RESUMO
The paper presents the technique and results of treatment of 450 fractures of the femur or tibia. Closed intramedullar fixation has been employed. There was no surgical approach to the fracture site. The intramedullar nail was inserted through small incision remote from the fracture. Flexible reamers were used to prepare the medullar cavity. X-ray intensifier was used to monitor the procedure. If the fracture was located outside the middle third the nail was interlocked. Fixation achieved was stable, no additional immobilization was needed. Mobilization was started at the first post-operative day. No wound infection or osteomyelitis occurred. Weight bearing was allowed after 2 months for 80 per cent of the patients. In all cases the union was achieved before the end of the third month.
Assuntos
Fraturas do Fêmur/cirurgia , Fixação Intramedular de Fraturas/métodos , Fraturas da Tíbia/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Pinos Ortopédicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Suporte de CargaRESUMO
Technical elements and details of surgical technique promoting stability of the fixation is analyzed by the author. Technical improvements of intramedullary fixation secured great stability of this type of fixation. The use of flexible reamers to drill medullar cavity permitted application of thicker nails and enlarged the area of exact fit between the nail and the cortical bone. Introduction of the interlocking system preventing rotational displacements allowed for the use of this method in fractures within the whole length of the shaft. Weight bearing from the first postoperative day is permitted for majority of the patients. Almost none of them needed external immobilization.
Assuntos
Fraturas do Fêmur/cirurgia , Fixação Intramedular de Fraturas/métodos , Fraturas da Tíbia/cirurgia , Desenho de Equipamento , Fraturas do Fêmur/fisiopatologia , Fêmur/fisiologia , Fixação Intramedular de Fraturas/instrumentação , Humanos , Fatores de Risco , Tíbia/fisiologia , Fraturas da Tíbia/fisiopatologia , Suporte de CargaRESUMO
The rare case of malignant tumor of thymus--Thymoma malignum was described. The initial diagnosis was difficult, because of the irregular symptoms of myasthenia gravis. The diagnostic difficulties, treatment and clinical features of this neoplasm were also discussed.
Assuntos
Miastenia Gravis/diagnóstico , Timoma/diagnóstico , Timo/patologia , Diagnóstico Diferencial , Humanos , Neostigmina/administração & dosagem , Neostigmina/uso terapêutico , Doenças Respiratórias/tratamento farmacológico , Timoma/patologia , Timoma/cirurgia , Timo/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Recurrence of duodenal ulcer was diagnosed in 15 patients who underwent highly selective vagotomy before 6-13 years, i.e. in 12.2%. Factors possibly contributing to such a recurrence were analysed. Patients with ulcer recurrence were: 1) non-qualified workers, 2) tobacco smokers, 3) heavy drinkers, 4) users of ulcerogenic medicines, and 5) were involved into conflict situations.
Assuntos
Úlcera Duodenal/cirurgia , Vagotomia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Fatores de RiscoRESUMO
The newest views are presented on the role of the central nervous system on the process of healing of bone fractures. The problem is discussed in the light of clinical observations and basic investigations carried out since several years in foreign centres in patients with severe brain injury with coexistent fractures of extremity bones.