scholarly journals Indications and Outcomes of the Kocher-Langenbeck Surgical Approach in the Management of Acetabular Fractures in a Resource Limited Setting

2022 ◽  
pp. 30
Author(s):  
Keyword(s):  
Sciatic Nerve ◽  
Surgical Site Infections ◽  
Posterior Wall ◽  
Late Complications ◽  
Fracture Reduction ◽  
Acetabular Fractures ◽  
Posterior Fixation ◽  
Operative Complications ◽  
Poor Outcomes ◽  
Post Operative Complications

The Kocher-Langenbeck (K-L) approach is the ‘workhorse’ of surgery for acetabular fractures needing posterior fixation. It is indicated for most of these fractures for proper surgical technique and optimal outcome. We therefore evaluated the outcome of surgically treated acetabular fractures through the K-L approach in our setting with limited resources. 57 patients were operated by the K-L approach during the 3-year study period. The most common indications of this approach were: posterior wall (38.6%) and transverse + posterior wall fractures (36.8%). Based on Matta’s criteria of fracture reduction, 81 % were judged anatomic, 16% imperfect and 3 % poor. A surgery waiting time of 8 to 14 days after injury, significantly favoured anatomic fracture reduction. The MAP score was excellent in 72 % and unacceptable in 10.6 %. Factors associated with poor outcomes were poor fracture reduction and the development of early post-operative complications. Iatrogenic sciatic nerve palsy (ISNP) was the most significant post-operative complication (19.3%). The levering of Hohmann retractors in the sciatic notches was the major risk factor for developing ISNP, compared to the use of sciatic nerve retractors. Other early and late complications included surgical site infections (12.3%) and heterotopic ossification (8.8 %), respectively. The overall outcome following surgery by the K-L approach is satisfactory. However, there is need to ameliorate the technique, especially at the level of instrumentation, to limit post-operative complications.

scholarly journals Evaluation of post-operative complications associated with tobacco use in thoracic surgery patients

2021 ◽  
Vol 8 (8) ◽  
pp. 2272
Author(s):  
Mehmet Degirmenci ◽  
Celal Kus
Keyword(s):  
Postoperative Complications ◽  
Thoracic Surgery ◽  
Tobacco Use ◽  
Intensive Therapy ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
Thoracic Diseases ◽  
Operative Complications ◽  
Poor Outcomes ◽  
Post Operative Complications

Background: Tobacco can make thoracic diseases more complicated by affecting their respiratory functions. Smoking causes many diseases that require surgical treatment and affects surgical results. The aim of the study was to determine the relationship between tobacco use and post-operative complications in thoracic surgery patients and contribute to public health.Methods: In this study, 754 patients were evaluated retrospectively. Patient characteristics and tobacco use habits of the patients were determined. Postoperative complications, admission to the intensive therapy unit, intubation, death, and length of stay in hospital were defined as surgical outcomes. These results were compared and analyzed with tobacco use.Results: The patients consisted of 536 (71.1%) men and 218 (28.9%) women. Tobacco use was more common in men (X2=223.216, p<0.001) and younger ages (X2=45.342, p<0.001). Complications occurred in 96 patients, 76 (79.2%) of whom used tobacco. Tobacco use (p<0.001, OR=3.547), ASA score (p=0.029, OR=2.004), major surgeries (p<0.001, OR=4.458), and minimally invasive surgeries (p=0.027, OR=2.323) are associated with complications. Length of hospital stay is related to the amount of tobacco (p<0.001, OR=3.706), size of surgery (p<0.001, OR=14.797), over 65 years (p<0.001, OR=2.635), and infectious diseases (p=0.039, OR=1.939).Conclusions: Tobacco use is related to poor outcomes in thoracic surgery patients, and it is a severe health problem, especially at young ages. Tobacco control programs should be supported to prevent the effects of tobacco use on thoracic diseases and postoperative complications.

