο 1st Inter-Balkan Congress on Spinal Diseases
Αθήνα 7-9 May, 1998.
We studied the influence of the surgical correction of the idiopathic curve on the height of the children an the relation between the elasticity of the curve, the achieved correction and the increase in height.
Thirty eight children, 27 girls and 11 boys with a mean age of 13 (12-19) years underwent posterior spinal fussion with segmental instrumentation (Luque rods or Hartshill rectangles and sublaminar wiring). Their height was measured preoperatively and at the 10th day postoperatively after the unsupported mobilization. It was measured as well, the scoliotic curve pre operatively on standing and lateral bending films and post operatively on standing films.
There was an average increase in height of 4 (2-7)cm with an average correction of the curve of 57%. Twenty six patients measured an increase of more than 3cm (pre op. standing aver. 63o, lateral bending aver. 37o, post op. standing aver. 24o). Twelve patients measured and increase of less than 3cm (pre op. standing aver. 56o, lateral bending aner. 34o, post op. standing aver. 25o).
Segmental spinal correction increases directly the height of the patient in an average of 4cm.

B. 8
ΤHE FUNCTION OF A PERIPHERAL NERVE ENTRAPPED IN CALLUS. EXPERIMENTAL STUDY IN RABBITS

Dr. P. Givissis.

Lecture at the 1st International Jordanian-Greek
Medical Congress.
Αmman , 10-12 May 2000, Jordan.

Searching the effect of the developing and mature callus on the entrapped peripheral nerve, fracture was caused surgically to twelve rabbits, a segment of bone of two cms was removed, and the sciatic nerve was coiled around the fracture. An intramedullary osteosynthesis with a k-wire followed. The union of all fractures was successful, and the sciatic nerve was in all cases entrapped in the callus. The function of the nerve was evaluated with EMG studies and clinical examinations. In the histopatological examination, done after the division of the animals in four groups, the way the callus affected the nerves was examined. Their sucrification was done at the 3rd , 6th,9th and the 16th postoperative week.
According to the results, the callus didn’ t strangle the sciatic nerve, in none of the main groups and it was well developed in some distance from it.
The nerve damages observed were mainly of ischaemic type, accompanied mainly by degeneration of nerve fibers, damage of the myeline sheath and some thickening of the supporting connective tissue, improvement of the function was obvious in all nerves in the long time survival groups and EMG studies, confirm that.
A hypothesis is defined: < the electrical resistance of nerves against the squeezing callus>, assuming the electronegativity ata the fracture site the continuity of the nerve trunk, which is able to conduct and produce electronegativity.
The delayed exploration of the paretic nerve after a fracture is supported by this study, as the callus does not affect entrapped nerve.

B. 9
UNCEMENTED THREADED HYDROXYAPATITE COATED ACETABULAR COMPONENT IN TOTAL HIP ARTHROPLASRY

J. Pournaras, G. Petsatodes, S. Trapotsis, P. Givissis

Poster at the 5th congress of the European Federation of National Associations of Orthopaedics and Traumatology, EFFORT,
Rhodes, Greece June 3-7, 2001

Purpose of the study: Wesent the medium-term results and we study the biological behaviour of 230 acetabular components performed by the same surgeon, with the same technique.
Materials and methods: The patient included sustained a Total Hip Arthroplasty, were 215 (15 cases bilateral ) with age between 24-76 years (aver. 58 years). Two hundred twenty cases were performed as a primary T.H.A. due to hip dysplasia – osteoarthritis while 10 cases were performed as a revision surgery due to aseptic loosening of a previous artrhroplasty. We used the ARC2F type prosthesis, which is a cementless, threaded, hemispherical acetabular component, coated with hydroxyapatite and matched with a U.H.M.W. polyethylene inset.
The postoperative protocol included early partial weight bearing, full weight bearing after two months and follow up on the 3rd, 6th, 12th month and afterwards every year. The clinical evaluation was performed with D’ Aubigne – Postel system while the radiological evaluation was performed according to the AAOS standards. The follow up period was ranged from 2 to 6 years (aver. 4,8 years).
Results: The main advantage of this type of prosthesis is the primary mechanical anchorage which allows a long term biological fixation. Only one of our cases became infected. All the order 229 records based on the evaluation scale are documented as perfect (15-18 points).
Conclusions: Our results are very satisfactory and we believe that this type of prosthesis is indicated in all the cases of primary hip arthroplasties and hip revisions.

B. 10
RADIAL HEAD FRACTURES – OPERATIVE TREATMENT WITH BIOABSORBABLE RODS

P. Givissis

Lecture at the Wrightington Hand & Upper Limb Unit, 25-Year Celebrations, 22-25 September, 2004.

