Cañadell, J.M. (J. M.)
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- Delayed distraction in bone lengthening improved healing in lambs.(Orthopaedica Scandinavica, 1993) Cañadell, J.M. (J. M.); Gil-Albarova, J. (Jorge); Pablos, J. (Julio) de; Franzeb, M. (Marco)We compared delayed distraction (DD) with immediate distraction (ID) in bone-lengthening. Open femoral diaphyseal osteotomy was performed on 24 three-month-old lambs, and extemal distractor fixators were applied. In the ID group (n 12 ), distraction commenced on the first postoperative day; in the DD group (n 12 ), distraction was delayed until the tenth day alter surgery. In all the animals, the femur was lengthened by 2 cm at the rate of 1 mm/day. The animals were killed 1, 2, and 3 months postoperatively. Radiography and densitometry of the lengthened callus showed that DD, compared with ID, improved the quality of the callus with quicker, denser, and more homogeneous bone formation.
- Banco de hueso de la Clínica Universitaria de Navarra(Universidad de Navarra, 1987) Cañadell, J.M. (J. M.); Cornejo, F. (F.)Describimos el Banco de hueso de la Clínica Universitaria de Navarra, con sus tres unidades: - Congelador eléctrico (-40°). - Congelador de nitrógeno líquido (-197°). - Programador de descenso de temperatura. La primera unidad es utilizada para la conservación del hueso esponjoso durante un tiempo limitado; la segunda unidad permite la conservación de injertos corticales, de forma indefinida; la tercera, permite el descenso lento de la temperatura para conservar la viabilidad del cartílago en los injertos que incluyen extremos epifisarios. Las aplicaciones de los injertos óseos son crecientes en áreas como la cirugía tumoral, cirugía y artrodesis del raquis y en cirugía reconstructiva, en la articulación de la cadera.
- Correction of angular deformities by physeal distraction(Springer, 1992) Cañadell, J.M. (J. M.); Pablos, J. (Julio) dePhyseal distraction is an alternative to more conventional treatments for the correction of angular deformities of the long bones. Twenty deformities of the femur and tibia, nine of which also involved associated shortening, were partially or completely corrected. In eight cases, there was physeal bony bridge. Complete correction of the angular deformity was achieved in 17 patients, and in seven patients, more than 80% correction was achieved. There were complications in four patients that hindered complete correction of the deformity, or shortening, or both. The external control of the correction until consolidation occurs is progressive and fairly noninvasive. The method allows external control of the correction until consolidation; it acts at the site of the deformity itself and permits lengthening and angular correction during therapy. In deformities with a physeal bony bridge, correction can be achieved with physeal distraction alone, prior resection of the bridge is not unnecessary. The technique is indicated in cases of angular deformities in patients nearing skeletal maturity and particularly in subjects in whom there is associated shortening.
- Sarcoma cordoide de fémur. Estudio a microscopio óptico y electrónico de un caso(Universidad de Navarra, 1975) Herranz, P. (Pilar); Cañadell, J.M. (J. M.); Pardo-Mindan, F.J. (Francisco Javier); Imizcoz, J.L. (J. L.); Vazquez, J.J. (Jesús Jaime)Areas of chordoma and chondrosarcoma have been reported extensively in the same tumoral mass located in espheno-palatine region. The same association in long bones of the extremities have been reported recently, with the name of "chordoide sarcoma", "parachordoma" or "chondroid chordoma". We present a case of "chordoid sarcoma". The cells of this tumor have morphologic features of chordoma and chondrosarcoma in both the optical and ultrastructural study. However some morphological, radiological and clinical aspects, suggest that this tumor possesses characteristics that define it as a separate entity.
- Elongación de miembros inferiores. Experiencia en la Clínica Universitaria(Universidad de Navarra, 1987) Cañadell, J.M. (J. M.); Pablos, J. (Julio) deEsta publicación trata de explicar cómo y por qué se han desarrollado las distintas técnicas de elongación ósea en el Departamento de Cirugía Ortopédica y Traumatología de la Clínica Universitaria de Navarra. La imprevisibilidad y poca efectividad de la estimulación ósea y la peligrosidad de los métodos de elongación extemporánea han hecho que actualmente se usen fundamentalmente métodos de elongación progresiva. De estos últimos, preferimos la elongación ósea mediante osteotomía metafisaria percutánea con distracción diferida, método que utilizamos tanto para elongaciones óseas simples a cualquier edad como para corrección de deformidades angulares en pacientes maduros. La distracción fisaria la creemos indicada en elongaciones óseas simples, en acortamientos congénitos y para corrección de deformidades angulares en niños inmaduros.
