scholarly journals Surgical Treatment of Periprosthetic Acetabular Fracture: A 5 Cases Report and Literature Review.

2021 ◽  
Author(s):  
Yuxuan Cong ◽  
Shuang Han ◽  
Hongli Deng ◽  
Binfei Zhang ◽  
Chao Ke ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Revision Surgery ◽  
Acetabular Fracture ◽  
Fixation Strength ◽  
Acetabular Fractures ◽  
Press Fit ◽  
Number Of Patients ◽  
Average Patient ◽  
The Stability ◽  
Component Loosening

Abstract Background: With the increasing number of patients undergoing total hip arthroplasty(THA) in recent years, the incidence of periprosthetic acetabular fractures is increasing, which is one of the most serious complications after THA. Periprosthetic acetabular fracture caused by trauma is rare, and it requires orthopedic surgeons to deal with acetabular fracture and component loosening at the same time. This article summarizes 5 cases of periprosthetic acetabular fracture that have undergone surgical treatment, we propose the reverse press-fit technology to increase the stability of fixation for this clinical rare diseases. And the literature for treatment recommendations is reviewed.Case presentation: A total of 5 patients (3 female) were included, the average patient age at the time of injury was 66.2 years (range 54–78 years). All patients received surgical treatment, 4 cases were treated with open reduction and internal fixation(ORIF), 1 case was treated with revision surgery. There were no postoperative complications. All patients could walk independently on the latest follow-up.Conclusions: The surgical treatment option of periprosthetic acetabular fracture is ORIF or revision surgery, and the purpose is to make the component stabilized. The reverse press-fit technology could improve the fixation strength between the component and bone, and it can be performed in appropriate situation.

scholarly journals ECONOMIC INDICATORS OF SURGICAL TREATMENT OF ATHEROSCLEROSIS OF THE FEMORAL-POPLITEAL SEGMENT IN PATIENTS FOR CRITICAL LIMB ISHEMIA

2021 ◽  
Vol 4 (18) ◽  
pp. 51-57
Author(s):  
O.A. Holyachenko ◽  
Y.M. Gupalo ◽  
O.I. Nabolotnuy ◽  
B.L. Kulikovskuy ◽  
A.V. Shamrai-Sas ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lower Extremity ◽  
Bypass Surgery ◽  
Transluminal Angioplasty ◽  
Economic Indicators ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Patients With Diabetes ◽  
Average Patient

Introduction: is to analyze the economic indicators of different types of surgical treatment of atherosclerosis of the femoral-popliteal segment of the lower extremity in patients for сritacal limb ishemia. Materials and methods. were analyzed 173 cases of atherosclerosis of the femoral-popliteal segment of the lower extremity in patients for сritacal limb ishemia, of which 93 underwent arterial percutaneous transluminal angioplasty and 80 bypass surgery of the affected vessels. For this an original model of determining the value of medical care was used. It included the determination of costs that was given as a payment for medical workers, material and technical costs, the surgical interventions costs, the drugs that were used, additional examinations, and etc. Results. Economic analysis of costs per average patient that underwent PTA was UAH 5025.85, and bypass surgery UAH 4351.1. However,analyzing the results of treatment showed that there are small differences between the two methods, in particular a larger number of patients with diabetes. Conclusions. Both methods of treatment gave almost the same result in terms of the cost of treatment, which requires consideration of other factors, especially the clinical course of the disease.

Drilling and plombage (core decompression) of a femoral head avascular necrosis

2010 ◽  
Vol 19 (01) ◽  
pp. 36-39 ◽  
Author(s):  
P. Chládek ◽  
V. Havlas ◽  
T. Trc
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Core Decompression ◽  
Effective Treatment Option ◽  
Simple Method ◽  
X Ray ◽  
Large Femoral Head ◽  
Press Fit ◽  
Round Shape ◽  
Late Stages

