scholarly journals Comparative analysis of the dynamics of the duration of the surgery and hematological indicators of blood loss after osteotomy of the ilium and acetabuloplasty in treatment of children with spina bifida

2021 ◽  
Vol 10 (2) ◽  
pp. 137-143
Author(s):  
Stanislav V. Ivanov ◽  
Vladimir M. Kenis
Keyword(s):  
Comparative Analysis ◽  
Spina Bifida ◽  
Blood Loss ◽  
Hip Joint ◽  
Surgical Intervention ◽  
Herniated Disc ◽  
Pronounced Decrease ◽  
Pediatric Orthopedic ◽  
Hematological Indicators ◽  
Dislocation Of The Hip

Introduction. Spina bifida is a severe malformation of the spine and spinal cord. Pathology of the hip joint in children with spina bifida has always been one of the most challenging pediatric orthopedic problems. Purpose of the study. The aim of this study is to perform a comparative analysis of the duration of operations and hematological indicators of blood loss after performing osteotomy of the ilium and acetabuloplasty to treat children with herniated disc consequences in the presence of hip subluxation and dislocation. It also seeks to determine the safest surgical intervention. Materials and methods. We observed and treated 60 patients aged 38 years with spina bifida with subluxation and dislocation of the hip. Patients were subdivided into two groups of 30 patients each, differing in the technique of performing the intervention on the pelvic component of the joint. The first group is represented by patients who underwent osteotomy of the ilium (52 joints) aimed to stabilize the hip joint. The second group comprised children who underwent acetabuloplasty (55 joints), another variant of intervention on the pelvic component of the joint. Results. As our study shows, performing osteotomy of the ilium required significantly more time than acetabuloplasty (p = 0.0088 (p 0.05)). In addition, performing osteotomy of the ilium was accompanied by a more pronounced decrease in the level of both hemoglobin and the number of blood erythrocytes than when performing acetabuloplasty. Conclusion. Our study demonstrates that osteotomy of the ilium requires more time for its implementation. It is accompanied by a more pronounced decrease in hemoglobin and blood erythrocytes than acetabuloplasty. Therefore, we can conclude that acetabuloplasty is preferable in cases where the expected clinical result and the required degree of correction are comparable.

scholarly journals Reconstructive and restorative interventions at the proximal end of the thigh and pelvic bones in destructive pathological dislocation of the hip in children after hematogenous osteomyelitis

2021 ◽  
Vol 4 (4) ◽  
pp. 367-372
Author(s):  
Khojaakhmed Shaykhislamovich Alpysbaev ◽  
Akhror Makhmutovich Djuraev ◽  
Elyar Abduvalievich Tapilov
Keyword(s):  
Surgical Treatment ◽  
Head And Neck ◽  
Hip Joint ◽  
Surgical Intervention ◽  
Pelvic Bones ◽  
Growing Period ◽  
Hematogenous Osteomyelitis ◽  
Early Surgical Intervention ◽  
Dislocation Of The Hip

It is generally known that children tend to get injured more easily than adults. Moreover, these injuries they get in growing period may leave for long in the forms of disability. This paper is about reconstructive and restorative interventions at the proximal end of the thigh and pelvic bones in destructive pathological dislocation of the hip in children after hematogenous osteomyelitis. After hematogenous osteomyelitis of the proximal end of the femur, destruction of the head and neck of the femur is often observed, up to their destruction. The optimal age for surgical treatment of pathological dislocation of the hip, according to our data, is 4-5 years of age of the child, because by this time the process of ossification of the structures of the hip joint ends in most patients, and early surgical intervention often causes severe secondary deformities, up to their destruction.

scholarly journals Technique for Spleen Resection Using Radiofrequency Ablation

2021 ◽  
pp. 1-7
Author(s):  
Ionkin Dmitry ◽  
Ionkin Dmitry ◽  
Stepanova Yulia Aleksandrovna ◽  
Alimurzaeva Maksalina Zakaryaevna ◽  
Vishnevsky Vladimir Aleksandrovich
Keyword(s):  
Comparative Analysis ◽  
Radiofrequency Ablation ◽  
Blood Loss ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Spleen Tissue ◽  
Surgical Interventions ◽  
National Medical ◽  
A New Technique

