Problems of surgical treatment of the anterior pelvic ring chronic injuries

2021 ◽  
Vol 19 (3) ◽  
pp. 47-54
Author(s):  
A. F. LAZAREV ◽  
◽  
E. I. SOLOD ◽  
YA. G. GUDUSHAURI ◽  
E. I. KALININ ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pelvic Ring ◽  
Metal Structure ◽  
Complex Problem ◽  
Long Term Results ◽  
Fixation Method ◽  
Surgical Interventions ◽  
Anterior Section ◽  
Pelvic Injuries ◽  
Study Results

A surgical treatment of the joints of the pelvic ring, especially the pubic joint is a separate and complex problem. When using standard plates, which are applied in the treatment of patients with fresh injuries to stabilize old injuries of the pelvic ring, problems arise with fatigue fracture of plates, destabilization of the metal structure and the need for repeated surgical interventions. Therefore, in the case of old injuries, during surgical treatment, it is necessary to use other tactical approaches to fixing pelvic injuries and to search for adapted structures for such cases. The purpose — to study the features of fixation of old injuries of the pelvic ring and to determine the results of different methods of the anterior pelvis fixation in old cases. Materials and methods. A retrospective analysis of the performed surgical treatment was carried out. In 2000-2015, in the first department of National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov, 117 patients underwent surgical treatment of old injuries of the anterior pelvic ring under our supervision using standard reconstructive plates applied in the surgical treatment of new injuries of the pelvic ring. Results. Of the 65 patients who underwent fixation of an old injury of the anterior semiring with AO reconstructive plates and AO pelvic plates, installed in a standard manner as in new injuries, 12 patients (10,2%) experienced migration or fracture of structures within 2 to 6 months from the operation. In 52 patients, fixation of the anterior section with two AO plates was applied, one of which was located in a standard way along the upper edge of the pubic bones, the second was implanted additionally along the anterior surface of the pelvic ring perpendicular to the first one. In this group, migration and destabilization of the structures was observed in 7 patients (13,4%) within a period from 2 weeks to 2 months from the date of the operation. Conclusion. The analysis of the study results suggests that surgical treatment of old injuries of the anterior pelvic ring requires a special approach to the choice of the surgical fixation method, which differs from the treatment of new injuries. Over time, in the absence of treatment for injuries and ruptures of the pelvic ring, cicatricial-fibrous adhesions of the pelvic ring occur, which does not always ensure the stability of the pelvic ring, but leads to rigid post-traumatic deformity of the pelvis. Taking into account the cases of destabilization in groups 1 — 10,2% and 2 — 13,4%, as well as the assessment of the long-term results according to the Majeed scale, the use of standard methods for fixing the anterior pelvic semiring can be considered ineffective in old pelvic injuries.

scholarly journals Surgical treatment of rectal prolapse: experience and late results with 51 patients

2004 ◽  
Vol 59 (4) ◽  
pp. 168-171 ◽  
Author(s):  
Carlos Walter Sobrado ◽  
Desidério Roberto Kiss ◽  
Sérgio C. Nahas ◽  
Sérgio E. A. Araújo ◽  
Victor E. Seid ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Fecal Incontinence ◽  
Rectal Prolapse ◽  
Late Results ◽  
Long Term Results ◽  
Complete Rectal Prolapse ◽  
Presacral Space ◽  
Perineal Rectosigmoidectomy ◽  
Study Results ◽  
Low Incidence

The "best" surgical technique for the management of complete rectal prolapse remains unknown. Due to its low incidence, it is very difficult to achieve a representative number of cases, and there are no large prospective randomized trials to attest to the superiority of one operation over another. PURPOSE: Analyze the results of surgical treatment of complete rectal prolapse during 1980 and 2002. METHOD: Retrospective study. RESULTS: Fifty-one patients underwent surgical treatment during this period. The mean age was 56.7 years, with 39 females. Besides the prolapse itself, 33 patients complained of mucous discharge, 31 of fecal incontinence, 14 of constipation, 17 of rectal bleeding, and 3 of urinary incontinence. Abdominal operations were performed in 36 (71%) cases. Presacral rectopexy was the most common abdominal procedure (29 cases) followed by presacral rectopexy associated with sigmoidectomy (5 cases). The most common perineal procedure was perineal rectosigmoidectomy associated with levatorplasty (12 cases). Intraoperative bleeding from the presacral space developed in 2 cases, and a rectovaginal fistula occurred in another patient after a perineal rectosigmoidectomy. There were 2 recurrences after a mean follow-up of 49 months, which were treated by reoperation. CONCLUSION: Abdominal and perineal procedures can be used to manage complete rectal prolapse with safety and good long-term results. Age, associated medical conditions, and symptoms of fecal incontinence or constipation are the main features that one should bear in mind in order to choose the best surgical approach.