SummaryThe treatment of femoral head necrosis of adults is still rather problematic. Conservative treatment has been reported relatively unsuccessful and surgical treatment does not show convincing results either. The most effective seems to be a surgical treatment in early stages of the disease, however, the diagnosis still remains relatively complicated. For the late stages (2B and above) the most effective treatment option is represented by core decompression and vascular grafting. However, drilling and plombage (especially when using press-fit technique) seems to be successful, although not excellent. The authors describe their own method of drilling and plombage of the necrotic zone of the femoral head in 41 patients with X-ray detected necrotic changes of the femoral head. The pain measured by VAS was seen to decrease after surgery in all patients significantly. The Jacobs score was also observed to have increased (from fair to good outcome). We have not observed any large femoral head collapse after surgery, moreover, in some cases an improvement of the round shape of the femoral head was seen. It is important to mention that in all cases femoral heads with existing necrotic changes (flattening or collapse) were treated. Although the clinical improvement after surgery was not significantly high, the method we describe is a safe and simple method of diminishing pain in attempt to prepare the femoral head for further treatment in a future, without significant restriction of the indication due to necrosis (osteochondroplasty, resurfacing, THR).

Mid-term results of a cementless primary press-fit cup in acetabular revision surgery

2020 ◽  
Author(s):  
N Kolbe ◽  
B Zimmer ◽  
P Matheis ◽  
M Streit ◽  
T Gotterbarm ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Acetabular Revision ◽  
Press Fit ◽  
Mid Term Results

Outcomes of Surgical and Nonsurgical Treatment for Colorectal Cancer in Nonagenarian Patients

2021 ◽  
pp. 000313482199506
Author(s):  
Youngbae Jeon ◽  
Kyoung-Won Han ◽  
Won-Suk Lee ◽  
Jeong-Heum Baek
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Mortality ◽  
Nonsurgical Treatment ◽  
Perioperative Outcomes ◽  
Rank Test ◽  
Kaplan Meier ◽  
Number Of Patients

Purpose This study is aimed to evaluate the clinical outcomes of surgical treatment for nonagenarian patients with colorectal cancer. Methods This retrospective single-center study included patients diagnosed with colorectal cancer at the age of ≥90 years between 2004 and 2018. Patient demographics were compared between the operation and nonoperation groups (NOG). Perioperative outcomes, histopathological outcomes, and postoperative complications were evaluated. Overall survival was analyzed using Kaplan-Meier methods and log-rank test. Results A total of 31 patients were included (16 men and 15 women), and the median age was 91 (range: 90‐96) years. The number of patients who underwent surgery and who received nonoperative management was 20 and 11, respectively. No statistical differences in baseline demographics were observed between both groups. None of these patients were treated with perioperative chemotherapy or radiotherapy. Surgery comprised 18 (90.0%) colectomies and 2 (10.0%) transanal excisions. Short-term (≤30 days) and long-term (31‐90 days) postoperative complications occurred in 7 (35.0%) and 4 (20.0%) patients, respectively. No complications needed reoperation, such as anastomosis leakage or bleeding. No postoperative mortality occurred within 30 days: 90-day postoperative mortality occurred in two patients (10.0%), respectively. The median overall survival of the operation group was 31.6 (95% confidence interval: 26.7‐36.5) and that of NOG was 12.5 months (95% CI: 2.4‐22.6) ( P = 0.012). Conclusion Surgical treatment can be considered in carefully selected nonagenarian patients with colorectal cancer in terms of acceptable postoperative morbidity, with better overall survival than the nonsurgical treatment.

scholarly journals Perfil Epidemiológico da Espondilodiscite Tratada Cirurgicamente

2016 ◽  
Vol 29 (5) ◽  
pp. 319 ◽  
Author(s):  
Joaquim Soares do Brito ◽  
António Tirado ◽  
Pedro Fernandes
Keyword(s):  
Staphylococcus Aureus ◽  
Mycobacterium Tuberculosis ◽  
Surgical Treatment ◽  
Epidemiologic Study ◽  
Neurological Impairment ◽  
Tuberculous Infection ◽  
Paravertebral Abscess ◽  
Number Of Patients ◽  
Epidemiological Profile ◽  
Relative Constant

