scholarly journals Ilizarov method in the treatment of children with periarticular fractures

2021 ◽  
Vol 27 (4) ◽  
pp. 418-423
Author(s):  
A.A. Korobeinikov ◽  
◽  
A.M. Aranovich ◽  
D.A. Popkov ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
External Fixation ◽  
Surgical Techniques ◽  
Distal Humerus ◽  
Growth Zone ◽  
Ilizarov Method ◽  
Potential Threat ◽  
Advantages And Disadvantages ◽  
Ilizarov Apparatus ◽  
Iatrogenic Damage

Introduction Periarticular injuries in children include types I and II fractures according to the Salter-Harris classification and metaphyseal fractures. In most cases, conservative treatment is an effective method, but in some cases, surgical treatment, including external fixation, is the method of choice. Purpose Discussion of the principles of using the Ilizarov apparatus in the treatment of children with periarticular fractures of various locations, its advantages and disadvantages. Materials and methods We present the principles and features of the Ilizarov surgical techniques for treatment of children with periarticular fractures of the distal humerus, femur, radius and tibia. Discussion The methods of osteosynthesis for pediatric periarticular fractures imply transphyseal introduction of fixators that have a potential threat of iatrogenic damage to the growth plate in contrast to external fixation which performance implies that transosseous elements do not injure the growth zone, providing stable fixation of bone fragments in combination with early functional recovery of the damaged segment which is a key advantage over other methods. Conclusion The use of the Ilizarov apparatus enables to achieve the desired result in the treatment of pediatric periarticular fractures and has a number of advantages over other methods of surgical treatment.

scholarly journals SURGICAL TECHNIQUES FOR TREATMENT OF COMPLICATED LARGE SIZE TRAUMATIC DIAPHRAGM HERNIA (CLINICAL CASE ANALYSIS)

2021 ◽  
Vol 20 (1) ◽  
pp. 25-30
Author(s):  
Vasyl Yatskyv ◽  
I. Polyansky ◽  
Vadim Sokolov ◽  
Sergiy Frimet ◽  
Yan Hyrla
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Bowel Perforation ◽  
Surgical Techniques ◽  
Diagnostic Methods ◽  
Surgical Approaches ◽  
Extensive Experience ◽  
Advantages And Disadvantages ◽  
Large Size ◽  
Diaphragm Hernia

The analysis of a clinical case of surgical treatment of a traumatic hernia of the left cupola of the diaphragm in a patient 66 years old, diagnosed 5 years after injury. The hernia was complicated by bowel perforation, gastrointestinal and cardiorespiratory syndrome due to organ translocation into the pleural cavity. Are noted the features of complications of traumatic hernias in the late period of their occurrence and associated diagnostic methods. The stages of diagnostics and treatment of this patient from the central district hospital to the regional clinical hospital have been analyzed; are presented the algorithm and methods of surgical treatment, the features of the postoperative period.The Department of Surgery No. 1 of the BSMU has extensive experience in the treatment of complicated diaphragm hernias, on the basis of which the article substantiates the indications for decompression of the mediastinal organs, gives the causes of pneumothorax, surgical techniques for its correction.Also are analyzed the types of surgical approaches for this pathology were are indicated the advantages and disadvantages of isolated laparotomy, thoracotomy, combined thoracoabdominal interventions.

scholarly journals Surgical Management of Patients with Chiari I Malformation

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
John Siasios ◽  
Eftychia Z. Kapsalaki ◽  
Kostas N. Fountas
Keyword(s):  
Surgical Treatment ◽  
Large Scale ◽  
Treatment Guidelines ◽  
Imaging Techniques ◽  
Surgical Techniques ◽  
Foramen Magnum ◽  
Chiari I Malformation ◽  
Advantages And Disadvantages ◽  
Clinical Series ◽  
Chiari I

Chiari malformations (CMs) constitute a variety of four mainly syndromes (I, II, III, and IV), which describe the protrusion of brain tissue into the spinal canal through the foramen magnum. These malformations frequently occur in combination with other pathological entities such as myelomeningocele, hydrocephalus, and/or hydrosyringomyelia. The recent improvement of imaging techniques has increased not only the rate of CM diagnosis but also the necessity for its early treatment. Several different surgical techniques have been employed in the treatment of patients with symptomatic CM-I. In our current study, a systematic and critical review of the pertinent literature was made for identifying the most commonly employed surgical procedures in the management of these patients. Emphasis was given in outlining the advantages and disadvantages of each surgical approach. Moreover, an attempt was made for defining those parameters that may be prognostic factors for their surgical outcome. There is a consensus that surgical treatment is reserved only for symptomatic patients with CM-I. It has also been postulated that early surgically intervention is usually associated with better outcome. Despite the large number of previously published clinical series, further clinical research with large-scale studies is necessary for defining surgical treatment guidelines in these patients.

