The frail fail: Increased mortality and post-operative complications in orthopaedic trauma patients: Methodological issues

Burns are among the most devastating of all home injuries with formidable sequelae ranging from considerable physicaldisability to emotional and mental trauma. Patients of burn require prolonged hospitalization resulting into considerable financial burden onpatient as well as the state. Treatment of burns can be made cost effective by early excision and grafting of the burned areas. A randomizedcontrolled study was conducted to evaluate the efficacy of early versus delayed excision and skin grafting in pediatric burns. Out of 80 burnedchildren, 30 underwent early excision and grafting whereas 50 were treated with delayed excision and grafting. Mean percent graft take was96.67 in early and 88.40 in delayed group. Over all post operative complications like minor graft rejection was found in 26% cases of early and48% of delayed group whereas major graft rejection was found in 14% of delayed group only. Post operative contractures developed in 8% ofdelayed group. Mean hospital stay was 13.66 and 37.46 days for early and delayed excision and grafting respectively. Early excision andgrafting in pediatric burns is a superior and cost effective to delayed excision and grafting in terms of post operative complications, cosmesisand hospital stay.

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Pelvic Canal Narrowing Caused by Triple Pelvic Osteotomy in the Dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633130 ◽

1994 ◽

Vol 07 (03) ◽

pp. 110-113 ◽

Cited By ~ 6

Author(s):

D. L. Holmberg ◽

M. B. Hurtig ◽

H. R. Sukhiani

Keyword(s):

Postoperative Complications ◽

Pelvic Osteotomy ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Canal Width ◽

Operative Complications ◽

Post Operative Complications

SummaryDuring a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.

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