scholarly journals 719. Clinical Outcomes of Single versus Double Anaerobic Coverage for Intra-abdominal Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S410-S410
Author(s):  
Lendelle Raymond ◽  
Eris Cani ◽  
Cosmina Zeana ◽  
William Lois ◽  
Tae Park
Keyword(s):  
Body Temperature ◽  
Hospital Mortality ◽  
Length Of Hospital Stay ◽  
Surgical Site Infections ◽  
Primary Objective ◽  
Clostridioides Difficile ◽  
Operative Complications ◽  
Abdominal Infections ◽  
Hospital Acquired ◽  
Post Operative Complications

Abstract Background Double anaerobic coverage (DAC) is often used for intra-abdominal infections (IAIs) post-operatively. The primary objective of the study was evaluating length of hospital stay (LOS), in-hospital post-operative complications, and re-admission within 30 days of discharge due to post-operative complications in patients who received piperacillin/tazobactam plus metronidazole versus piperacillin/tazobactam for IAIs post-operatively. The secondary objective was comparing in-hospital mortality and hospital-acquired Clostridioides difficile infections (CDI) between the two groups. Methods This was a retrospective, cohort study including adults with surgically managed IAIs at an urban community hospital between January 1, 2016 and June 30, 2019. The following data were collected: age, sex, body mass index, comorbidities, Charlson Comorbidity Index (CCI), 5-day post-operative body temperature, American Society of Anesthesiologists (ASA) pre-operative assessment score, surgical wound classification, and IAI diagnosis. Multivariate analysis and aggregate resampling of the sampling distribution were conducted. An alpha of &lt; 0.05 was considered statistically significant. Results Out of 163 patients, 96 patients received piperacillin/tazobactam plus metronidazole and 67 patients received piperacillin/tazobactam. The patients who received DAC were sicker with higher CCI (p=0.021) and 5-day post-operative body temperature (p=0.013). They were also at a higher risk for surgical site infections (p=0.002). Double anaerobic coverage was more often used for acute cholecystitis (p=0.0001) and gastrointestinal perforations (&lt; 0.0001). After adjusting for these variables, DAC was associated with longer LOS (median 9 days vs. 4 days, p&lt; 0.0001) and in-hospital post-operative complications (23% vs. 9%, p&lt; 0.0001). There were more re-admissions within 30 days of discharge due to post-operative complications in the single anaerobic coverage group (4% vs. 1%, p=&lt; 0.0001). In-hospital mortality (4% vs. 0%) and hospital-acquired CDI (1% vs. 0%) were only observed in DAC group. Conclusion Double anaerobic coverage was associated with no clinical benefit in surgically managed IAIs and in some cases may produce worse outcomes. Disclosures All Authors: No reported disclosures

scholarly journals Complications associated with splenectomy in thalassemia

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Farogh Zahra ◽  
Muhammad Ashraf ◽  
Muhammad Aslam ◽  
Qaim Deen ◽  
Javeria Mannan
Keyword(s):  
Clinical Study ◽  
Study Design ◽  
Perioperative Management ◽  
Late Complications ◽  
Prospective Clinical Study ◽  
Massive Splenomegaly ◽  
Study Materials ◽  
Operative Complications ◽  
Post Operative Complications

Aims and Objectives: The study aims at investigating the complications associated with splenectomy in thalassemic patients Study Design: It was a prospective clinical study. Materials and Method: Sixty Splenectomies were preformed electively after pre-operative preparation in Sir Ganga Ram Hospital, Lahore during the year Jan 2003 to Sep 2005. Results: Complications were categorized into per-operative, early post-operative and late complications. The frequency of per-operative complications was 3%, early post-operative complications were 10% and late complications were 1.6%. Interpretation and Conclusion: The rate of complications has decreased markedly as the patients are well prepared and improved post operative carp has also reduced the post-operative complications. With good perioperative management, splenectomy in children with massive splenomegaly is both safe and effective.

