Comparison of Two Bandage Splint Constructs in an Ex Vivo Equine Metacarpal Fracture Model.

OBJECTIVES: The aim of this study was to compare the deflection distance, deflection angle and pre-loading sub-bandage pressure of a transverse, mid-metacarpal fracture in an equine cadaver limb when loaded in bending while stabilized with either a Robert Jones Bandage (RJB) or a single-stack bandage (SS), each containing two orthogonal splints. STUDY DESIGN: In an ex vivo experimental study, forelimb pairs from eight horses were collected, and one forelimb from each pair was assigned to either the SS or RJB groups. A transverse osteotomy was performed at the midpoint of the metacarpus. After bandaging, the limbs were loaded in bending. Pre-loading sub-bandage pressure, pre- and post-loading radiographs and post-loading deflection distance measurements were taken. Dorsopalmar radiographs were used to measure the loaded deflection angle. RESULTS: There was no significant difference between RJB and SS constructs in change in deflection angle (10.7 ± 3.0 degrees vs. 9.8 ± 2.6 degrees; p = 0.5) or deflection distance (13.1 ± 2.6 cm vs. 11.4 ± 3.1 cm; p = 0.2). Sub-bandage pressures were significantly greater for the SS than the RJB both dorsally and laterally. CONCLUSION: The SS splint construct resists bending forces similarly to the RJB splint construct in an ex vivo transverse, metacarpal fracture model. The SS splint construct may be a useful alternative to the RJB splint construct in field situations for metacarpal fracture stabilization.

[Post-traumatic hemoperitoneum: role of laparoscopy]. / Emoperitoneo post-traumatico: ruolo della laparoscopia.

The use of laparoscopic as a diagnostic instrument in blunt penetrating abdominal traumas was first proposed by some authors in the 70s. The introduction of sophisticated instrumental tests, such as CAT and echotomography (ETG), confined this method to narrow diagnostic field which was gradually less frequently used. The lively interest expressed by the surgical world and the enormous spread of laparoscopy after the end of the 80s, following the introduction of laparoscopic cholecystectomy, has prompted the renewed use of the laparoscopic technique also in those subjects with blunt abdominal trauma. Over the past 12 months the authors have used laparoscopy in 8 subjects with hemoperitoneum secondary to contusive abdominal trauma in hemodynamically stable conditions, in which instrumental test (CAT and ETG) and peritoneal lavage were positive for the presence of hematic effusion. The use of laparoscopy in 7 patients allowed a wait-and-see approach to be adopted, thus eliminating the need for explorative laparotomy. It was only necessary to proceed with laparotomy in one patient to control bleeding from a major splenic lesion.

[Prevention of immunodeficiency and postoperative infective complications in patients undergoing surgical resection for carcinoma of the colon-rectum. Clinical study on 50 cases, using thymus hormones and thymopentin in particular]. / La prevenzione dell'immunodeficit e delle complicanze infettive postoperatorie in pazienti sottoposti ad intervento di resezione per carcinoma del colon-retto. Studio clinico su 50 casi, mediante l'impiego degli ormoni timici e della timopentina in particolare.

As well as being related to the spread of the tumour, cancer patients present a state of immunodeficiency which is linked to age, malnutrition which is often present, particular in cases of cancer of the gastroenteric tract, surgery and the possibility of associated chemo- or radiotherapy. The authors studied two groups of 25 patients with colorectal cancer. In addition to antibiotic prophylaxis, group A received immunostimulating therapy with thymopentin-TP5. Group B was treated with antibiotic therapy alone. Cell-mediated immunity was checked preoperatively and after 15 days on the basis of skin reaction to 7 booster antigens (Multitest-IMC). Strictly surgical infective complications were more frequent in group B patients (28.1%) receiving antibiotic treatment alone compared to subjects in group A (21.6%). Infections in a non-surgical site were more than double in the absence of perioperative immune therapy. Of the 25 patients examined in group A, 3-4 postoperative infections and as many long-distance infections were reported, all of which resolved without sequelae within a few days. There was a greater and faster recovery of body weight in those subjects receiving thymopentin treatment in addition to antibiotic therapy. In colorectal cancer surgery antibiotic prophylaxis alone is without doubt a valid surgical antisepsis but, above all in hypoergic patients, it is significantly enhanced by perioperative treatment with thymopentin. This association reduces both postoperative infectious complications, in particular postoperative abdominal abscess, and infections in other areas, such as respiratory complications.

[Complicated torsion of the gallbladder. Presentation of a clinical case]. / Torsione complicata della colecisti. Presentazione di un caso clinico.

A case of gallbladder torsion complicated by sigmoid volvulus and sub-torsion of the ileus is reported because of the difficulty of diagnosis, conditioned by polymorphic symptomatology, the expression of a variety of causes and contributing causes that play an important role in the greater or less onset of dramatic symptomatology, and because of the rarity of the pathology.