RESUMO
After trochanteric fractures, the rate of survival of old patients was best when treated by the Ender method: 15% died during 3 months following the fracture. The procedure is uneasy and an excellent radiologic technique is necessary. The position of the proximal end of the first nail in the femoral head is most important. Excessive external rotation was frequent, but little desabling. Secondary displacement of the nails toward the distal end occurred in 25% of the cases and was difficult to avoid but remained moderate. The procedure is indicated in old people with porotic bones. It should not be done in subtrochanteric fractures.
Assuntos
Pinos Ortopédicos/efeitos adversos , Fraturas do Quadril/cirurgia , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Métodos , Pessoa de Meia-Idade , Complicações Pós-OperatóriasRESUMO
Presentation of two cases of imperforate anus managed in infancy. In first case, at age of 19, surgical closure of recto-urethral fistula associated to excision of a rectal pouch complicated with infected lithiasis and renal damage provides definitive therapy. In second case, recto-urethral fistula was well tolerated for more than 50 years without renal damage. Simple removal of a prostatic lithiasis partially obstructing fistula, provided fair good result. Etiology of these fistulae, well known in pediatric patients, is then discussed. Management must be adapted to complaints and risks.