<p><strong>Introduction:</strong> The term spondylodiscitis aims to describe any spinal infection. Medical treatment is the gold standard; nevertheless, surgical treatment can be indicated. The aim of this work was to study the epidemiological profile in a group of patients with spondylodiscitis surgically treated in the same medical institution between 1997 and 2013. <br /><strong>Material and Methods:</strong> Eighty five patients with spondylodiscitis were surgically treated in this period. The authors analysed clinical data and image studies for each patient.<br /><strong>Results:</strong> We treated 51 male and 34 female patients with an average age of 48 years old (min: 6 - max: 80). The lumbar spine was more often affected and <em>Mycobacterium tuberculosis</em> the most frequent pathogen. The number of cases through the years has been grossly stable, with a slight increase of dyscitis due to <em>Staphylococcus aureus</em> and decrease of the dyscitis without pathogen identification. Paravertebral abscess was identified in 39 patients and 17 had also neurological impairment, mostly located in the thoracic spine and with tuberculous aetheology. Immunosuppression was documented in 10 patients. <br /><strong>Discussion:</strong> In this epidemiologic study we found a tuberculous infection, male gender and young age predominance. Despite a relative constant number of patients operated over the years, pyogenic infections due to <em>Staphylococcus aureus</em> seems to be uprising. Paravertebral abscess and neurological impairment are important dyscitis complications, especially in tuberculous cases.<br /><strong>Conclusion:</strong> Spinal infections requiring surgical treatment are still an important clinical condition. <em>Mycobacterium tuberculosis</em> and <em>Staphylococcus aureus</em> represent the main pathogens with a growing incidence for the latest.</p>

scholarly journals Lateral Ankle Instability Surgical Treatment

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Bahman Sahranavard ◽  
Cesar de Cesar Netto ◽  
Ashish Shah ◽  
Parke Hudson ◽  
Ibukunoluwa Araoye ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Revision Surgery ◽  
Surgical Repair ◽  
Ankle Instability ◽  
Primary Repair ◽  
P Value ◽  
Complication Rates ◽  
Suture Anchors ◽  
Lateral Ankle ◽  
Lateral Ankle Instability

Category: Ankle, Sports Introduction/Purpose: Lateral ankle instability is a common cause of disability in the active population. Although the majority of patients can be treated conservatively, surgical repair of the ligaments, with or without reinforcement, represents an excellent option for refractory cases. Failed primary surgical repair, recurrence of the ankle instability and need for revision surgery can rarely happen and is probably affected by multiple variables. That includes patient’s characteristics such as BMI and comorbidities and surgical aspects such as the use of suture anchors and soft-tissue reinforcement. The purpose of this study was to compare patient’s characteristics and complication rates of primary repair and revision procedures. Methods: We retrospectively reviewed 231 patients (160 Female, 71 Male) who underwent surgical treatment for lateral ankle instability between 2010-2016. Thirty-two were revision cases (14.2%), including 24 females and 8 males, and 199 were primary direct repairs (85.8%). The mean age at the time of the surgery was 39 (19-65)years, and average follow-up was 9 (2-55) months. The procedures were performed by four different surgeons. All cases were reviewed based on age, gender, BMI, procedure type and number of incisions, comorbidities, and complications. Data found was compared between the two groups (primary repair and revision surgery) by T-test. A p-value <0.05 was considered significant. Results: The Brostrom-Gould procedure was used in 69.5% of the primary repairs and 63.6% of the revision cases. The use of suture anchors was also similar in both groups (51%). Repair of the calcaneofibular ligament was performed in 68% of primary repairs and 81.8% of the revisions. We didn’t find significant differences regarding comorbidities between two groups: smoking (23.4% x 27.2%, p-value 0.371); diabetes (6.8% x 6%, p-value 0.951) and body mass index above 30 (28.5% x 24.2%, p-value 0.347). We found significant difference in the complication rate of the procedures, with a higher incidence in the revision group (48.4%) when compared to the primary repair group (24%). That included: sural neuritis (15.1% x 3.4%), superficial peroneal neuritis (12.1% x 4.5%), skin problems (9% x 7.4%). Conclusion: Our study of 231 patients that underwent surgical treatment for lateral ankle instability found significant higher incidence of complications in patients who had revision procedures when compared to primary repair. No differences regarding smoking status, diabetes and BMI were found.