scholarly journals Surgical techniques used for tonsil disease in children

2015 ◽  
Vol 62 (3) ◽  
pp. 294-297
Author(s):  
A. Zamfir-Chiru-Anton ◽  
◽  
D.C. Gheorghe ◽  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Surgical Techniques ◽  
The Other ◽  
Intraoperative Blood Loss ◽  
Advantages And Disadvantages ◽  
Surgical Methods ◽  
Surgical Options ◽  
The Difference

The authors review the techniques described for the surgical treatment of the tonsils. Each new method has its own advantages and disadvantages. The difference can be evaluated by studying the intraoperative blood loss and safety of the procedure. Also, the postoperative complications and quality of life can be used as an adjunct to objectively appreciate the different surgical techniques. There is no literature consensus about the superiority of one technique over the other. Multiple studies brought multiple significant results. It is also hard to evaluate the entire panel of surgical methods described concomitantly. The experience of one surgeon and his/her mastering of a certain technique is the actual cause of so many surgical options still in use for tonsil treatment in children.

scholarly journals Knee arthrodesis as a salvage method for septic TKA failure

2019 ◽  
Vol 2 (1) ◽  
pp. 3-8
Author(s):  
Traian Ciobanu ◽  
Ioan Mihau Japie ◽  
Octavian Nutiu ◽  
Alexandru Papuc ◽  
Dragos Radulescu ◽  
...  
Keyword(s):  
External Fixation ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Surgical Techniques ◽  
Revision Arthroplasty ◽  
Ilizarov Method ◽  
Cement Spacer ◽  
Knee Arthrodesis ◽  
Knee Amputation ◽  
Prosthetic Implants

AbstractPeriprosthetic joint infection is the most common reason for a failed TKA, with a septic TKA reported rate of 1 to 4% of primary TKA patients. Septic TKA has a various number of treatment options which include chronic-suppressive antibiotics, irrigation and debridement, single or staged revision arthroplasty. The goal is to eradicate the periprosthetic joint infection and reimplant a sterile and fully functional total knee prosthesis. In case the infection becomes uncontrollable, there is only one option to eradicate the infection: knee arthrodesis or above-knee amputation.We report the case of a 63-year-old patient who in 2009 underwent TKA, the 1 year follow-up showed periprosthetic infection. At first stage, the prosthetic implants were removed and a solid cement spacer was shaped to occupy the remaining space. In 2011, after achieving complete clinical and biological remission of the infection, the cement spacer was removed and LCCK revision prosthesis was inserted.In 2013 reinfection occurred leading to removal of the prosthetic implants and reinsertion of an antibiotic impregnated cement spacer.Since the patient suffered significant bone loss and the local conditions were unfavorable, being prone to infection, there were 2 options to evaluate: knee arthrodesis or above knee amputation. We chose knee arthrodesis using Ilizarov external fixation technique.Many surgical techniques are available to achieve knee arthrodesis: internal fixation with plates or intramedullary nails and external fixation. The Ilizarov method is a very effective technique that could be taken into consideration when knee arthrodesis is required.

scholarly journals Long-Term Clinical Outcomes of Osteochondritis Dissecans Lesions of the Elbow Treated with Arthroscopy

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0020
Author(s):  
Michael Ryan ◽  
Benton Emblom ◽  
E. Lyle Cain ◽  
Jeffrey Dugas ◽  
Marcus Rothermich
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Failure Rate ◽  
Osteochondritis Dissecans ◽  
Surgical Techniques ◽  
The Other ◽  
Return To Play ◽  
Exclusion Criteria

