Distinctive features of the results of operative treatment of intraarticular and extraarticular fractures in HIV-infected patients

2021 ◽  
Vol 19 (3) ◽  
pp. 103-108
Author(s):  
S. N. KHOROSHKOV ◽  
◽  
N. G. DORONIN ◽  
N. V. YARIGIN ◽  
V. G. BOSYKH ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Rapid Progression ◽  
Treatment Results ◽  
Expected Time ◽  
Soft Tissue Regeneration ◽  
Articular Fractures ◽  
Intraarticular Fractures ◽  
Fracture Consolidation ◽  
Secondary Displacement ◽  
The Moment

The purpose — to evaluate the effectiveness of the developed algorithm for determining the tactics and methods of treating intraarticular fractures in HIV-infected patients. Material and methods. From 2016 to 2020, 56 HIV-infected patients with intra-articular fractures underwent surgical treatment. In the course of treatment, an algorithm developed in the clinic for determining the tactics and method of treating HIV-infected patients was used, which proved effective in treating extra-articular fractures. Results. The results were evaluated in the average expected time of the fracture consolidation of the selected location, as well as 6 and 12 months from the moment of surgery using the algorithm developed by us for determining the tactics and method of treating fractures in HIV-infected patients. Good results (according to the Luboschitz — Mattis scale) were noted in 16 (30,8%), satisfactory — in 27 (51,9%) and unsatisfactory — in 9 (17,3%) cases. For patients of this category, the most typical complications were the rapid progression of deforming arthrosis of the joints, the secondary displacement of bone fragments against the background of bone resorption, and the development of an inflammatory process of predominantly non-infectious etiology. Conclusion. The use of the developed algorithm for determining the tactics and method of treatment in HIV-infected patients with extra-articular fractures, taking into account the effect of HIV infection and antiretroviral therapy on the processes of bone remodeling and soft tissue regeneration, can significantly reduce the number of unsatisfactory treatment results. At the same time, the peculiarities of the effect of HIV infection on the state of cartilage, subchondral bone and synovial fluid determine the nature and risks of postoperative complications in HIV-infected patients. In the future, it is planned to correct the developed algorithm taking into account the data obtained and to carry out a comparative analysis of the treatment results.

scholarly journals Features of choosing the tactics and method of treatment of external joint frequencies of long external bones in people living with HIV

2020 ◽  
Vol 12 (1) ◽  
pp. 65-72
Author(s):  
N. G. Doronin ◽  
S. N. Khoroshkov ◽  
S. L. Maksimov
Keyword(s):  
Hiv Infection ◽  
Infectious Complications ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Long Bones ◽  
Treatment Results ◽  
Improve Treatment ◽  
Articular Fractures ◽  
And Migration ◽  
Living With Hiv

Objective. Develop an algorithm for determining tactics and parameters of their treatment to improve treatment outcomes. Methodology. Material and research methods. A statistical analysis of the treatment results of 90 HIV-infected patients aged from 23 to 54 years with extra-articular fractures of long bones of the extremities was carried out. When determining the tactics and method of treatment, the peculiarities of the effect of HIV infection, antiretroviral drugs, and opportunistic diseases on the patient’s body were not taken into account. Results. Non-infectious complications are characteristic of HIV-infected patients: sides of the postoperative wound (seromas, hematomas, discrepancy of wound edges, delayed crushing), aseptic loosening and migration of fixatives, delayed consolidation of fractures. The presence of a statistically significant relationship between the objective factors characterizing the course of HIV infection: the stage of the disease, the number of CD lymphocytes, the ratio of CD4 / CD8 lymphocytes, viral load and the risk of postoperative complications was revealed.Conclusion. The application of the developed algorithm allows you to objectify the procedure and provide an individual approach in determining the tactics and method of treatment for HIV-infected patients with extraarticular fractures of long bones of the extremities

scholarly journals EXPERIENCE IN TREATMENT OF DISTAL HUMERAL EPIMETAPHYSEAL INTRA-ARTICULAR FRACTURES USING COMBINED OSTEOSYNTHESIS BY SUBMERSIBLE SCREWS AND EXTERNAL FIXATION HINGE DISTRACTION SYSTEM

