Subject(s)
Esophageal Neoplasms , Esophagectomy , Esophageal Neoplasms/surgery , Esophagus/surgery , HumansABSTRACT
Background and objectives: Occipital condyle fractures (OCF) occur rarely in children. The choice of treatment is based on the Anderson-Montesano and Tuli classification systems. We evaluated the outcome of unstable OCF in children and adolescents after halo-vest therapy. Materials and Methods: We treated 6 pediatric patients for OCF, including 3 patients (2 girls, 1 boy) with unstable OCF. Among the 3 patients with unstable OCF, 2 patients presented with an Anderson-Montesano type III and Tuli type IIB injury, while 1 patient had an Anderson-Montesano type I fracture (Tuli type IIB) accompanied by a C1 fracture. On admission, the children underwent computed tomography (CT) of the head and cervical spine as well as magnetic resonance imaging (MRI) of the cervical spine. We treated the children diagnosed with unstable OCF with halo-vest immobilization. Before removing the halo vest at the end of therapy, we applied the CT and MRI to confirm OCF consolidation. At follow-up, we rated functionality of the craniocervical junction (CCJ) based on the Neck Disability Index (NDI) and Questionnaire Short Form 36 Health Survey (SF-36). Results: All children achieved OCF consolidation after halo-vest therapy for a median of 13.0 weeks (range: 12.5-14.0 weeks). CT and MRI at the end of halo-vest therapy showed no signs of C0/C1 subluxation and confirmed the correct consolidation of OCF. The only complication associated with halo-vest therapy was a superficial infection caused by a halo-vest pin. At follow-up, all children exhibited favorable functionality of the CCJ as documented by the NDI score (median: 3 points; range: 3-11 points) and SF-36 score (median: 91 points; range: 64-96 points). Conclusions: In our small case series, halo-vest therapy resulted in good mid-term outcome in terms of OCF consolidation and CCJ functionality. In pediatric patients with suspected cervical spine injuries, we recommend CT and MRI of the CCJ to establish the diagnosis of OCF and confirm stable fracture consolidation before removing the halo vest.
Subject(s)
Fractures, Bone , Spinal Fractures , Adolescent , Cervical Vertebrae/injuries , Child , Female , Humans , Magnetic Resonance Imaging , Male , Spinal Fractures/diagnostic imaging , Spinal Fractures/etiology , Spinal Fractures/therapy , Tomography, X-Ray ComputedSubject(s)
Duodenal Diseases/surgery , Duodenum/abnormalities , Intussusception/surgery , Pancreatitis, Chronic/surgery , Adult , Cysts/congenital , Cysts/diagnosis , Cysts/surgery , Duodenal Diseases/diagnosis , Duodenal Diseases/etiology , Duodenum/surgery , Humans , Intussusception/diagnosis , Intussusception/etiology , Pancreaticoduodenectomy , Pancreatitis, Chronic/diagnosis , Pancreatitis, Chronic/etiology , Tomography, X-Ray ComputedABSTRACT
The aim of the study was to present a clinical use of compression anastomosis clip (CAC) implants made of shape memory materials--nickel titanium alloys (NiTi). The concept involved in the use of CAC was to compress 2 bowel walls together, cause necrosis, and detach the CAC from the tissue to be expelled with the stool. The CAC is a double-ring elliptical device with a diameter of 30 mm. The device has the ability to recover its original closed shape when it senses a change in ambient temperature. In all, 20 anastomoses using CACs were performed: 6 of the small with the large bowel and 14 between the small bowel and small bowel. Two patients experienced complications. Although the anastomosis is not difficult to perform, the rules on how to apply the CAC must be well known. Because only a small number of anastomoses have been performed by us to date, this procedure requires further study.