scholarly journals Lijecenje akutne rupture Ahilove tetive neoperativno vs. operativno

2013 ◽  
Vol 60 (3) ◽  
pp. 57-60 ◽  
Author(s):  
Nikola Bulatovic ◽  
Velisa Aligrudic ◽  
Zarko Dasic ◽  
Dzihad Pepic ◽  
Aleksandar Juskovic

INTRODUCTION: It affects most frequently middle aged recreational male sportsmen (30-50 years old), previously followed by prodromal symptoms (5-33%). Rupture spot is 3 to 5 cm above heel bone vertex (90-95%). Retrospective study. WORKING OBJECTIVE: Comparison of functional results and complications of cast immobilization non-operative treatment and open suture surgical treatment. MATERIAL AND METHODS: Overall 46 patients included who were treated at the Clinic for Orthopedics and Traumatology within the Clinical Center of Montenegro in Podgorica between 2004 and 2012. Patients were divided into two groups: I group consisted of 21 patients (45.65%) who were treated by cast immobilization and the II (control) group consisted of 25 patients (54.35%) who were treated by open surgical technique. Division by gender: 44 male patients (95.65%) and 2 female patients (4.35%). WORKING RESULTS: The average age of patients was 38.8+2.79 (21-60 years of age); for the patients treated operationally 37.1+3.98 years of age, for the patients treated non-operationally 40.2+2.39; 28 right side patients (60.86%), 18 left side patients (39.14%); Surface infection detected on 1 patient (2.17%) 2 patients with partial rupture, while 3 patients had complete rupture during early rehabilitation period after immobilization was taken off. Complete rupture detected on 3 patients (6.25%) has been recovered surgically. Thromboembolism noticed on 3 patients (6.52%) while 2 patients (4.34%) were affected by pulmonary embolism. Tendon elongation present on 3 patients (Magnetic Resonance (MR) Diagnostics) and on 1 patient reoperation was performed 3 months after the primary surgical intervention. CONCLUSION: This study didn?t show significant statistical difference between two ways of treatment, but early immobilization is recommended because of better results. In case of Achilles tendon rupture, the advantage should be given to the surgical treatment, especially if younger population is treated.

2015 ◽  
Vol 62 (1) ◽  
pp. 85-88
Author(s):  
Nikola Bulatovic ◽  
Miroslav Kezunovic ◽  
Zarko Dasic ◽  
Nikola Fatic

INTRODUCTION: Achilles tendon rupture usually occurs in recreational athletes of middle age 30-50godina and typical place of the rupture of 3-5 cm above the insertion of the heel bone. Most common in recreational athletes. OBJECTIVE: To view the surgical technique suture the tendon with a guide ?Achillon? the functional outcome of acute injuries. MATERIAL AND METHODS: retrospective analysis included a total of 20 patients treated at the Clinic of Orthopedics and Traumatology, Clinical Center of Montenegro in Podgorica in the 2009-14. They were monitored for 12 months. Diagnosis is based on history, clinical examination Thompson?s Simmond O?Brien test, ECHO and NMR. RESULTS: The average age was 38.8 ?2.79 years 21-52 years. Right in 14 respondents 70%, the left side in 6 30%. There were no complications as: infection, thrombosis, rerupture and embolism. Functional results tables we have shown through specific scores. CONCLUSION: It can be concluded that this procedure provides a simple and quick surgical technique, a small percentage of complications, shorter immobility time and good functional results.


2015 ◽  
Vol 20 (3) ◽  
pp. 135-138
Author(s):  
Obada B. ◽  
Serban Al. O.

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.


2020 ◽  
Vol 37 (2) ◽  
pp. 54-64
Author(s):  
A. G. Baindurashvili ◽  
E. A. Kostomarova ◽  
I. E. Nikityuk ◽  
E. L. Kononova ◽  
D. B. Barsukov ◽  
...  