2018 ◽  
Vol 25 (2) ◽  
pp. 56-62
Author(s):  
A. A. Shuiskiy ◽  
G. A. Kesyan ◽  
R. Z. Urazgil’deev ◽  
G. S. Karapetyan ◽  
I. G. Arsen’ev ◽  
...  
Keyword(s):  
External Fixation ◽  
Dash Score ◽  
Joint Stability ◽  
Articular Fractures ◽  
Articular Surfaces ◽  
Fracture Consolidation ◽  
Secondary Displacement ◽  
Combined Osteosynthesis ◽  
Passive Movements

Purpose of study: to evaluate the results of distal humeral epimetaphyseal intra-articular fractures treatment by the proposed combined osteosynthesis technique.Patients and methods. From 2014 to 2017 thirty three patients (21 male, 12 female) aged 22-68 years were treated for the distal humeral epimetaphyseal intra-articular fractures of types 13B1.2 — 13B3.3, 13C1.3 and 13C3.1t by AO/OTA classification. The technique included open reposition, transchondral osteosynthesis using titanium alloy (n=18) and biodegradable (n=15) cannulated screws followed by the application of the external fixation hinge distraction system. The results were evaluated roentgenologically and by DASH Score. Results. Follow up period made up from 3 to 12 months. Fracture consolidation was achieved in all patients. Functional treatment results were evaluated by DASH Score. In 30 patients the results were assessed as excellent, in 3 — good. No poor results were recorded.Conclusion. The advantages of the proposed technique are the early initiation of active and passive movements in the operated joint to prevent contracture and posttraumatic arthrosis development, reduction of risks of fracture fragments secondary displacement and screw migration, joint unloading owing to articular surfaces dosed distraction, ensuring of the operated joint stability. The result did not depend on the type of cannulated screw used.

scholarly journals External fixator by Mitkovic in the treatment of comminuted intraarticular fractures of the distal radius

2004 ◽  
Vol 57 (9-10) ◽  
pp. 473-479 ◽  
Author(s):  
Ivan Micic ◽  
Milorad Mitkovic ◽  
Desimir Mladenovic ◽  
Sasa Karalejic ◽  
Sasa Milenkovic ◽  
...  
Keyword(s):  
Distal Radius ◽  
External Fixator ◽  
Wrist Joint ◽  
Functional Results ◽  
Kirschner Wires ◽  
Articular Fractures ◽  
Intraarticular Fractures ◽  
Anatomic Reduction ◽  
Joint Incongruity ◽  
The Moment

Introduction Comminuted intraarticular fractures of the distal radius metaphysis are a major challenge for orthopedic surgeons. The aim of this study was to present results of the survey on treatment of these fractures using an external fixator. Material and methods 73 patients (30 females and 43 males) with closed comminuted intraarticular fractures of the distal radius, type C AO/ASIF (based on radiography at the moment of injury) were treated by a Mitkovic external fixator and followed-up for at least 2 years. An external fixator and Kirschner wires were used in 43 patients. An external fixator without Kirschner wires was used in 30 patients. Results At the end of treatment, functional results and outcomes were excellent in 39 (53.4%), good in 19 (26%), fair in 10 (13.7%), and poor in 5 (6.8%) patients according to Jakim score. Lesser degree of limitation of the movement of the wrist joint was established in 19 patients (26%). Joint incongruity of the distal radius, 0-2 mm, was observed in 22 patients (30%) and over 2 mm in 3 patients. A minimal degree of posttraumatic osteoarthrosis was recorded in 21 patients (28.7%) and moderate ostheoarthrosis in 5 patients (6.8%). Conclusion The anatomic reduction of the articular surfaces and healing of the fracture in a proper functional position are prerequisites for adequate function of the wrist and hand. It appears that an external fixator, with or without Kirschner wires, can be a method of choice in treatment of these complex articular fractures.

scholarly journals METHOD OF FORENSIC ASSESSMENT OF RISK FACTORS OF TREATMENT FAILURE OUTCOMES AS AN ELEMENT OF QUALITY MANAGEMENT OF MEDICAL CARE