- Fractures of allografts used in limb preserving operations(Springer Verlag, 1998) Cañadell, J.M. (J. M.); San-Julian, M. (Mikel)One hundred and thirty-seven allografts used since 1986 in limb preserving operations for malignant bone tumours were reviewed. The follow up was longer than two years. There were fourteen fractures (10.2%) in twelve patients at a mean time of 22 months from the operation. Most of them were in the metaphyseal area and were related to perforations of the allograft made for stabilisation with plates, for tendon and ligament reattachment, or any other hole in the allograft. Fractures occurred always after the allograft-host junction was united. Healing was achieved in 7 cases by internal fixation with autologous bone grafting in a mean of 5 months. In cases of multiple fractures of the allograft, the graft was exchanged. We recommend using intramedullary fixation in order to reduce the incidence of allograft fracture, and the use of internal fixation, with intramedullary whenever possible, and autologous bone grafting to achieve consolidation of the fractures.
- Iliac allograft used for sternal reconstruction after resection of a chondrosarcoma(Springer Verlag, 1993) Cañadell, J.M. (J. M.); Cara, J.A. (José Antonio); Lacleriga, A. (Antonio)We report the case of a man, aged 48 years, with a primary chondrosarcoma of the sternum which was treated by radical resection and reconstruction with an iliac allograft and musculocutaneous flaps. No complications were seen at follow up after two years.
- Preoperative identification of patients at high risk of deep venous thrombosis despite prophylaxis in total hip replacement(Schattauer, 1988) Paramo, J.A. (José Antonio); Cañadell, J.M. (J. M.); Rocha, E. (Eduardo); Alfaro, M.J. (M.J.)Clinical and laboratory variables were measured on the day before operation in 111 patients who underwent total hip replacement prophylactically treated with acetylsalicylic acid or heparin-dihydroergotamine. Postoperative deep vein thrombosis (DVT) was detected in 16 patients by ascending venography. Stepwise logistic discriminant analysis was used to identify DVT predicting factors. Three such factors, fibrinogen degradation products (FDP), plasminogen activator inhibitor (PA-inhibitor) and tissue type plasminogen activator (t-PA), were found to be significantly associated with DVT and were used to construct a predictive index. The predictive index, I = -2.09 + 0.46 (FDP) + 1.39 (PA-inhibitor) -0.24 (t-PA), was 100% sensitive and 95% specific in the prediction of DVT. This index would allow for identification of those patients in whom routine prophylaxis would be sufficient and for selecting those in whom more effective prophylactic regimens would be necessary.
- Consolidation of massive bone allografts in limb-preserving operations for bone tumours(Springer Verlag, 1995) Cañadell, J.M. (J. M.); Mora, G. (Gonzalo); Leyes, M. (Manuel); San-Julian, M. (Mikel)This study analysed the influence of several factors affecting the consolidation time of 83 massive bone allografts in 79 patients with malignant bone tumours: osteosarcoma 57; Ewing's sarcoma 8; malignant fibrous histiocytoma 3; chondrosarcoma 4; fibrosarcoma 5; and giant cell tumours 2. The mean age of the patients was 19 years and the mean length of the allografts was 18 cm. The minimum follow up was for 12 months. The mean consolidation time for metaphyseal and diaphyseal osteotomies was 6.5 and 16 months respectively. Fifteen diaphyseal osteotomies required autologous cancellous grafting. There were 8 allograft fractures after consolidation. The following factors which might influence consolidation were analysed: age of the host and donor; allograft length and site; type of osteotomy and osteosynthesis; intra-arterial and systemic chemotherapy; intraoperative and external radio-therapy. In diaphyseal osteotomies there were statistically significant differences in consolidation time with the use of systemic chemotherapy, external radiotherapy and the recipient's age.
- Enfermedad tromboembólica y modificaciones de la coagulación tras artroplastia total de cadera. Acción de la profilaxis con ácido acetilsalicílico o heparina-dihidroergotamina(C Elosegui Y J Guasch, 1986) Paramo, J.A. (José Antonio); Cañadell, J.M. (J. M.); Rocha, E. (Eduardo); Pablos, J. (Julio) de; Alfaro, M.J. (M.J.)