Identification of Decision Criteria for Revision Surgery Among Patients With Proximal Junctional Failure After Surgical Treatment of Spinal Deformity

Spine ◽  
2013 ◽  
Vol 38 (19) ◽  
pp. E1223-E1227 ◽  
Author(s):  
Robert Hart ◽  
Ian McCarthy ◽  
Michael OʼBrien ◽  
Shay Bess ◽  
Brett Line ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Spinal Deformity ◽  
Revision Surgery ◽  
Decision Criteria ◽  
Proximal Junctional Failure

scholarly journals Infra-acetabular screw exited between ischial tuberosity and ischial spine is more suitable for Asian population: A 3D Morphometric study

2020 ◽  
Author(s):  
Fei Liu ◽  
Xiaoreng Feng ◽  
Yang Xiao ◽  
Jie Xiang ◽  
Keyu Chen ◽  
...  
Keyword(s):  
Asian Population ◽  
3D Models ◽  
Ischial Tuberosity ◽  
Fixation Strength ◽  
Maximum Diameter ◽  
Acetabular Fractures ◽  
Morphometric Study ◽  
Exit Point ◽  
Ischial Spine ◽  
Length Direction

Abstract Background Recently, the infra-acetabular screw has been proposed for use in treatment of acetabular fractures as a part of a periacetabular fixation frame. Biomechanical studies have shown that an additional infra-acetabular screw placement can enhance the fixation strength of acetabular fracture internal fixation. Currently, the reported exit point of the infra-acetabular screw has been located at the ischial tuberosity (Screw I). However, our significant experience in placement of the infra-acetabular screw has suggested that when the exit point is located between the ischial tuberosity and the ischial spine (Screw II), the placement of a 3.5 mm infra-acetabular screw may be easier for some patients. We conducted this study in order to determine the anatomical differences between the two different IACs. Methods The raw datasets were reconstructed into 3D models using the software MIMICS. Then, the models, in the STL format model, were imported into the software Geomagic Studio to delete the inner triangular patches. Additionally, the STL format image processed by Geomagic Studio was imported again into MIMICS. Finally, we used an axial perspective based on 3D models in order to study the anatomical parameters of the two infra-acetabular screw corridors with different exit points. Hence, we placed the largest diameter virtual screw in the two different screw corridors. The data obtained from this study presents the maximum diameter, length, direction, and distances between the entry point and center of IPE. Results In 65.31% males and 40.54% females, we found a screw I corridor with a diameter of at least 5 mm, while a screw II corridor was present in 77.55% in males and 62.16% in females. Compared to screw I, the length of screw II is reduced, the angle with the coronal plane is significantly reduced, and the angle with the transverse plane is significantly increased.Conclusions For East Asians, changing the exit point of the infra-acetabular screw can increase the scope of infra-acetabular screw use, especially for females.

scholarly journals Surgery of cholesteatoma: Surgical technique and cholesteatoma recurrences

2004 ◽  
Vol 51 (1) ◽  
pp. 103-107
Author(s):  
Nenad Arsovic ◽  
Radomir Radulovic ◽  
Snezana Jesic ◽  
S. Krejovic-Trivic ◽  
P. Stankovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Complete Removal ◽  
Initial Surgery ◽  
Group I ◽  
Number Of Patients ◽  
Significant Difference ◽  
Diffuse Form ◽  
Surgical Failure

Past experience with open and closed techniques of tympanoplasty in surgery of cholesteatoma has shown that recurring illness is one of the major causes of surgical failure. The literature has reported varying trend of surgical treatment of cholesteatoma. The objective of the study was to analyze the significance of surgical technique in relation to the incidence and most frequent localization of recurrent cholesteatoma. Our study analyzed 120 patients operated on for cholesteatoma. The patients were divided into two groups, group I (45) with recurring disease and group II (75) without any recurring condition, which were followed up three years. Statistical analysis was carried out by modified t-test. The largest number of patients was re-operated in the first two years from the initial surgery (50%), In the majority of patients (50%), recurrent cholesteatoma was most commonly localized (stage I) in attic (20%) and much rarely in mesotympanum (11,9%). Stage III recurrent cholesteatoma was verified in 35% of patients, most frequently diffuse form (13,4%). The involvement of attic by all three stages of disease accounted for over 60%. The analysis of the used techniques of surgical treatment in both groups revealed significant difference. Open techniques of tympanoplasty were used in 60% of patients with no recurrence. Closed techniques were used more frequently in patients with recurring disease, i.e. in over 90% of cases. Recurrent cholesteatoma develops, in the majority of cases, during the first two years after the surgical intervention. Attic is the most common localization of cholesteatoma. More frequent utilization of open technique of tympanoplasty for surgery of cholesteatoma significantly reduces the incidence of recurring condition. The indications for CWD technique are the initial spread of cholesteatoma, possibility of complete removal of cholesteatoma and postoperative follow-up of patients.

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