Evaluation of the combined medical and surgical treatment in nasal polyposis. I: Functional results

Introduction. Developmental dysplasia of the hip (DDH) represents one of common diseases of the locomotor system. Late discovery and inadequate healing of this defect leads to serious disability in the best years of human life. Objective. The aim of this study was to analyze the quality of functional and anatomic restitution of the diseased hip, depending on the age of the patient at the time of surgery. Methods. Our retrospective study was developed on 78 children surgically treated for DDH. The examiners were distributed in three groups according to age in which they had been operated. The data were produced on the basis of full-scale medical documents for each patient. Results. We analyzed and compared anatomic and functional results of surgeries treating DDH in the group of examiners. On examination, we got data that the most prevalent were distorted gait, inequality of the legs and positive Trendelendburg?s sign in the group of children who had been operated in the oldest age. The patients who were surgically treated in older age had worse postoperative results in aspect value angle of flexion and abduction in treated hip, higher frequency in manifesting pain and asymmetric gait. Better corrective results on aspect of dimension of the colodiaphyseal and Hilgenrainer?s angle will be obtained if DDH treatment is conducted in younger age of patients. In 94.95%, the patients were treated with Salter innominate osteotomy of pelvis with osteotomy of the femur involving its shortening and reverse rotation. Preoperative treatment with Pavliks harness was provided in 44.02% children, with abduction of Hilgenrainer?s apparatus in 2.6%, with abductions ?Niva? slips in 2.6% and preoperative extension in 28.2%. Conclusion. The surgical treatment of DDH in the observed patients done at the earlier age of growth resulted in the evidently better anatomical and functional results at postoperative observation.

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Scrotal reconstruction with superomedial fasciocutaneous thigh flap

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-6991e-20181389 ◽

2018 ◽

Vol 45 (1) ◽

Cited By ~ 1

Author(s):

DANIEL FRANCISCO MELLO ◽

AMERICO HELENE JÚNIOR

Keyword(s):

Surgical Treatment ◽

Complication Rate ◽

Longitudinal Direction ◽

Functional Results ◽

Fasciocutaneous Flap ◽

Surgical Time ◽

Cross Sectional ◽

Skin Loss ◽

Scrotal Reconstruction ◽

The Mean

ABSTRACT Objective: to describe the use of a superomedial fasciocutaneous thigh flap for scrotal reconstruction in open areas secondary to the surgical treatment of perineal necrotizing fasciitis (Fournier’s gangrene). Methods: retrospective analysis of cases treated at the Plastic Surgery Service of Santa Casa de Misericórdia, São Paulo, from 2009 to 2015. Results: fifteen patients underwent scrotal reconstruction using the proposed flap. The mean age was 48.9 years (28 to 66). Skin loss estimates in the scrotal region ranged from 60 to 100%. Definitive reconstruction was performed on average 30.6 days (22 to 44) after the initial surgical treatment. The mean surgical time was 76 minutes (65 to 90) to obtain the flaps, bilateral in all cases. Flap size ranged from 10cm to 13cm in the longitudinal direction and 8cm to 10cm in the cross-sectional direction. The complication rate was 26.6% (four cases), related to the occurrence of segmental and partial dehiscence. Conclusion: the superomedial fasciocutaneous flap of thigh is a reliable and versatile option for the reconstruction of open areas in the scrotal region, showing adequate esthetic and functional results.

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Experience in surgical treatment of idiopathic macular ruptures in Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-2-97-100 ◽

2021 ◽

pp. 97-100

Author(s):

A.S. Firsov ◽

◽

A.D. Chuprov ◽

V.A. Trubnikov ◽

A.E. Voronina ◽

...