Objective. To study the functional state of the musculoskeletal system in patients with Legg Calve Perthes disease after surgical treatment. Material and methods. The study of 31 patients at the age of 8 to 13 years with unilateral Legg Calve Perthes disease (LCPD) was performed in the period from 2 to 5 years after surgical treatment. In the control group (15 children), correcting (varus) osteotomy (VO) was fulfilled, in the main group (16 children) triple pelvic osteotomy (TPO), and the group of healthy children (18 persons) was examined as well. Walking biomechanics was studied using of the STEDIS complex (Neurosoft LLC, Ivanovo, Russia). The vertical balance of the body was evaluated on a stabilometric platform MBN "Biomechanics" (LLC NMF MBN, Moscow). Results. After surgical treatment, the indicators of vertical balance and biometry of the step phases in both groups of children with LCPD did not reach the same level as in healthy individuals at the indicated follow-up dates. The least significant indicators of step phase asymmetry were found in patients after TPO compared with patients after VO. In patients after VO, the destabilization of the center of pressure significantly exceeded that in patients after TPO. Conclusions. Biomechanical studies allow us to compare the functional results of various techniques of surgical treatment of children with unilateral LCPD. After TPO operation, patients have a more complete restoration of the supportability of the affected lower limb compared to VO operation.


2019 ◽  
Vol 18 (5) ◽  
pp. 46-53

Despite the progress in otosurgery, the efficient treatment of patients with the cochlear form of otosclerosis (according to the classification of N.A. Preobrazhensky, 1962) remains an important task. The authors have developed and implemented an advanced stapedoplasty method, providing the improvement of hearing in this category of patients. and described the methods of differential diagnostics for selection of patients according to the developed method. The article describes in details the early and long-term functional results of surgical treatment of 60 patients with cochlear and mixed II forms of otosclerosis, divided into the main and control groups. The main group is represented by 30 patients who underwent a cartilage-on-vein stapedoplasty according to the improved method. The control group included 30 patients, in which 18 people underwent a cartilage-on-vein stapedoplasty according to the method developed by Lenin Prize winner V. F. Nikitina, and 12 people who underwent V. T. Palchun’s piston stapedoplasty. The results demonstrate a statistically significant improvement of bone conduction in the main group in average by 15–20 dB throughout the entire tone scale (except for high frequencies in some patients) and the complete closure of the bone-air interval with subsequent preservation of the results. Based on the obtained data, the authors present the expediency and perspectivity of implementation of the advanced stapedoplasty method.


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Moses Lee ◽  
Jin Soo Suh ◽  
Myung Jin Shin

Category: Sports Introduction/Purpose: No physical exam or clinical test can clearly predict a final course of acute Achilles tendon rupture after surgical treatment. But, in recent studies, ability to perform single-heel-raise during the early postoperative period was considered as a significant prognostic factor. Therefore, analysis of the relationship between preoperative factors and timing of the single heel raise might help to predict the prognosis and aid to establish an individualized rehabilitation plan. The purpose of this study was to analyze the factors affecting early single heel raise after surgical treatment of acute Achilles tendon rupture. Methods: From January 2012 to August 2015, a retrospective analysis was performed for 68 patients who met the inclusion criteria among 98 cases of surgically treated acute Achilles tendon rupture. Operative technique and rehabilitation protocol were same in all cases. The patients who were able to perform a single heel raise within 3 months postoperatively were classified into the study group and the rest was determined as the control group. During periodic outpatient observation, we evaluated Achilles tendon total rupture score (ATRS), Visual Analog Scale (VAS), and timing capable of a single heel raise. We also preoperatively measured defect size and distance between calcaneal osteotendinous junction and rupture site by ultrasound image in all cases. Results: No difference was found in demographic factors between the study group (23 cases) and the control group (45 cases) who performed a single heel raise later than 3 months postoperatively. There were no significant difference in defect size and distance between calcaneal osteotendinous junction to the rupture site (P=0.38, P=0.63). However, when the rupture site was divided into hyporvascular zone (from calcaneal osteotendinous junction to the rupture site: 4~7 cm) and hypervascular zone, the study group showed a significantly low hyporvascular zone rupture rate. (14/23, 41/45, P=0.003). Also, in the logistic regression analysis that included age, BMI, smoking, hyporvascular zone rupture, defect size, and operation delay, patients with hypervascular region rupture showed odds ratio of 5.3 (P=0.017) in performing a single heel raise within postoperative 3 month. ATRS score at postoperative 3 months and last f/u were significantly higher in the study group. (p<0.01) Conclusion: Achilles tendon rupture at hypovascular zone is a poor prognostic factor for the early single heel raise and might significantly affect the prognosis after acute Achilles tendon rupture operation.


