Reconstructive surgery after postraumatic infected talus necrosis.

OBJECTIVES: A case of a young female patient is presented who underwent a tibiocalcaneal arthodesis for infected necrosis of the talus after total talus extrusion. We report our surgical technique of tibiocalcaneal arthrodesis as a salvage procedure for this complex problem. It was performed in two stages. Total talectomy and implantation of antibiotic spacer was followed by tibiocalcaneal fusion using a blade plate. The bone loss was compensated with autodigested, antigen extracted allogeneic bone. BACKGROUND: Total extrusion of the talus is a rare and severe injury of the foot. The outcome is unpredictable and the presence of infection and bone loss is a challenge for the surgeon to achieve a successful outcome. METHODS: Union was defined both clinically and radiographically. The clinical outcomes were mesured using a AOFAS hindfoot score. The radiographic healing was determined by the presence of trabeculation across the arthrodesis. RESULTS: The time of follow up was 18 months and the fusion was achieved after 8 months. CONCLUSION: The presented technique for tibiocalcaneal arthrodesis is an option for the treatment of these serious lower extremity injuries and chemosterilized, antigen-extracted autolyzed allograft is appropriate for the reconstructive procedures of the foot and ankle (Fig. 2, Ref. 6).

Our experience with chemosterilized antigen-extracted autolyzed allografts (AAA) in a series of elective foot and ankle procedures.

BACKGROUND: It is generally accepted that the golden standard for bone grafting is the autogenous bone. OBJECTIVES: The purpose of our retrospective study was to review and show a single-surgeon experience with chemosterilized antigen-extracted autolyzed (AAA) bone allograft in foot and ankle procedures. METHODS: The study population consisted of 35 patients who were operated on between January 2005 and Januray 2009. All patients were eligible for inclusion in this study if their surgery was performed using the chemosterilized antigen-extracted autolyzed allogeneic bone (AAA). In this study, the authors wanted to emphasize the effectiveness of AAA bone grafts in reconstructive foot surgery. All allografts were harvested, prepared and obtained from West Hungarian Regional Tissue Bank Gybr. RESULTS: Union was defined both clinically and radiografically and was established on subjective and objective criteria. A total of 35 consecutive foot and ankle implant procedures were performed, there were 32 healed sites (91.43%) 2 nonunion (5.71%) and 1 deep infection complication (2.86%). CONCLUSION: The authors have shown that AAA allograft is appropriate for reconstructive procedures of the foot and ankle with a low rate of complication (Tab. 1, Fig. 2, Ref. 8).

[Unusual infection complication of total hip arthroplasty]. / Neobvyklá infekcná komplikácia totálnej náhrady bedrového klbu.

Authors present the case history of a 66-year old patient after repeated reimplantations of the THA with a deep infect caused by a rare aetiological agent (Serratia marcescens) associated with a pyogenic sinus. They describe the disease history, therapeutic procedure, complications associated with the surgery as well as postoperative course after the reimplantation of a customized total hip replacement. In the conclusion they state that in case of an infected total hip arthroplasty the treatment is focused on the salvage of the infection process and preservation of the function of the affected limb. Of essential importance is surgical revision with a radical removal of necrotic tissues and hardware in combination with an intensive parenteral antibiotic administration.

Radiation measurements aboard Spacelab 1.

The radiation environment inside Spacelab 1 was measured by a set of passive radiation detectors distributed throughout the volume inside the module, in the access tunnel, and outside on the pallet. Measurements of the low-LET (linear energy transfer) component obtained from the thermoluminescence detectors ranged from 102 to 190 millirads, yielding an average low-LET dose rate of 11.2 millirads per day inside the module, about twice the low-LET dose rate measured on previous flights of the space shuttle. Because of the higher inclination of the orbit (57 degrees versus 28.5 degrees for previous shuttle flights), substantial fluxes of highly ionizing HZE particles (high charge and energy galactic cosmic rays were observed, yielding an overall average mission dose-equivalent of about 150 millirems, more than three times higher than measured on previous shuttle missions.