Clostridium perfringens in the spine: A rare cause of post-surgical infection.

BACKGROUND: Post-surgical infections of the spine occur in from 0% to 18% of cases. Postoperative spine infections due to Clostridium Perfringens (CP) resulting in necrotizing fasciitis are extremely rare. However, since they may be fatal, early and definitive treatment is critical. CASE DESCRIPTION A: 62-year-old male with a T8-T9 Type C fracture, in ASIA Grade "E" (neurologically intact) underwent a posterior T6-T10 arthrodesis. However, 2 weeks postoperatively, he developed a postoperative thoracic wound infection; the cultures were positive for CP. As the patient developed necrotizing fasciitis, emergent debridement, negative pressure continued drainage, and initiation of appropriate antibiotic therapy were critical. CONCLUSION: Postoperative spinal infections due to CP with accompanying necrotizing fasciitis are extremely rare. As these infections may be fatal, they must be rapidly diagnosed and treated.

A Simple Bone Cyst in Cervical Vertebrae of an Adolescent Patient.

INTRODUCTION: Spinal simple bone cysts, also known as solitary cysts, are extremely unusual benign primary bone tumors with few cases reported in the literature. CASE PRESENTATION: Incidental Magnetic Resonance Imaging (MRI) finding of a C2 Simple bone cyst in a 13-year-old female patient is reported. Complementary studies suggested the benign nature of the lesion. Patient underwent cervical curettage followed by tumor excision. A lateral submandibular approach to the upper cervical spine was used and careful bone resection was possible with a radiofrequency assisted burr and no instrumentation or fixation was required. The stability of the defect was ensured by filling it with bone allograft and by prescribing a postsurgical plastic cervical collar to maintain neck immobilization. Histological examination supported the diagnosis of simple bone cyst. At 6-12-month follow-up the patient presented no recurrence or symptomatology. CONCLUSIONS: Solitary bone cysts are infrequent entities in the cervical vertebrae and preservation of spine stability without instrumentation to avoid neurological complications is often challenging. In this case, the proximity of the cyst to the right vertebral artery and the risk of injury were high; however the surgical approach used was successful and no recurrence or instability was evidenced on postoperative MRI.

Luxación AcromioClavicular. Tratamiento quirúrgico mediante cerclaje con cinta de dacrón (Cervi-set ) / Dislocation Acromioclavicular n. Surgical treatment by Dacra cerclage tape n (Cervi-set)

Objetivos: 1. Revisar las implicaciones dentro de la biomecánica de hombro, de la integridad y de la lesión del complejo capsuloligamentoso de la articulación acromio – clavicular. 2. Elaborar un protocolo para el diagnóstico preciso, clínico y radiológico, y el seguimiento de pacientes con luxación acromioclavicular G III tratados quirúrgicamente. 3. Evaluar los resultados clínicos y radiológicos en pacientes con luxación acromio-clavicular G III tratados quirúrgicamente mediante reducción abierta, reparación de los ligamentos y cerclaje coracoclavicular con cinta de dacrón (Cervi-set ). Materiales y métodos: De 1985 a 1987, se operaron 23 paciente con luxación acromio clavicular, en el servicio de ortopedia y traumatología del Hospital Clínica San Rafael de Bogotá, de los cuales se lograron seguir 15. De los 23 pacientes, 21 son hombres y 2 mujeres, cuyas edades variaron entre los 23 y los 65 años con un promedio de 43 años, sin encontrar diferencia notable en cuanto al hombro comprometido. La mayoría de las lesiones se debieron a accidentes de tránsito y deportivos. Todos los pacientes ingresaron por el servicio de urgencias siendo avaluados según parámetros clínicos y radiológicos establecidos dentro del protocolo que se expone a continuación...

Lesiones producidas por explosion en atentados terroristas / Injuries produced by explosion in terrorist transgressions

Siendo testigos del aumento desproporcionado del numero de atentados terroristas mediante detonacion de explosivos en lugares publicos el ultimo ano, y del problema de tipo medico que ello conlleva, por la gran afluencia de politraumatizados remitidos a nuestros hospitales no siempre preparados para resolver tales situaciones hemos querido en este trabajo analizar la fisiopatologia de la lesion producida por explosion y la experiencia en tres de los hospitales universitarios de la capital (Hospital Militar Central, Hospital San Rafael, y Hospital de Kennedy) como muestra representativa se recolectaron 107 casos, victimas del atentado terrorista perpretado contra las instalaciones del DAS, el 6 de dicimebre de 1989, variedad de lesiones encontradas y de su magnitud, cuyos resultados se exponen en el presente estudio