scholarly journals Surgical treatment of pulmonary sequestration in adults and children: long-term results

2020 ◽  
Vol 31 (1) ◽  
pp. 71-77
Author(s):  
Beatrice Trabalza Marinucci ◽  
Giulio Maurizi ◽  
Camilla Vanni ◽  
Giuseppe Cardillo ◽  
Camilla Poggi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Respiratory Symptoms ◽  
Pulmonary Sequestration ◽  
Adult Patients ◽  
Long Term Results ◽  
Study Results ◽  
Group A ◽  
Group B ◽  
Histological Results

Abstract OBJECTIVES Few experiences comparing paediatric and adult patients treated for pulmonary sequestration (PS) have been reported. Surgical treatment is considered the best choice, but the time of surgery is still controversial. We present our experience in this setting, comparing characteristics, histological results and outcome of paediatric and adult patients undergoing PS resection. METHODS Between 1998 and 2017, a total of 74 patients underwent lobectomy or sublobar resection for PS. Sixty patients were children (group A: ≤16 years old) and 14 were adults (group B: >16 years old). Preoperative diagnosis was radiological. PS was intralobar (42 cases) and extralobar (32 cases). The operation was a muscle-sparing lateral thoracotomy or video-assisted thoracoscopic surgery. Preoperative characteristics, histological results and short-/long-term results of the 2 groups were retrospectively analysed and compared. RESULTS Thirty-seven percent of the patients in group A presented with respiratory symptoms and 79% in group B (P = 0.44). Most symptomatic patients were treated with a lobectomy. In group A, 2 patients (3%) had a malignant transformation of the lesion. Patients with a prenatal diagnosis treated after the age of 1 year became more symptomatic than those operated on before the age of 1 year (57% vs 23%; P = 0.08). No differences were found in postoperative complications. Long-term stable remission of respiratory symptoms was obtained in 91% of patients in group A and 100% in group B. Adulthood (P = 0.03) and the association with congenital cystic adenomatoid malformation (P = 0.03) were negative prognostic factors for the development of respiratory symptoms. CONCLUSIONS Surgical treatment of PS is safe and feasible. Despite the small number of patients included, study results indicated that an early operation during childhood may prevent the subsequent development of respiratory symptoms. Surgical treatment is also recommended to prevent the rare transformation into malignancy.

scholarly journals The role of external osteosynthesis in treatment of unstable pelvic osseous injuries

2019 ◽  
Vol 86 (5) ◽  
pp. 48-53
Author(s):  
N. L. Аnkin ◽  
L. N. Аnkin ◽  
T. M. Petryk ◽  
V. А. Ladyka
Keyword(s):  
External Fixation ◽  
Pelvic Ring ◽  
Fixation Method ◽  
Group Iii ◽  
Results Of Treatment ◽  
Pelvic Injuries ◽  
Group I ◽  
Joint Revision ◽  
Effect Of Treatment ◽  
Group Ii