Keyword(s):

Surgical Treatment ◽

Silicone Oil ◽

Platelet Rich Plasma ◽

Functional Results ◽

State Institution ◽

Federal State ◽

Rate Of Increase ◽

Surgical Methods ◽

Medical Effectiveness ◽

Group 5

Purpose. To study the anatomical and functional results of various methods of surgical treatment of idiopathic macular rupture. Material and methods. In the course of this study, 50 medical records of patients with a diagnosis of macular rupture were randomly selected from the total number of those, who underwent the surgery at the Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution for 2020 year. Patients were divided into 3 groups. In the first group (38 eyes), the macular rupture was closed using ACP and PRP, in the second group (7 eyes) – using an inverted flap of the internal border membrane, in the third group (5 eyes) – by mechanical convergence of the edges of the rupture followed by tamponade of the vitreous cavity with silicone oil. Results. To assess the medical efficiency of the studied methods of surgical treatment of idiopathic macular rupture, the rate of increase in the maximum corrected visual acuity (MCVA) was calculated for each patient. Conclusion. The calculated indicator of the dynamics of vision improvement «the rate of BCVA growth» as a whole reflects the positive dynamics of the treatment of idiopathic macular rupture by surgical methods and can be used to assess the medical effectiveness of methods of treating patients with eye diseases initially with different values of the BCVA parameter. In the course of the analysis, no significant differences were found between the influence of various methods of surgical treatment of macular rupture on the rate of BCVA growth or rupture closure. Correlation analysis did not establish a statistically significant dependence of the growth rate of BCVA on the initial size of the rupture. Key words: macular rupture, inverted flap, platelet-rich plasma (PRP), autologous conditioned plasma (ACP).

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Method of surgical treatment of small and medium diameter macular holes with the foveal-sparing internal limiting membrane peeling

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-213-216 ◽

2021 ◽

pp. 213-216

Author(s):

A.A. Shpak ◽

◽

A.I. Kolesnik ◽

F.A. Avakyan ◽

V.A. Pismenskaya ◽

...

Keyword(s):

Surgical Treatment ◽

Functional Results ◽

Internal Limiting Membrane ◽

Developed Countries ◽

Clear Understanding ◽

Ilm Peeling ◽

Internal Limiting Membrane Peeling ◽

Macular Holes ◽

Air Tamponade ◽

Medium Diameter

Introduction and purpose. Idiopathic macular hole (IMH) is an urgent medical and social problem of the population of developed countries. It is known that microinvasive 3-port vitrectomy with gas-air tamponade is a generally accepted method of surgical treatment of IMH. There is still no clear understanding of the reasons for incomplete functional success in this category of patients, despite the anatomical success.Thus, there is a need to develop and implement in clinical practice a modification of the ILM peeling technique for the treatment of small and medium-diameter of IMH, which would not be inferior in anatomical effectiveness to existing methods and would be accompanied by a less damaging effect on the structures of the retina. Material and methods. The study included 10 patients with a diagnosis of IMH, who underwent a 3-port microinvasive 25G vitrectomy with the preservation of foveal ILM. Results. The analysis of the clinical and functional results of surgical treatment of IMH with the foveal fragment left revealed the complete closure of the macular tear, the absence of gross defects of the ellipsoid zone, an increase in the values of the average visual acuity and microperimetry from the 1st month of dynamic observation. Conclusion. The proposed low-traumatic method of fovea - sparing ILM peeling provides stable anatomical and functional result, the restoration of both morphological and functional parameters, and minimizes the mechanical impact on the retina in the fovea. Key words: macular rupture, internal limiting membrane, fovea-sparing ILM peeling.

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Achilles Tendon Ruptures: Comparison between the Clinical Results of Classical Versus Mini-Invasive or Percutaneous Surgical Treatment

ARS Medica Tomitana ◽

10.2478/arsm-2014-0024 ◽

2015 ◽

Vol 20 (3) ◽

pp. 135-138

Author(s):

Obada B. ◽

Serban Al. O.

Keyword(s):

Surgical Treatment ◽

Achilles Tendon ◽

Achilles Tendon Rupture ◽

Functional Results ◽

Clinical Results ◽

Needle Insertion ◽

Invasive Technique ◽

Percutaneous Technique ◽

Degree Of Satisfaction ◽

Invasive Techniques

Abstract The aim of the study is to evaluate the surgical treatment comparing the results obtained with different techniques. We revised 68 cases with acute Achilles tendon rupture who underwent surgical correction between 2004 and 2011, with a 40 month average follow-up. 34 of these were submitted to a classical open repair using the Kessler or Krakow technique, 25 to a mini-invasive technique (Achilon) and 9 to a percutaneous technique (Tenolig). We report a 29% rate of complications when using the classical technique: the major complications were one re-rupture, two surgical wound dehiscences, one infection and one sural nerve injury. In the mini-invasive/percutaneous techniques, two re-ruptures occurred (5.9% total, one in each technique) and one fistula at the needle insertion location. In regards to the percutaneous and mini-invasive techniques, the functional results and degree of satisfaction were higher, with fewer complications, reflecting a trend that has been expressed in the international literature.