From modern positions, removal of the spleen is undesirable due to the risk of post-splenectomy syndrome development, where first of all, the clinical manifestations of the syndrome of suppressive post-splenectomy infections are taken into account, which justifies either performing organ-preserving surgical interventions on the spleen, or heterotopic autotransplantation of spleen tissue. Spleen resection is accompanied by significant blood loss, both during the intervention and in the postoperative period. The various methods of prevention of bleeding (clips, coagulation instruments, local hemostatics, etc.) are not always effective. Currently, there have been reports of the possibility of using radiofrequency ablation (RFA) in interventions on the spleen. The literature data and own 10 observations of spleen resection with the use of RFA in patients with focal organ lesions are presented. All described in literature technologies use the Rita® device for RF destruction and the corresponding attachment, which consists of 4 needle active electrodes. The spleen parenchyma is "burned" blindly, and the organ parenchyma is divided in the middle, between the treated injections. A new technique for performing spleen resection using radiofrequency ablation has been proposed at A.V. Vishnevsky National Medical Research Center of Surgery. The essence of our proposed method for minimizing blood loss during spleen resection is as follows: RFA-exposure is carried out along the zone of organ ischaemia under the control of ultrasound. For RFA, we used a Radionics Cool-Tip® Ablation System and a set of water-cooled electrodes (MEDTRONIC, USA). The features of the surgical intervention are noted. No bleeding was noted either intraoperatively or in the postoperative period in any case. A comparative analysis of the results of various methods of organ-saving surgical treatment is presented.

scholarly journals Early surgical intervention for active thoracic spinal tuberculosis patients with paraparesis and paraplegia

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Weiwei Li ◽  
Zheng Liu ◽  
Xiao Xiao ◽  
Zhenchao Xu ◽  
Zhicheng Sun ◽  
...  
Keyword(s):  
Blood Loss ◽  
Surgical Intervention ◽  
Spinal Tuberculosis ◽  
Thoracic Spinal ◽  
Cobb’S Angle ◽  
Perioperative Complication ◽  
The Mean ◽  
Early Surgical Intervention ◽  
Thoracic Spinal Tuberculosis

Abstract Background To explore the therapeutic effect of early surgical intervention for active thoracic spinal tuberculosis (TB) patients with paraparesis and paraplegia. Methods Data on 118 active thoracic spinal TB patients with paraparesis and paraplegia who had undergone surgery at an early stage (within three weeks of paraparesis and paraplegia) from January 2008 to December 2014 were retrospectively analyzed. The operation duration, blood loss, perioperative complication rate, VAS score, ASIA grade and NASCIS score of neurological status rating, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb’s angle, and duration of bone graft fusion were analyzed to evaluate the therapeutic effects of surgery. Results The mean operating time was 194.2 minutes, and the mean blood loss was 871.2 ml. The perioperative complication rate was 5.9 %. The mean preoperative VAS score was 5.3, which significantly decreased to 3.2 after the operation and continued decreasing to 1.1 at follow up (P<0.05). All cases achieved an increase of at least one ASIA grade after operation. The rate of full neurological recovery for paraplegia (ASIA grade A and B) was 18.0 % and was significantly lower than the rate (100 %) for paraparesis (ASIA grade C and D) (P<0.05). On the NASCIS scale, the difference in the neurological improvement rate between paraplegia (22.2 % ± 14.1 % in sensation and 52.2 % ± 25.8 % in movement) and paraparesis (26.7 % ± 7.5 % in sensation and 59.4 % ± 7.3 % in movement) was remarkable (P<0.05). Mean preoperative ESR and CRP were 73.1 mm /h and 82.4 mg/L, respectively, which showed a significant increase after operation (P>0.05), then gradually decreased to 11.5 ± 1.8 mm/h and 2.6 ± 0.82 mg/L, respectively, at final follow up (P<0.05). The mean preoperative kyphotic Cobb’s angle was 21.9º, which significantly decreased to 6.5º after operation (P<0.05) while kyphotic correction was not lost during follow up (P>0.05). The mean duration of bone graft fusion was 8.6 ± 1.3 months. Conclusions Early surgical intervention may be beneficial for active thoracic spinal TB patients with paraparesis and paraplegia, with surgical intervention being more beneficial for recovery from paraparesis than paraplegia.