Objective. To specify the role and indications for application of аpparatus of external fixation (АEF) in treatment of unstable pelvic osseous injuries (UPOI); to study up the advantages and faults of the external fixation method; to share the experience of treatment, using this procedure. Маterials and methods. There were 229 patients, suffering pelvic injuries, examined on the base of orthopedic-traumatological centre of Kyiv’s Regional Clinical Hospital in 2005 - 2017 yrs and distributed into three Groups. In Group I 143 (62.4%) injured persons were included, in whom external osteosynthesis played the function of temporary measures of fixation, in Group II - 27 (11.8%) patients, in whom while hospitalization a fracture was fixed, using AEF, аnd after stabilization of the state the posterior pelvis osteosynthesis and reposition was conducted, in Group III - 59 (25.8%) patients, who, using several indications, were definitely treated, applying the external fixation method only. Results. Excellent effect of treatment in Group I was registered in 23 (19.0%), a good one - in 58 (47.9%), satisfactory - in 32 (26.4%), poor - in 8 (6.6%) of 121 patients; in Group II - accordingly, - in 5 (20.8%), 11 (45.8%), 7 (29.2%) and 1 (4.2%) of 24 patients; in Group III - accordingly, in 4 (8.3%), 12 (25%), 23 (47.9%) and 9 (18.6%) of 48 patients. Conclusion. Best results of treatment of patients with unstable pelvic osseous injuries were obtained while applying the tactics of change from external fixation into internal one. On the first stage the pelvic ring fixation, using AEF, was performed, аnd after stabilization of a patient general status - internal osteosynthesis. Application of the internal osteosynthesis method permits to control and stabilize the reposition achieved, to conduct the sacro-ileal joint revision.

scholarly journals A SURGICAL TACTICS IN THE INJURY OF TRACHEA AND BRONCHI IN CHILDREN

2020 ◽  
Vol 23 (6) ◽  
pp. 351-354
Author(s):  
Viacheslav I. Ponomarev ◽  
A. V. Pisklakov ◽  
A. V. Lysov ◽  
V. V. Vysotsky
Keyword(s):  
Surgical Treatment ◽  
Incidence Structure ◽  
Early Period ◽  
Early Postoperative Period ◽  
Long Term Results ◽  
Airway Patency ◽  
Surgical Interventions ◽  
Ventilation Failure ◽  
Surgical Tactics ◽  
Trachea And Bronchi

Introduction. Tracheal and bronchial injuries in children are not at the last place in the trauma incidence structure . It is an urgent issue for both adult and pediatric surgeons. Purpose. To show ways for obtaining good outcomes in patients with trachea and bronchi rupture. Material and methods. The researchers analyzed outcomes of surgical treatment of 19 patients with trachea and bronchi ruptures. The patients had surgeries at various intervals after the injury: from few hours to 10 days. X-ray and tracheobronchoscopy examinations were made. On the first day after the injury, a radical surgery was performed to restore the airway patency. Late surgical interventions ended with pulmonectomy or lobectomy. At the final stage of the trial, early and long-term results were analyzed. Results. The radical surgical treatment consisting of thoracotomy and complete restoration of anatomical integrity and airway patency had 16 children of various age on the first day after their injury . Surgery lasted for 85 ± 15 min. There were no any complications during the surgery. At the early period of observation after the surgery, a ventilation failure of degree I was seen in 3 patients. Two years later, compensated stenosis of the bronchus without signs of ventilation failure was seen in one child. Three children were operated on in 10 days after their injury. Organ-sparing surgeries were performed in them (lobectomy and pulmonectomy). These surgeries lasted for 130 ± 15 min. At the early postoperative period, all three patients had ventilation failure of degree II. In 2 years, two children developed a persistent deformation of the chest, two children were disabled. Conclusion. A successful treatment of children with lower airways injury may be expected if the radical assistance is provided by a thoracic surgeon and shortly after the injury.

scholarly journals Surgical Treatment of Old Pelvic Ring and Lower Urinary Tract Injuries in Men

2014 ◽  
pp. 32-38
Author(s):  
A. F. Lazarev ◽  
Ya. G. Gudushayri ◽  
A. V. Verzin ◽  
E. I. Solod ◽  
M. G. Kakabadze ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Surgical Treatment ◽  
Lower Urinary Tract ◽  
Pelvic Ring ◽  
Surgical Interventions ◽  
Pelvic Bones ◽  
History Of ◽  
Bone Fragments ◽  
Urethral Defect ◽  
Lower Urinary

