RESUMO
The Marchetti-Vicenzi elastic nail was used in the osteosynthesis of 15 diaphyseal or metadiaphyseal fractures of the humerus, 14 cases achieved consolidation, 1 resulted in nonunion. Surgical approach was always distal, transtricipital and the nail was always locked distally. In the cases that healed, the mean radiographic consolidation time was 90 days. There were no immediate postoperative complications.
Assuntos
Fixação Intramedular de Fraturas , Fraturas do Úmero/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Fixação Intramedular de Fraturas/instrumentação , Humanos , Fraturas do Úmero/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Aparelhos Ortopédicos , Cuidados Pós-Operatórios , Radiografia , Fatores de TempoRESUMO
The authors comment on the experience acquired in the treatment of chronic osteomyelitis of the long bones with intramedullary reaming. The procedure is reserved for the femur and tibia with stage I chronic osteomedullary infection according to the Cierny-Mader classification. 2 A total of 36 patients were treated. Surgical treatment consists in reaming of the medullary canal and in its contra-opening with antiseptic solutions. Mean time for lavage is 6 days. Criteria for healing involves the absence of clinical, humoral, and radiologic signs of active medullary sites of infection. The percentage of healing was 83.2%, mean long-term follow-up was 2.9 years.
Assuntos
Fêmur , Osteomielite/cirurgia , Tíbia , Adolescente , Adulto , Idoso , Doença Crônica , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/métodosRESUMO
There are specific forms of nonunion secondary to per-inter-subtrochanteric fractures that make surgical planning a critical phase. In cases such as these, it may be useful to transform the center of the nonunion into an osteotomy plane. Because of the anatomotopographical features, course and progression of the lesion, cases such as these constitute a pathology that is difficult to define in terms of a therapeutic protocol. The authors report the surgical technique used in 4 cases of nonunion of the proximal metaphysis of the femur.
Assuntos
Fraturas não Consolidadas/cirurgia , Fraturas do Quadril/cirurgia , Osteoartrite do Quadril/cirurgia , Osteotomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas não Consolidadas/etiologia , Fraturas do Quadril/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A total of 25 pathologic fractures in patients affected with thoracolumbar vertebral metastases associated with neurologic deficit are reported. None of the pathologic fractures were stable, while 14 were unstable and 11 were very unstable. Decompression with intralesional excision of the neoplastic mass compressing the dural sac was performed in all of the cases. Posterior stabilization was performed in the first cases using systems of sublaminar segmental fixation, and thereafter using systems of pedicle fixation. Removal of the vertebral body followed by anterior fusion after preventive posterior stabilization was performed in 2 cases. Pain symptoms regressed in 85% of the cases and in more than 50% of the patients there was improvement in the neurologic findings and in vertebral deformity consequent to fracture. Mean survival rate was 12 months. Despite the limited number of cases posterior stabilization of pathological fractures is a good choice of treatment in patients with severe neurologic deficit.
Assuntos
Fraturas Espontâneas/cirurgia , Vértebras Lombares , Fraturas da Coluna Vertebral/cirurgia , Neoplasias da Coluna Vertebral/secundário , Vértebras Torácicas , Adulto , Idoso , Feminino , Fixação de Fratura , Fraturas Espontâneas/diagnóstico por imagem , Fraturas Espontâneas/etiologia , Humanos , Laminectomia , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/etiologia , Fusão Vertebral , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
The authors report a case of cardiac metastasis of a rectal adenocarcinoma that infiltrated the right ventricle and partially obstructed its outflow tract. Surgical treatment was performed because of syncopal attacks. The differential diagnosis between organized thrombi and intracardiac tumor is considered.