scholarly journals ALTERNATIVE TO THE INVERTED “Y” INCISION IN SCOLIOSIS SECONDARY TO MYELOMENINGOCELE

2019 ◽  
Vol 18 (1) ◽  
pp. 14-16
Author(s):  
Diego Veiga Bezerra ◽  
Luis Eduardo Munhoz da Rocha ◽  
Dulce Helena Grimm ◽  
Carlos Abreu de Aguiar ◽  
Luiz Müller Ávila ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Spina Bifida ◽  
Postoperative Period ◽  
Medical Records ◽  
Surgical Intervention ◽  
Case Series ◽  
Material Failure ◽  
Spinal Deformities ◽  
Level Of Evidence ◽  
Skin Conditions

ABSTRACT Objective: To evaluate the healing of the modified inverted “Y” incision in patients with scoliosis due to myelomeningocele. Methods: Retrospective study through medical records review of patients with myelomeningocele surgically treated with a modified inverted “Y” approach between January 2013 and December 2015. Results: We analyzed the medical records of six patients. Two patients progressed with skin complications in the immediate postoperative period and only one of them required surgical intervention for debridement and suturing. In another patient, it was necessary to perform two surgical reviews due to material failure without skin complications in these interventions. Conclusions: The modified inverted “Y” technique is a great alternative to traditional incision and inverted “Y” because it has good results in patients with spina bifida associated with poor skin conditions treated surgically for correction of spinal deformities. Level of Evidence IV; Case series.

Anteroinferior dislocation of the hip joint associated to a fracture of the greater trochanter

2021 ◽  
Vol 25 ◽  
pp. 101115
Author(s):  
Fekhaoui Mohammed Reda ◽  
Bakayan Mohammed Said ◽  
Boussouga Mostapha
Keyword(s):  
Hip Joint ◽  
Greater Trochanter ◽  
Dislocation Of The Hip

scholarly journals Traumatic Obturator Dislocation of the Hip Joint Associated with Greater Trochanter Fracture: A Case Report

2021 ◽  
Author(s):  
Qifeng Tao ◽  
Fenglin Zhong ◽  
Chuan Wang ◽  
Hongping Wang ◽  
Chunyu Chen ◽  
...  
Keyword(s):  
Case Report ◽  
Hip Joint ◽  
Greater Trochanter ◽  
Trochanter Fracture ◽  
Dislocation Of The Hip

Nephrometric score based on 3D modeling (3D nephrometry score) for the probability prediction of intra- and postoperative complications for kidney surgery

2021 ◽  
pp. 039156032110364
Author(s):  
Georgiy Andreevich Mashin ◽  
Vasiliy Vladimirovich Kozlov ◽  
Denis Vladimirovich Chinenov ◽  
Yaroslav Nikolaevich Chernov ◽  
Alexandra Vladimirovna Proskura ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
3D Modeling ◽  
Roc Analysis ◽  
Linear Models ◽  
Surgical Intervention ◽  
Renal Tumors ◽  
Discriminant Functions ◽  
Nephrometry Score ◽  
Probability Prediction

Aim: The purpose of the study is the development and evaluation of the informativeness of the author’s 3D nephrometric score application to predict the probability of intraoperative and postoperative complications in kidney operations. Material and methods: The study includes 264 patients who underwent surgical treatment of renal tumors, before that CT and 3D modeling were carried out. All patients underwent an analysis of the surgical intervention complexity on the C-index, PADUA, R.E.N.A.L., and developed 3D nephrometric score. To determine the set of variables that allow to classify patients, the method of discriminant analysis was used to predict the nature, volume of blood loss, duration of ischemia, and the number of complications. The sensitivity and specificity of the predictors were estimated with the help of ROC analysis. Results: Indicators have been established to classify patients according to the probability of complications, the amount of blood loss and the duration of ischemia during surgery for kidney cancer. We have created linear models that predict the development of bleeding during surgery, the volume of blood loss of more than 200 ml and the duration of ischemia more than 20 min, as well as the likelihood of complications using discriminant functions. The proposed author’s nephrometric score exceeds the capabilities of C-index, PADUA, R.E.N.A.L in many ways in blood loss and time of ischemia predicting, which allows us to recommend it for the assessment of resectability in kidney operations.

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