Surgical treatment results for 56 men with old pelvic bones and junctions injuries complicated or associated with either strictures or obliteration of membranous and bulbomembranous urethral segment are presented for the period from 2002 to 2013. Terms after trauma made up from 1 month to 6 years, mean age of patients - 36 (16-66) years. All patients were admitted with epicystoma and history of 3-5 failed surgical interventions directed to uresis restoration. The pattern of pathologic mobility, degree of pelvic ring injury, length of urethral defect, and connec- tion of urethra with either bone fragments or displaced pelvic bones were assessed during complex urologic and traumatologic examination. Treatment tactics, i.e. one- or two-step, was chosen depending on the diagnosed injuries. In two-step treatment tactics orthopaedic step always preceded the urologic one (urethra plasty) that followed in about 2 months after primary intervention. Observation terms made up from 1 month to 6 years. Loco-motor function was restored in all patients, urination - in 54 of 56 patients. Thus, elaborated method of surgical treatment for old concomitant pelvic ring and lower urinary tract injuries showed high efficacy in patients with posttraumatic urethral stricture or obliteration

scholarly journals RESULTS OF SURGICAL TREATMENT OF NON-PARASITIC SPLENIC CYSTS IN CHILDREN

2018 ◽  
Vol 22 (1) ◽  
pp. 32-35
Author(s):  
A. V. Myzin ◽  
Vasily G. Kuleshov ◽  
A. E. Stepanov ◽  
N. V. Gerasimova ◽  
K. Yu. Ashmanov
Keyword(s):  
Surgical Treatment ◽  
High Efficiency ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Long Term Results ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Splenic Cysts ◽  
Good Cosmetic

Introduction. Currently, there are different views on the treatment of non-parasitic spleen cysts in children. The choice of method of treatment is under discussion. The aim of our study was to evaluate and analyze the immediate and long-term results of surgical interventions performed on nonparasitic spleen cysts in children. Material and methods. There are presented results of surgical treatment of the 21 patient, who was on treatment at the Department of Abdominal Surgery of the Russian Children Clinical Hospital over the period from 2013 to 2016. Patients were examined by means of ultrasound of the abdominal cavity, CT, MRI. All patients have been operated. 22 surgical interventions were performed by using laparoscopic access, out of which 2 partial resections of the spleen, 1 splenectomy, 19 fenestrations of spleen cysts.Results. During the course of the operation and in the immediate postoperative period there were no complications. Patients were observed for the period of from 1 year to 3 years. Good results of treatment were obtained in 20 (95.2%) children. In a long-term period a relapse occurred in the one patient one year after the operation. The patient was reoperated, splenectomy was performed. Conclusion. The surgical treatment of spleen cysts is the basic one. It is indicated for cysts sized larger than 5 cm and cysts with clinical symptoms. Minimally invasive interventions in children are optimal because of their low traumatism and good cosmetic effect. Our study showed a high efficiency of laparoscopic operations in children suffered from non-parasitic spleen cysts with good long-term results.

scholarly journals Surgical treatment of the unstable type C pelvic injury

2013 ◽  
Vol 60 (2) ◽  
pp. 53-58 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Jordan Saveski ◽  
Ivan Micic ◽  
Milan Mitkovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Open Reduction ◽  
Pelvic Ring ◽  
Posterior Pelvic Ring ◽  
Pelvic Ring Injuries ◽  
Pelvic Injuries ◽  
Ring Complex ◽  
Type C ◽  
Stable Internal Fixation

Rotationally and vertically unstable injuries to the pelvic ring (Type C) require stabilisation of the anterior and posterior pelvic ring complex. Inadequate treatment of these injuries leads to chronic instability of the pelvic ring, which can finally cause permanent disability. Open reduction and stable internal fixation of the anterior and posterior complex of unstable pelvic ring injuries are standard procedures in the treatment of hemodynamically stable patients with (Type C) pelvic injuries. Our aim is to show that this type of treatment achieves excellent and good results. All patients were operated on using the method of open reduction and anterior plate fixation of sacroiliac complex as well as fixation of the pubic symphisis. We present a retrospective study of the results concerning the treatment of 19 patients with (Type C ) unstable pelvic injuries. The average age of the patients was 43,21 years old. The final functional results, 2 years post-surgery according to the Majeed scoring system and the results were excellent in 11 (57.89%) and good in 8 (42.1%) patients. There were no bad results to report. Type C pelvic ring injuries are unstable and unless they are adequately treated, they can lead to permanent consequences. Surgical treatment that includes open reduction and stable internal fixation of the anterior and posterior pelvic ring complex leads to excellent and good results. The patients that were treated surgically by fixation of the anterior and posterior pelvic ring complex return to their everyday lives and work activities.