2020 ◽  
Vol 73 (5) ◽  
pp. 1041-1047
Author(s):  
Vyacheslav K. Sokol ◽  
Vira A. Kolesnichenko ◽  
Kostyantin M. Sokol ◽  
Vladyslav A. Smiianov
Keyword(s):  
Forensic Assessment ◽  
Adverse Outcomes ◽  
Expert Assessment ◽  
Delayed Fracture ◽  
Fracture Consolidation ◽  
Secondary Displacement ◽  
Bone Fragments ◽  
Diaphyseal Fractures ◽  
Post Traumatic ◽  
The Stability

The aim: The aim of this research was to study causes of the development of adverse outcomes in isolated femоral diaphyseal fractures. Materials and methods: A retrospective analysis of the protocols of clinical and radiological examination of 21 patients was performed. Based on the initial expert assessment, these patients have not been established the severity of injuries due to the development of complications in the postoperative period. Conclusions: Patient-dependent, implant-dependent, and surgery-dependent causes that caused a violation of the stability of osteosynthesis (95.2%) were identified. This led to a secondary displacement of bone fragments (71.4%), delayed fracture consolidation (61.9%), the formation of pseudarthrosis (38.1%), the development of post-traumatic osteomyelitis (14,3), migration of screws from the osseous plate (47.6%), and the development of post-traumatic contracture of the knee joint (81.0%).

scholarly journals PREDISPOSING FACTORS AND TREATMENT OF OSTEOARTHRITIS AFTER SURGERIES PERFORMED FOR TIBIAL FRACTURES

World Science ◽  
2019 ◽  
Vol 1 (12(52)) ◽  
pp. 16-19
Author(s):  
Dudko O. G. ◽  
Glubochenko O. V. ◽  
Pickula V. V. ◽  
Marchuk O. F. ◽  
Shayko-Shaykovskiy O. G.
Keyword(s):  
Surgical Treatment ◽  
Healing Process ◽  
Joint Stiffness ◽  
Tibial Fractures ◽  
Joint Surface ◽  
Aseptic Necrosis ◽  
Intraarticular Fractures ◽  
Rehabilitation Period ◽  
The Moment ◽  
Treatment Procedures

Tibial fractures are very common injuries that require surgical management. For many cases, when the fracture involves the joint further complications occur, such as joint stiffness, osteoarthritis, aseptic necrosis of articular surfaces, ankylosis, infection complications, etc. To prevent joint stiffness open reduction and internal fracture fixation is used. That allows better positioning of fracture fragments forming joint surface and improve outcome. The article analyses results of surgical treatment of intraarticular fractures as well as biomechanical factors that are affecting the joint within the healing process and in later outcome period. Various treatment procedures are suggested to prevent development of osteoarthritis or to decrease its severity. The following options are used on all stages of treatment starting since the moment of injury, primary surgical procedures, rehabilitation period, and further non-surgical treatment in the internal medicine department. Important roles are assigned for use of chondroprotective drugs, intraarticular injections of Hyaluronic acid, physiotherapy and physical activity.

scholarly journals Rapid Progression of Kaposi’s sarcoma complicated with hemophagocytic syndrome in a severely immunosuppressed patient with HIV-infection: a case report

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Pingzheng Mo ◽  
Liping Deng ◽  
Xiaoping Chen ◽  
Yong Xiong ◽  
Yongxi Zhang
Keyword(s):  
Hiv Infection ◽  
Kaposi's Sarcoma ◽  
Hemophagocytic Syndrome ◽  
Kaposi’S Sarcoma ◽  
Rapid Progression ◽  
Immunosuppressed Patient ◽  
Timely Manner ◽  
Cutaneous Lesions ◽  
Case Presentation ◽  
Life Threatening

Abstract Background AIDS-related KS generally involves cutaneous lesions, that slowly progress over months to years. Neither rapidly progressing of KS nor KS complicated with hemophagocytic syndrome (HPS) has rarely been reported. Case presentation We report a rare case of rapid progression of Kaposi’s sarcoma complicated with hemophagocytic syndrome in a severely immunosuppressed patient with HIV-infection. The symptoms of this patient were atypical, showing only persistent high fever and rapid progressed to hemophagocytic syndrome. This patient was successfully treated with antiretroviral therapy combined with liposomal doxorubicin. Conclusions The condition of the KS patient could deteriorate rapidly over a period of days and even developeded into HPS, which was life-threatening. However, chemotherapy initiated in a timely manner might improve prognosis.

