RESUMO
BACKGROUND: Initially considered as an established salvage procedure for tibiotalocalcaneal arthrodesis (TTCA), intramedullary nailing indications have expanded as evidenced in recent literature. We have tried to identify factors influencing functional result and bone union. METHODS: In a retrospective study, 30 patients were treated by a TTCA between January 2006 and November 2011. Indications, operative technique, bone fusion, X-rays and functional result [American Foot and Ankle Society (AOFAS) and short-form health survey (SF-36) scores] before and after surgery were registered and analyzed. RESULTS: Thirty cases of TTCA were included. The patient's average age was 52 (range 24-90). Union rate was 86% for the tibiotalar joint and 74% for the subtalar joint with an average follow-up of 25.4 months (8-67). The mean AOFAS' score significantly improved (from 37 to 59) as the SF-36' score. Global complication rate was about 56%. It has not been possible to identify factors significantly influencing bone fusion or functional results. All septic cases achieved fusion without any septic resurgence. CONCLUSION: Retrograde intramedullary nailing in TTCA is an effective technique, which allows good clinical results even in case of septic history of the patient. Fusion rate and functional results were not significantly influenced by any of the factors examined in this study.
Assuntos
Artrodese/métodos , Calcâneo/cirurgia , Fixação Intramedular de Fraturas/métodos , Tálus/cirurgia , Fraturas da Tíbia/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/cirurgia , Artrodese/instrumentação , Pinos Ortopédicos , Calcâneo/diagnóstico por imagem , Calcâneo/lesões , Avaliação da Deficiência , Feminino , Fixação Intramedular de Fraturas/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Radiografia , Reoperação , Estudos Retrospectivos , Tálus/diagnóstico por imagem , Tálus/lesões , Fraturas da Tíbia/diagnóstico por imagem , Resultado do Tratamento , Adulto JovemRESUMO
Nonbacterial arthritis is a rare but well-recognized complication of acute varicella in children. Reported cases usually described monoarthritis of the knee that occurs at the onset of the rash or shortly after. Herein, we describe a case of arthritis of the hip that occurred in a 4-year-old girl 6 days before the onset of rash. The presence of varicella-zoster virus DNA in synovial fluid was confirmed by real-time polymerase chain reaction. A review of the literature reported 26 previous cases of aseptic arthritis due to varicella infection among children.