scholarly journals Assessment of functional outcome of operative management of displaced acetabular fractures and complications

2021 ◽  
Vol 7 (6) ◽  
pp. 1145
Author(s):  
Jawed A. Bhat ◽  
Tabasum Akbar ◽  
Abdul Hanan Javaid ◽  
Faizan Javaid ◽  
Faesal Mir ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Elderly Patients ◽  
Functional Outcome ◽  
Nerve Injury ◽  
Avascular Necrosis ◽  
Operative Management ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Operative Complications ◽  
Morbid Conditions

<p><strong>Background:</strong> Aim of the study was to assess the functional outcome of operative management of displaced acetabular fractures and complications.</p><p><strong>Methods:</strong> The study included sixty patients presenting within 2 weeks with displaced fractures of more than 2 mm. Elderly patients with osteoporotic bones and co-morbid conditions were excluded.</p><p><strong>Results: </strong>A total of sixty patients were operated on. Union was achieved in anatomical position in 51 patients (85%) and in malposition in 9 (15%) patients. Excellent results were obtained in 15 (25%) patients, good results in 32 (53%), fair results in 7 (11.6%) and poor results in 6 (10%) patients. Post operative complications included infection in 2 (3%), sciatic nerve injury in 2 (3%) and avascular necrosis (AVN) in 3 (5%) patients.</p><p><strong>Conclusions:</strong> In the present study, majority of the patients were operated within two weeks. The Harris hip score averaged 58.</p>

Prevalence of malnutrition and its associated outcomes in pediatric patients with scoliosis undergoing elective posterior spinal fusion or spine growth modulation – a retrospective review

2021 ◽  
Author(s):  
CA Karls ◽  
A Duey-Holtz ◽  
OA Lampone ◽  
A Dopp ◽  
H Tolo ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Statistical Significance ◽  
Retrospective Chart Review ◽  
Surgical Site Infections ◽  
Posterior Spinal Fusion ◽  
Chi Square ◽  
Surgical Interventions ◽  
Operative Complications ◽  
American Society ◽  
Post Operative Complications

Recent attention within pediatric orthopedics focuses on the prevalence and prevention of post-operative complications, including surgical site infections (SSIs). While poor nutrition status has been noted as a risk factor, various definitions have been utilized. The aim of this retrospective chart review was to utilize the Academy of Nutrition and Dietetics (AND) and the American Society for Parenteral and Enteral Nutrition (ASPEN) diagnostic criteria to determine both the prevalence of malnutrition in pediatric patients undergoing spine deformity surgery and its influence on the prevalence of post-operative complications. A total of 2603 patients had a spine procedure between 2012 and 2018. Patients were excluded if they were less than 2 years of age or greater than 18 years of age and/or did not have their spine procedure completed at Children’s Wisconsin. Patients who met inclusion criteria and had an irrigation and debridement (I&D) were selected for an I&D group. From the remaining charts, 127 patients were randomly selected for the non-I&D group. Patients in both groups were further divided into well-nourished and malnourished groups. T-tests and chi square tests were used to determine statistical significance. We found that 50% of patients who had an I&D had malnutrition during their clinical course. This is compared with 17% of patients who didn’t require an I&D. Additionally, patients requiring multiple surgical interventions, had an increased prevalence of malnutrition. With the recent focus on reducing the prevalence of post-operative complications, the identification and treatment of malnutrition may be helpful in reducing post-operative complications.

Pelvic Canal Narrowing Caused by Triple Pelvic Osteotomy in the Dog

1994 ◽  
Vol 07 (03) ◽  
pp. 110-113 ◽  
Author(s):  
D. L. Holmberg ◽  
M. B. Hurtig ◽  
H. R. Sukhiani
Keyword(s):  
Postoperative Complications ◽  
Pelvic Osteotomy ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Canal Width ◽  
Operative Complications ◽  
Post Operative Complications

SummaryDuring a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.

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