2021 ◽  
Vol 8 (1) ◽  
pp. 30-36
Author(s):  
V. Skyba ◽  
V. Rybalchenko ◽  
O. Ivanko ◽  
N. Voytyuk ◽  
Dar Yasin Akhmed

Purpose of the work. improving the results of surgical treatment of patients with primary intra-abdominal infiltrates and abscesses. Material and methods. From 2006 to 2019, 191 patients with primary intra-abdominal infiltrates and abscesses were treated. The patients' age ranged from 16 to 85 years. There were 96 male patients (50.26%), 95 female patients (49.74%). Results. The patients were divided into 3 subgroups depending on the underlying disease. The first group included 74 (38.74%) patients with destructive appendicitis, of which 39 (20.42%) were in the control group, and 35 (18.32%) were studied. The second group included 48 (25.13%) patients suffering from perforated gastric ulcer and 12 duodenal ulcer, of which the control group was 26 (13.61%), and the studied group was 22 (11.52%). The third group included 69 (36.13%) patients with cholecystitis, of which 37 (19.37%) were in the control group, and 32 (16.76%) were studied. All patients were operated on. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and 12 duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis from 69 (36.13%) in 48 (25.13%) laparotomic and in 21 (11.00%) laparoscopically. The use of water-jet technologies in 64 (33.51%) patients made it possible to minimize damage to the serous membrane and cleanse the peritoneum from acquired formations.


2010 ◽  
Vol 16 (2) ◽  
pp. 64-67
Author(s):  
B. Sh. Minasov ◽  
A. R. Sahabutdinova ◽  
M. Yu. Khanin

A study of the efficacy of medical rehabilitation of 170 patients with spinal-cord injury through the application of modern rehabilitation and surgical technologies was conducted. Patients of I (control) group received standard set of conservative treatment and rehabilitation. Patients of II (main) group the rehabilitation was supplemented with therapeutic exercises with the use of loop complex «Hope» and the rate of adaptation to the stress of hypoxia in the late period of injury. Patient of III (control) group surgical treatment and the conventional range of rehabilitation were performed. Patients of IV (main) group the rehabilitation was completed with early activation using espandernogo complex «Hope» and the rate of adaptation to the stress of hypoxia in the late period of injury. It is proved that the developed complex rehabilitation of patients with spinal-cord injury using an early stable functional osteosynthesis with the minimum extent necessary, the use of complex «Hope» can improve the functional results at the expense of early motor activation, preventing the formation of contractures and muscle atrophy. The use of adaptation to the stress of hypoxia in the late period of vertebro-spinal cord injury improves overall health, reduces the severity of autonomic reactions, emotional stress, can cut pain syndromes.