Objectives: While numerous studies exist evaluating the short-term clinical outcomes for patients who underwent arthroscopy for osteochondritis dissecans (OCD) of the capitellum, literature on long-term clinical outcomes for a relatively high number of this subset of patients from a single institution is limited. We performed a retrospective analysis on all patients treated surgically for OCD of the capitellum at our institution from January 2001 to August 2018. Our hypothesis was that clinical outcomes for patients treated arthroscopically for OCD of the capitellum would be favorable, with improved subjective pain scores and acceptable return to play for these patients. Methods: Inclusion criteria for this study included the diagnosis and surgical treatment of OCD of the capitellum treated arthroscopically with greater than 2-year follow-up. Exclusion criteria included any surgical treatment on the ipsilateral elbow prior to the first elbow arthroscopy for OCD at our institution, a missing operative report, and/or any portions of the arthroscopic procedure that were done open. Follow-up was achieved over the phone by a single author using three questionnaires: American Shoulder and Elbow Surgeons – Elbow (ASES-E), Andrews/Carson KJOC, and our institution-specific return-to-play questionnaire. Results: After the inclusion and exclusion criteria were applied to our surgical database, our institution identified 101 patients eligible for this study. Of these patients, 3 were then excluded for incomplete operative reports, leaving 98 patients. Of those 98 patients, 81 were successfully contacted over the phone for an 82.7% follow-up rate. The average age for this group at arthroscopy was 15.2 years old and average post-operative time at follow-up was 8.2 years. Of the 81 patients, 74 had abrasion chondroplasty of the capitellar OCD lesion (91.4%) while the other 7 had minor debridement (8.6%). Of the 74 abrasion chondroplasties, 29 of those had microfracture, (39.2% of that subgroup and 35.8% of the entire inclusion group). Of the microfracture group, 4 also had an intraarticular, iliac crest, mesenchymal stem-cell injection into the elbow (13.7% of capitellar microfractures, 5.4% of abrasion chondroplasties, and 4.9% of the inclusion group overall). Additional arthroscopic procedures included osteophyte debridement, minor synovectomies, capsular releases, manipulation under anesthesia, and plica excisions. Nine patients had subsequent revision arthroscopy (11.1% failure rate, 5 of which were at our institution and 4 of which were elsewhere). There were also 3 patients within the inclusion group that had ulnar collateral ligament reconstruction/repair (3.7%, 1 of which was done at our institution and the other 2 elsewhere). Lastly, 3 patients had shoulder operations on the ipsilateral extremity (3.7%, 1 operation done at our institution and the other 2 elsewhere). To control for confounding variables, scores for the questionnaires were assessed only for patients with no other surgeries on the operative arm following arthroscopy (66 patients). This group had an adjusted average follow-up of 7.9 years. For the ASES-E questionnaire, the difference between the average of the ASES-E function scores for the right and the left was 0.87 out of a maximum of 36. ASES-E pain was an average of 2.37 out of a max pain scale of 50 and surgical satisfaction was an average of 9.5 out of 10. The average Andrews/Carson score out of a 100 was 91.5 and the average KJOC score was 90.5 out of 100. Additionally, out of the 64 patients evaluated who played sports at the time of their arthroscopy, 3 ceased athletic participation due to limitations of the elbow. Conclusions: In conclusion, this study demonstrated an excellent return-to-play rate and comparable subjective long-term questionnaire scores with a 11.1% failure rate following arthroscopy for OCD of the capitellum. Further statistical analysis is needed for additional comparisons, including return-to-play between different sports, outcome comparisons between different surgical techniques performed during the arthroscopies, and to what degree the size of the lesion, number of loose bodies removed or other associated comorbidities can influence long-term clinical outcomes.

scholarly journals Lymphoscintigraphy in breast cancer: a short review about the impact on upper limb after surgical treatment

2008 ◽  
Vol 51 (spe) ◽  
pp. 83-89
Author(s):  
Anke Bergmann ◽  
Juliana Miranda Dutra de Resende ◽  
Sebastião David Santos-Filho ◽  
Marcelo Adeodato Bello ◽  
Juliana Flavia de Oliveira ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Current Trend ◽  
Surgical Techniques ◽  
Short Review ◽  
Lymphatic Drainage ◽  
Key Words Breast ◽  
Axillary Lymphadenectomy ◽  
The One ◽  
The Impact

