Functional outcome of open reduction and internal fixation of pelvic ring injuries.

Between January 1996 and August 1998, 15 patients with pelvic ring injuries were treated by open reduction and internal fixation. Fractures types included Tile A1 (7%), B1 (33%), C1 (53%) and C3 (7%). The patients were observed for an average of 1 year (range: 5 to 21 months). Thirteen patients (87%) who were operated within 3 weeks after injury had their pelvic disruption healed. One patient with Tile C1 and non-union of the fracture dislocation of sacroiliac joint was operated 11 months after injury and developed implant failure and non-union of the fracture dislocation of sacroiliac joint. Another patient with Tile C1 injury with transforamina sacral fracture was fixed anteriorly only and developed non-union of the sacral fracture and redisplacement of pelvic disruption. Both of them had a poor functional outcome. A 40 points pelvic outcome grading scale (Cole et al 1996) based on physical examination, pain, radiographic analysis and activity/work status was used. Six patients (40%) (1 Tile A1, 5 Tile B1) had an excellent functional outcome. Seven patients (47%) (6 Tile C1, 1 Tile C3) had a good functional outcome.

An unusual cause of efferent loop obstruction.

A patient who presented with massive upper gastrointestinal hemorrhage underwent a Billroth II partial gastrectomy. He developed efferent loop obstruction due to a retained abdominal drain. Relaparotomy for removal of drain was performed. Retained drains are known complications but rarely, it is cause of efferent loop obstruction.

Susceptibility of non-fermentative gram-negative organisms to ureidopenicillins and quinolones.

The susceptibility of non-fermentative Gram-negative bacteria (excluding Pseudomonas aeruginosa) to ureidopenicillins and new quinolones was investigated. The ureidopenicillins were not active against the strains except against Pseudomonas species, 90% of which were inhibited by 64 mg/l. The new quinolones, particularly ciprofloxacin, had excellent activity (MIC range 0.06-8 mg/l) against these strains which included those resistant to beta-lactams and aminoglycosides. This suggested a promising alternative group of compounds to be used in chemotherapy of infections caused by non-fermenters.