The incidence of infection in open cruris fracture grade III A-B treated by external fixation after golden period at Dr. Moewardi General Hospital, Surakarta, Indonesia

Background: Infected nonunion of long bones after fractures is one of the most challenging complication to treat in clinical practice. It is commonly treated by a two-stage approach; controlling infection initially and then application of external fixator and bone graft. Treatment with Ilizarov had been the gold standard but is associated with few complications. The objective of the study was to evaluate the clinical, radiological and functional outcomes of infected non-union of long bones treated with single-stage bone grafting and external fixation.Material and Methods: This retrospective study was carried out at Orthopedics Department of Northwest General Hospital, Peshawar Pakistan from 2014 to 2019. Medical records of 17 patients, aged 32 years and treated with Single-stage bone grafting and external fixation were reviewed. Nonunion included 7 humerii, 5 femurs, 3 tibias and 2 radius/ulna. Preoperative plain radiographs for any sequestrum or sclerosed bone margins and baseline investigations (like CBC, ESR, CRP and Vitamin-D status) were reviewed. All patients underwent radical debridement, reaming of intramedullary canals, external fixation and autogenous bone grafting. The outcomes evaluated were union of the bone (clinically and radiologically), resolution of infection, complication rate and number of re-intervention surgeries.Results: Among 17 patients, 10 were males and 7 were females. After treatment, mean follow-up duration was 9.414.48 months (4–18 months). None of the patients were lost to follow-up, had recurrence of infection or required further surgery. The mean duration of bone union was 8.4  4.48 months (range 3 to 17 months) and all of the patients achieved infection free union with satisfactory functional outcome.Conclusions: Single-stage bone grafting and external fixation is an effective technique in terms of resolution of infection and satisfactory bone union without any complications and can be used as an alternative to Ilizarov for treating cases of infected nonunion of long bones.

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External Skeletal Fixation: Experience in a Small Rural Hospital in Northern Kenya

Tropical Doctor ◽

10.1177/004947559302300212 ◽

1993 ◽

Vol 23 (2) ◽

pp. 73-76 ◽

Cited By ~ 4

Author(s):

S Galvagno

Keyword(s):

External Fixation ◽

General Hospital ◽

Low Cost ◽

Appropriate Technology ◽

District Level ◽

Rural Hospital ◽

External Device ◽

Northern Kenya ◽

Limb Fractures

The author describes the use of external skeletal fixation in the management of complicated septic limb fractures. Eight fractures in seven patients were treated at Sololo General Hospital using a low cost, simple external device, with good results. The report emphasizes how external fixation can solve difficult fracture cases in small up-country hospitals; a good example of appropriate technology at district level.

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Underestimation of malnutrition among Pakistani infants weighed with clothes on

Eastern Mediterranean Health Journal ◽

10.26719/1996.2.2.255 ◽

2021 ◽

Vol 2 (2) ◽

pp. 255-260

Author(s):

A. Faisel

Keyword(s):

Nutritional Status ◽

General Hospital ◽

Health Facilities ◽

Malnourished Children ◽

Grade Ii ◽

Grade Iii

Manygrowth monitoring programmes at health facilities and in communities in Pakistan weigh children with their clothes on. The nutritional status of infants at the Rawalpindi General Hospital was estimated from weight without clothes on and showed that about 8% of malnourished children were being missed. This underestimation mostly affected children with grade II and grade III malnutrition. Generally, more boys have normal nutritional status than girls. Accordingly, weight with clothes on was found to underestimate the malnutrition status of girls more than that of boys. Children should be weighed without clothes on so as estimate their nutritional status and risk accurately

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Heat-Etching with a Bullivant Type II Simple Freeze-Cleave Device

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100067522 ◽

1970 ◽

Vol 28 ◽

pp. 106-107 ◽

Cited By ~ 1

Author(s):

Ronald S. Weinstein ◽

N. Scott McNutt

Keyword(s):

New Zealand ◽

General Hospital ◽

Massachusetts General Hospital ◽

Type I ◽

Type Ii ◽

Collaborative Effort ◽

Temperature And Pressure ◽

The University

The Type I simple cold block device was described by Bullivant and Ames in 1966 and represented the product of the first successful effort to simplify the equipment required to do sophisticated freeze-cleave techniques. Bullivant, Weinstein and Someda described the Type II device which is a modification of the Type I device and was developed as a collaborative effort at the Massachusetts General Hospital and the University of Auckland, New Zealand. The modifications reduced specimen contamination and provided controlled specimen warming for heat-etching of fracture faces. We have now tested the Mass. General Hospital version of the Type II device (called the “Type II-MGH device”) on a wide variety of biological specimens and have established temperature and pressure curves for routine heat-etching with the device.

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