RESUMO
The therapeutic approach for the treatment of children with radiologically "normal" hip presenting with epiphysiolysis of the contralateral upper femur is controversial. We here report the case of a 12-year-old boy with osteonecrosis of radiologically "normal" and asymptomatic left femoral head prophylactically fixed due to acute femoral epiphysiolysis of the contralateral hip. Eight months after first surgery, the patient developed symptoms of avascular osteonecrosis of the femoral head. Specific criteria to be used in evaluating the most effective treatment between preventive screw or simple close monitoring exist. Despite these criteria, the risk of osteonecrosis in the "healthy" hip is not zero.
Assuntos
Epifise Deslocada/cirurgia , Necrose da Cabeça do Fêmur/complicações , Cabeça do Fêmur/patologia , Parafusos Ósseos , Criança , Epifise Deslocada/patologia , Humanos , MasculinoRESUMO
INTRODUCTION: This study aimed to identify patients at risk for venous thromboembolism (VTE) among all patients hospitalised, and to determine the proportion of at-risk hospital patients who received effective types of VTE prophylaxis in sub-Saharan Africa (SSA). METHODS: A multinational, observational, cross-sectional survey was carried out on 1 583 at-risk patients throughout five SSA countries. RESULTS: The prevalence of VTE risk was 50.4% overall, 62.3% in medical and 43.8% in surgical patients. The proportion of at-risk patients receiving prophylaxis was 51.5% overall, 36.2% in medical and 64% in surgical patients. Low-molecular weight heparin was the most frequently used prophylactic method in 40.2% overall, 23.1% in medical and 49.9% in surgical patients. DISCUSSION: This study showed a high prevalence of VTE risk among hospitalised patients and that less than half of all at-risk patients received an American College of Clinical Pharmacy-recommended method of prophylaxis. CONCLUSION: Recommended VTE prophylaxis is underused in SSA.