Breast cancer is still associated with high mortality rates and one of the most important factors governing long survival is accurate and early diagnosis. In underdeveloped countries, this disease frequently is only detected in advanced stages; however, through mammography, many women have been diagnosed at early stages. In this context, the sentinel lymph node (SLN) technique is associated with less postoperative morbidity compared to axillary lymphadenectomy. Lymphoscintigraphy has emerged as a method for the evaluation of lymphatic drainage chains in various tumours, being both accurate and non invasive. The aim of this work is to present the main aspects which cause controversy about SLN and lymphoscintigraphy and the impact that these procedures have had on lymphedema after surgical treatment for breast cancer. A short review including papers in English, Spanish and Portuguese, available on Lilacs and Medline database, published between January, 2000 and July, 2008 was performed. The key words breast cancer, lymphoscintigraphy, SLN biopsy, lymphedema were used. Various studies have aimed to compare the incidence and prevalence of lymphedema according to the technique used; however, the population subjected to SLN is different from the one with indication for axillary lymphadenectomy regarding staging. Moreover, little is known about long term morbidity since it is a relatively new technique. In conclusion, the development of surgical techniques has permitted to minimize deformities and the current trend is that these techniques be as conservative as possible. Thus, lymphoscintigraphy plays an important role in the identification of SLN, contributing to the prevention and minimization of postoperative complications.

Achievements of the Clinic of Traumatology and Orthopedics of Moscow State Medical and Dentistry University named after A. I. Evdokimov in treatment of complications and consequences of fractures of long bones of extremities

2021 ◽  
Vol 19 (3) ◽  
pp. 144-151
Author(s):  
P. E. ELDZAROV ◽  
Keyword(s):  
Surgical Treatment ◽  
Treatment Process ◽  
Treatment Effectiveness ◽  
Chronic Osteomyelitis ◽  
Surgical Techniques ◽  
Long Bones ◽  
Delayed Fracture ◽  
Reconstructive Operations ◽  
Fracture Consolidation ◽  
Rapid Restoration

The work is devoted to improving the effectiveness of treatment of patients with complications and consequences of fractures of the long bones of the extremities by improving and developing new surgical techniques aimed at early individual social and household rehabilitation due to the maximally complete and rapid restoration of the integrity and functions of the damaged segment. Reconstructive operations were performed in 285 patients with delayed fracture consolidation, incorrectly fused fractures, false joints, and false joints with chronic osteomyelitis. The analysis of the applied treatment methods effectiveness from the viewpoint of optimizing the treatment process allowed us to develop an algorithm for the surgical treatment of patients with complications and consequences of fractures of the long bones of the extremities. The use of the proposed algorithm in surgical treatment maximally eliminates possible errors and increases the treatment effectiveness.

scholarly journals Surgical treatment of internal carotid artery restenosis following eversion endarterectomy

2012 ◽  
Vol 140 (9-10) ◽  
pp. 577-582
Author(s):  
Djordje Radak ◽  
Slobodan Tanaskovic ◽  
Miloje Vukotic ◽  
Srdjan Babic ◽  
Nikola Aleksic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Surgical Techniques ◽  
Minor Stroke ◽  
Graft Occlusion ◽  
Redo Surgery ◽  
Eversion Endarterectomy ◽  
Late Morbidity

Introduction. Carotid angioplasty and internal carotid artery stenting is the therapeutic method of choice in the treatment of carotid restenosis, but when it is not technically feasible (expressed tortuosity of supraaortic branches, calcifications, presence of pathological elongation of very long lesions) a redo surgery is indicated. Objective. The aim of our study was to examine the benefits and risks of redo surgery in patients with symptomatic and asymptomatic significant internal carotid artery restenosis and its impact on early and late morbidity and mortality. Methods. The study included 45 patients who were surgically treated for a hemodynamically significant internal carotid artery restenosis from January 2000 to December 2009. Surgical techniques included redo endarterectomy with direct suture, redo anderectomy with a patch plastic and resection with Dacron tubular graft interposition. The patients were followed for postoperative neurological ischemic events (transient ischemic attack (TIA), stroke), local surgical complications and lethal outcome after one month, six months, one year and after two years). Results. In the early postoperative period (up to 30 days) there were no lethal outcomes. TIA was diagnosed in four patients (8.8%), minor stroke in one patient (2.2%) and one patient (2.2%) also had cranial nerve injury. After two years two patients died (4.4%) due to fatal myocardial infarction, three patients (6.5%) had ipsilateral stroke and one patient developed graft occlusion (2%). Conclusion. In the case of symptomatic and asymptomatic carotid restenosis that cannot be treated by carotid percutaneous angioplasty, redo surgical treatment is therapeutic option with an acceptable rate of early and late postoperative complications.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

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