scholarly journals Acute HIV infection with rapid progression to AIDS

2010 ◽  
Vol 14 (3) ◽  
pp. 291-293 ◽  
Author(s):  
Marcio de Oliveira Silva ◽  
Milena Bastos ◽  
Eduardo Martins Netto ◽  
Nancy Alves de Lima Gouvea ◽  
Alex Jose Leite Torres ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Rapid Progression ◽  
Acute Hiv Infection ◽  
Acute Hiv

scholarly journals Gingival esthetics: an orthodontic and periodontal approach

2012 ◽  
Vol 17 (5) ◽  
pp. 190-201 ◽  
Author(s):  
Máyra Reis Seixas ◽  
Roberto Amarante Costa-Pinto ◽  
Telma Martins de Araújo
Keyword(s):  
Tooth Movement ◽  
Treatment Results ◽  
Transdisciplinary Approach ◽  
The Moment ◽  
Smile Esthetics

INTRODUCTION: Currently, people's esthetic requirements and expectations have increased substantially. Therefore, dentists have been seeking ways to provide excellent treatment results which, consequently, increasingly require a well organized transdisciplinary approach. The link between orthodontics and periodontics became evident from the moment professionals began to understand the biology of tooth movement. As regards smile esthetics, however, such cooperation is now essential. OBJECTIVE: To show clinically how and when orthodontists and periodontists should work jointly to enhance smile esthetics based on the display and harmony of the gingival contour.

scholarly journals Prevalence of HIV, syphilis and genital chlamydial infection among women in North-West Ethiopia

1998 ◽  
Vol 120 (2) ◽  
pp. 171-177 ◽  
Author(s):  
A. ASEFFA ◽  
A. ISHAK ◽  
R. STEVENS ◽  
E. FERGUSSEN ◽  
M. GILES ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Rural Women ◽  
Treponema Pallidum ◽  
Significant Risk ◽  
Rapid Progression ◽  
North West ◽  
First Marriage ◽  
North West Ethiopia ◽  
Active Syphilis ◽  
Chlamydial Antigen

The prevalence of sexually transmitted diseases (STD) among women visiting antenatal (ANC) and gynaecological clinics in Gondar, north-west Ethiopia, was investigated. Between April and August 1995, 728 women consented to enter the study. Prevalence rates were 5·9% (41/693) for chlamydial antigen in cervix, 18·8% (113/600) for syphilis (Treponema pallidum haemagglutination assay [TPHA]) and 25·3% (150/593) for HIV. Active syphilis (RPR)+, TPHA+ was detected in 7·4% (44/597). HIV infection rate was higher among women with higher age of first marriage and low gravidity. It was significantly associated with young age, urban residence, and presence of genital ulcer (odds ratio [OR]=6·3), and lymphadenopathy (OR=2·8) on examination. Women seropositive for syphilis had married at an earlier age, were significantly older and had changed husbands. Low gravidity and age <30 were independently significant risk factors for cervical chlamydial antigen positivity which was predominantly asymptomatic. Significant association was observed between HIV infection and syphilis (OR=2·6). Active syphilis was associated with chlamydial (OR=3·4) and HIV infection (OR=4·1). The rate of 23·4% and 15·1% of HIV seropositivity among ANC attenders and rural women respectively is an indicator of the rapid progression of the HIV epidemic in the area.

Arthroscopically-Assisted Reduction of Intra-Articular Fractures of the Distal Radius

1998 ◽  
Vol 23 (3) ◽  
pp. 391-395 ◽  
Author(s):  
L. ADOLFSSON ◽  
P. JÖRGSHOLM
Keyword(s):  
Distal Radius ◽  
Closed Reduction ◽  
Joint Surface ◽  
Percutaneous Fixation ◽  
Articular Fractures ◽  
Intraarticular Fractures ◽  
Arthroscopically Assisted ◽  
Arthroscopically Assisted Reduction

Twenty-seven patients with intraarticular fractures of the distal radius with a step of more than 1 mm in the joint surface after attempted closed reduction, were treated by reduction under arthroscopic control and percutaneous fixation. All fractures healed without measurable incongruity of the joint surface and at follow-up 3 to 38 months after surgery 19 patients had excellent and eight patients good results according to the Mayo modified wrist score.

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