2011 ◽  
Vol 1 (3) ◽  
pp. 171-174
Author(s):  
Elvedin Osmanovic ◽  
Mensura Aščerić ◽  
Esed Omerkic

Introduction: Antibiotic prophylaxis is defined as the use of antimicrobials in the absence of symptoms of infection, with the aim of preventing or reducing the incidence of infection after surgery. We analyzed the incidence of surgical wound infection in patients in whom a protection of hemoprophylaxis conducted using cefazolin and gentamicin, and determine the frequency of surgical wound infection in patients in whom there was a deviation in the implementation of hemoprophylaxis protection.Methods: This retrospective-prospective study included 100 patients surgically treated at the The Department of Orthopedics and Traumatology, University Clinical Center in Tuzla from December 2007 to February 2010, which examined the incidence of surgical wound infection after surgical treatment of fractures or degenerative changes in the hip, thigh and lower leg fractures.Results: In the first group, in patients who were treated with cefazolin were detected in 2 cases (5.7%) while the length of hemoprophylaxis was 7 days, patients who were treated with cefazolin and gentamicin were detected in 1 case (2.8%) and duration hemoprophylaxis was 7 days. In another control group tah was found 9 cases of wound infection (30%), and hemoprophylaxis duration was 10 days.Conclusion: The combination of cefazolin and gentamycin for a period of 5 days significantly reduces the incidence of infection and significantly shortened the time of antibiotics in group that is respected application protocol in accordance with international recommendation.


2018 ◽  
Vol 17 (1) ◽  
pp. 58-63 ◽  
Author(s):  
I. S. Shormanov ◽  
M. S. Los’ ◽  
K. S. Titov

Currently it is a constant search for new and effective methods of protection against ischemic injury in limb-salvage surgery on kidneys. Objective – improvement of functional results of surgical treatment, reducing the time of hospitalization. Materials and methods. We conducted a clinical trial involving 69 patients. Time “warm ischemia” – 14,2 ± 2,4 min. All performed on the kidney sparing surgery for renal cell carcinoma for elective indications. After surgery, the study group (n = 35) held sessions of hyperbaric oxygenation parallel receiving α-tocopherol acetate. The control group included 34 patients. The analysis of inflammatory changes in tindicators of total blood test, glomerular filtration rate, the state of immunity, peripheral circulation, renal function, the assessment of quality of life was performed. Results. The scheme of post-operative rehabilitation of patients with renal cell carcinoma helps to activate the anti-inflammatory and immune response to surgical treatment, more rapid and complete restoration of blood flow and function of organ operated. Conclusion. This reduces the incidence of postoperative complications and period of hospitalization.


2018 ◽  
Vol 4 (2) ◽  
pp. 58-62
Author(s):  
Roksana Yeasmin ◽  
MA Muttalib ◽  
Kazi Nazneen Sultana ◽  
Nizamul Hoque Bhuiyan ◽  
Md Jamil Hasan Karami ◽  
...  

Background: Type 2 diabetes mellitus is a chronic disease characterized by relative or absolute deficiency of insulin, resulting in glucose intolerance.Objectives: The present study was planned to see the associations of serum uric acid with positive Rheumatoid factor in type 2 male diabetes mellitus patients. Methodology: This case control study was carried out at the department of Biochemistry at Ibrahim Medical College, Dhaka, Bangladesh. The duration of the study was from June 2015 to June 2016 for a period of one year. In this present study, male patients with type 2 diabetes mellitus were taken as case group and age and sex matched healthy male were taken as control group. Rheumatoid factor was measured from the blood of all case and control group respondents. Others blood para meters were also measured for the correlation with the diabetes mellitus patients.Results: In this present study, 110 male patients presented with type 2 diabetes mellitus were recruited as case and age and sex matched healthy male were recruited as control. More rheumatoid factor positive in type 2 DM male patients with the uric acid range between 6.5 to 9.5 mg/dL. The number of patients was 5 out of total 9 rheumatoid factor positive cases. In this study serum uric acid was significantly correlated with rheumatoid factor in type 2 male diabetic patients. Rheumatoid factor positive cases were taking insulin among 9 and it was statistically significantly associated (p<0.001). Conclusion: In this study serum uric acid is significantly associated with positive rheumatoid factor in type 2 male diabetic patients.Journal of Current and Advance Medical Research 2017;4(2):58-62


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