Surgical Treatment for Unstable Pelvic Ring Injuries

2013 ◽  
Vol 20 (4) ◽  
pp. 9-16
Author(s):  
S. V Donchenko ◽  
V. E Dubrov ◽  
L. Yu Slinyakov ◽  
A. V Chernyaev ◽  
A. F Lebedev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
External Fixation ◽  
Pelvic Ring ◽  
Damage Control ◽  
Main Group ◽  
Control Group ◽  
Concomitant Injuries ◽  
Surgical Interventions ◽  
Pelvic Ring Injuries ◽  
Unstable Pelvic Ring Injuries

Treatment results for 67 patients (43 men, 24 women), aged 15–70 years, with unstable pelvic ring injuries are presented. In 15 cases conservative treatment (control group) and in 52 cases various surgical interventions (main group) were performed. In the main group of patients a strategy of two5step surgical treatment of the victims with multiple and concomitant injuries Damage control concept was applied. It included urgent stabilization of pelvic ring with external fixation devices and C-frame, bleeding arrest, final fixation within first 5–7 days after stabilization of patient’s condition. Restoration of the anterior semi5ring was performed using either external fixation device or a reconstructive plate. Stabilization of sacroiliac junction was per5 formed with cannulated screws. All patients were allowed to walk on crutches within 1–5 days after operation. In control and main groups the duration of hospitalization made up 43.7±2.5 and 25.7±3.1 days (p

Vertebral hydatid disease

1976 ◽  
Vol 44 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Werner L. Apt ◽  
Juan L. Fierro ◽  
Ciro Calderón ◽  
Carlos Pérez ◽  
Patricio Mujica
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Postoperative Period ◽  
Long Term Results ◽  
Common Procedure ◽  
Laboratory Findings ◽  
Content Type ◽  
Surgical Interventions ◽  
Fine Print

✓ The authors present 27 cases of vertebral hydatidosis with clinical and laboratory findings. The most frequent location of the lesion was the lumbar spine. Principal neurological symptoms were paraparesis, sphincter disturbances, paresthesia and paraplegia. The average number of surgical interventions per patient was 2.6; the most common procedure was laminectomy with extirpation of the cyst and surgical toilet. The results of surgical treatment were generally good in the immediate postoperative period, but long-term results were poor.

scholarly journals SURGICAL TREATMENT OF CONGENITAL DEFORMATION OF THORACOLUMBAR SPINE IN CHILDREN

2013 ◽  
Vol 1 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Sergey Valentinovich Vissarionov ◽  
Dmitriy Nikolaevich Kokushin ◽  
Sergey Mikhailovich Belyanchikov ◽  
Vladislav Valerevich Murashko ◽  
Kirill Alexandrovich Kartavenko
Keyword(s):  
Surgical Treatment ◽  
Thoracolumbar Spine ◽  
Deformity Correction ◽  
Metal Structure ◽  
Posterior Spinal Fusion ◽  
Neurological Complications ◽  
Long Term Results ◽  
Patients Âgés ◽  
Local Bone ◽  
Minimum Number

The analysis of the results of surgical treatment of 32 patients with congenital spinal de formity against lateral and posterolateral hemivertebrae in the area of the thoracolumbar junction was carried out. The patients' ages ranged from 1.2 to 4 years old, 11 boys and 21 girls. Terms of postoperative follow-up were from 2 to 10 years. The angle of scoliosis before surgery was from 26 to 52, kyphosis - from 12 to 56. Surgical intervention was performed with the combined approach in the amount of extirpation of abnormal vertebrae with surrounding disks, deformity correction with dorsal metalwork, corporodesis and posterior fusion with local bone autograft. Metal structure was removed in 1.5-2 years after surgery. Correction of scoliosis was 94-100 %, kyphotic - 82-90 %. The progression of deformation, neurological complications and joining of the dysplastic process were not observed. In assessing of the long-term results, scoliosis curve ranged from 0 to 8 (average - 4.2), kyphotic from 0 to 10 (average - 5.1). The progression of the spinal deformity with hemivertebrae in the area of the thoracolumbar transition requires early surgical elimination of the defect with a full radical correction of congenital deformation, restoration of the anatomy of the spinal canal and the physiological curves of the spine at the level of deformation with fixation of a minimum number of spinal motion segments with metal construction and bone plastic stabilization (front and posterior spinal fusion).

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