RESUMO
Non-union of an undisplaced fracture of the radial neck in a rheumatoid patient is presented. Possible causes are discussed, and the literature reviewed.
Assuntos
Artrite Reumatoide/complicações , Lesões no Cotovelo , Fraturas não Consolidadas/etiologia , Fraturas do Rádio/etiologia , Fraturas do Rádio/terapia , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/fisiopatologia , Feminino , Seguimentos , Fixação de Fratura/métodos , Fraturas não Consolidadas/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Fraturas do Rádio/diagnóstico , Amplitude de Movimento Articular , Tomografia Computadorizada por Raios X , Falha de TratamentoRESUMO
BACKGROUND AND OBJECTIVES: Pathologic fractures due to disseminated metastases are common and often involve major long bones, where the metastasis is responsible for wide bone erosion that is equivalent to major bone loss. Stabilization of these fractures necessitates tumor excision and reconstruction of the destructive metastatic process. METHODS: Massive allografts were used either as intercalary or "composite" grafts (allografts and regular prostheses) in 17 patients. RESULTS: Fourteen patients could ambulate independently after surgery, and nursing of the remaining three became feasible and less painful. CONCLUSION: In the event of pathologic fractures due to metastatic bone diseases associated with major bone involvement, massive bone allografts offer an inexpensive, adjustable, simple, solution.
Assuntos
Neoplasias Ósseas/complicações , Neoplasias Ósseas/secundário , Transplante Ósseo , Fraturas Espontâneas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Transplante Ósseo/métodos , Neoplasias da Mama/patologia , Feminino , Seguimentos , Fraturas Espontâneas/etiologia , Humanos , Neoplasias Renais/patologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Transplante HomólogoRESUMO
OBJECTIVE: The increasing number of patients with acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus(HIV)-positive carriers, poses difficulties when musculo-skeletal tissues are considered for banking in readiness for future clinical application. This study was conducted to test the actual yield of gamma irradiation on HIV infectivity, within HIV-infected bones. METHODS: The effect of gamma irradiation on bones containing T-cells chronically infected with HIV type I (HIV-I) was studied, in respect to inactivation of the virus. RESULTS: After exposure of the cell-free virus or infected T-cells to 2.5 megarads of gamma irradiation, the authors were able to demonstrate complete inactivation of the virus. CONCLUSIONS: It would appear from this study that gamma irradiation at this dose is sufficient to achieve clinical sterilisation of bones and facilitate their use for reconstructive procedures by eliminating the risk of HIV transmission to the recipient. Furthermore, when preparing bones for banking, this would also seem to be the method of choice in preventing the transmission of various strains of bacteria, fungi and other viruses.
Assuntos
Bancos de Ossos , Osso e Ossos/virologia , Desinfecção/métodos , HIV-1/efeitos da radiação , Bancos de Ossos/normas , Osso e Ossos/efeitos da radiação , Linhagem Celular , Técnicas de Cocultura , Raios gama , Humanos , Linfócitos/efeitos da radiação , Linfócitos/virologiaRESUMO
Severe plantarflexion of the foot associated with adduction and supination resulted in medial subtalar dislocation in three patients. Closed manipulation in two patients and open reduction in one restored normal anatomy of the foot, with no complications in a follow-up of 1 to 2 years.