We present the late results of 21 cases of radial head fractures fixed with bio-absorbable pins. The material used was poly-L-DL-lactide polymer. Its slower degradation process necessitates the study of the long term outcomes including possible delayed adverse effects. Our patients were followed up for an average period of six and a half years (range 2.5 – 11 years). There were 9 Mason II, 10 Mason III and 2 Mason IV factures which were evaluated clinically and radiologically. According to the Mayo Elbow Performance Score, there were 17 excellent, three good and one poor result. All fractures healed well with no radiological signs of osteolysis. No material-related adverse effects were observed. Concerns considering soft tissue or bone reactions from the use of these materials in radial head fractures, having overcome the maximum degradation period, are not justified according to our results.

Β. 11
LIMP SALVAGE IN POLYTRAUMA PATIENTS WITH MUSCOLOSKELETAL AND VASCULAR INJURIES.

G. Petsatodes, Ap. Hatzisymeon, P. Givisis, P. Papadopoulos, P. Antonarakos J. Pournaras,
1st Orthopaedic Department, Aristotle’s University of Thessaloniki, Greece

Ανακοινώθηκε στο 7th Congress of the European Federation of National Associations of Orthopaedics & Traumatology, (EFFORT)
June 2005, Lisbon

For a period of 5 years (Sep 1999-Sep 2004) 24 patients having sustained multi-ple injuries were admitted with signs of poor vascularization distally to the lesion. 19 were male and 5 female, their ages ranging from 16 to 49 years (av. 28 years). The musculoskeletal injuries were: open III C humeral fracture in 2 patients, open III C femoral fractures 4, open IIIC tibial shaft fractures 10, knee joint dislocations 8 patients. All patients had a preoperative angiography in order to assess the severity of the vascular lesion. Immediate stabilization of the fracture with an external fixation system was performed, followed by restoration of the vascular injury by means of a by- pass, end – to- end suture or interposition of a “stent” Posteoperative follow – up from 6 to 54 months (mean 34 months) Amputation was performed in 4 patients due to failure of the revascularization procedure 2 weeks postoperatively. External fixation was maintained as a final method of treatment in 7 cases, while in 13 cases we exchanged it to intramedullary nailing. In the 8 cases of knee dislocation, ligament reconstruction was impe¬rative. Eventually 20 limps were salvage with a satisfactory functional outcome. In polytrauma patients with both musculoskeletal and vascular injuries the immediate application of an external fixator represents a precausative for a suc¬cessful vascular operation. Exchanging the external fixation system to interlocking Intramedullary nailing accelerates the healing process.

Β. 12
COMPARISON OF THREE METHODS OF INTERNAL FIXATION FOR A.O./C FRACTURES OF THE DISTAL THIRD OF THE FEMUR.

G. Petsatodes , Ap. Hatzisymeon , P. Givisis , An. Christodoulou , P. Antonarakos ,J. Pournaras,
1st Orthopaedic Department, Aristotle’s University of Thessaloniki, Greece

Ανακοινώθηκε στο 7th Congress of the European Federation of National Associations of Orthopaedics & Traumatology, (EFFORT)
June 2005, Lisbon

We evaluate the results of treatment of A.O. type C distal femoral fractures with 3 methods of internal fixation (condylar plate, 95° condylar blade plate, D.C.S.). Between 1988 – 2003, 108 patients (59 male, 49 female), aging 19 to 84 years (aver. 46 years), with 116 fractures A.O. / C were treated. 108 were closed and 8 open, Gustillo type ΙΙ. We used condylar plate in 38 patients (group Α), 95° condylar blade plate in 24 (group Β) and D.C.S. in 54 (group C).Postoperative follow-up ranged from 1 to 15 years. An early mobilization program was initiated. The results were evaluated using the Schatzker-Lambert criteria. Pseudarthrosis was found in 4 cases in group a, 6 in Β and 3 in C. Varous deformity was present in 10 cases in group Α, 6 in Β and 2 in C. Severe knee stiffness was present in 2 patients of group a, 2 of Β and none of group C. The Dynamic Condylar Screw – D.C.S. seems to have an advantage compared to the other 2 methods of internal fixation regarding the treatment of A.O. / C distal femoral fractures offering stability, anatomical reduction, and early mobilization with a good functional outcome.

B. 13
AVULSION OF THE DISTAL INSERTION OF THE BICEPS BRACHII TENDON TREATED SURGICALLY WITH ANTERIOR ONLY PROCEDURE

V. Kefalas, B. Chalidis, P. Givissis, K. Ditsios, A. Christodoulou. J. Pournaras

Ανακοινώθηκε στο International Congress Hand-Upper Limb and Microsurgery,
Σάμος 7-10 Σεπτεμβρίου 2005