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Surgical treatment of pertrochanteric fractures by dynamic methods of external and internal fixation

Vojnosanitetski pregled ◽

10.2298/vsp0306663m ◽

2003 ◽

Vol 60 (6) ◽

pp. 663-667 ◽

Cited By ~ 2

Author(s):

Sasa Milenkovic ◽

Milorad Mitkovic ◽

Mile Radenkovic ◽

Desimir Mladenovic ◽

Gordana Soldatovic ◽

...

Keyword(s):

Surgical Treatment ◽

Internal Fixation ◽

External Fixation ◽

Functional Results ◽

Surgical Trauma ◽

Pertrochanteric Fractures ◽

Skeletal Mass ◽

Dynamic Methods ◽

Life Threat ◽

Methods Of Treatment

Pertrochanteric fractures usually occur in patients over 65 years of age, with greater loss of skeletal mass (osteoporosis). Nonsurgical methods of treatment are accompanied by relatively high lethality rate. Moreover, they do not produce satisfactory anatomical and functional results. Surgical treatment by using dynamic implants represents a method of choice in the fixation of pertrochanteric fractures. This paper presents the treatment results of 110 patients, 61 with pertrochanteric fractures, who were surgically treated by the dynamic method of internal fixation, and 49 patients who were treated by the method of external fixation. Dynamical implants enabled both dynamization and compression of the fracture in the axis of the neck, as well as the diaphysis of the femur, which lowered the risk of mechanical complications, and, at the same time, provided effective healing of the fracture, early activation, and mobilization of the patients on whom the surgery was performed. In patients infected by various diseases, for whom surgical trauma represents a life threat, the external fixation is recommended as a method of choice.

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Alkaptonuria with extensive ochronotic degeneration of the Achilles tendon and its surgical treatment: a case report and literature review

Asian Biomedicine ◽

10.2478/abm-2021-0016 ◽

2021 ◽

Vol 15 (3) ◽

pp. 129-136

Author(s):

Nesrin Mwafi ◽

Ali Alasmar ◽

Monther Al-Momani ◽

Sattam Alazaydeh ◽

Omar Alajoulin ◽

...

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Achilles Tendon ◽

Tendon Repair ◽

Functional Results ◽

Sudden Onset ◽

Flexor Hallucis Longus ◽

History Of ◽

Complete Disruption ◽

Collagenous Tissues

Abstract Background Alkaptonuria is a rare genetic metabolic disorder due to deficiency of homogentisate 1,2-dioxygenase (HGD), an enzyme catalyzing the conversion of homogentisate to 4-maleylacetoacetate in the pathway for the catabolism of phenylalanine and tyrosine. HGD deficiency results in accumulation of homogentisic acid and its pigmented polymer. Ochronosis is a bluish-black discoloration due to the deposition of the polymer in collagenous tissues. Extensive ochronotic involvement of the Achilles tendon in alkaptonuria and its surgical treatment is rarely reported. Case report A 43-year-old man presented to our clinic in March 2019 with sudden onset of left Achilles tendon pain with no history of prior trauma. Surgical exploration revealed a complete disruption of the tendon at its attachment to the calcaneus. Black pigmentation was extensive and reached the calcaneal tuberosity, extending about 7 cm from the insertion. Discussion Achilles reconstruction was performed using flexor hallucis longus tendon transfer. The patient experienced uncomplicated healing with satisfactory functional results. Conclusion Orthopedic surgeons should be aware of the progressive nature of alkaptonuria. Extensive degenerative changes of the ruptured tendon should be suspected so that physicians can plan tendon repair and facilitate prompt surgical intervention.

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