Archives of orthopaedic and trauma surgery
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Thirty-three cases of acute septic arthritis of the hip in children were treated at our hospital from 1986 to 1997. The average follow-up period was 6 years (range 2-11 years). In 17 cases the right hip was affected, and in 16 the left hip. ⋯ Satisfactory results can also be expected with arthrocentesis and medical treatment if the diagnosis is made early, and antibiotic treatment affords a good clinical response. Four out of 7 cases with an unsatisfactory result were associated with osteomyelitis of the proximal femur. The two most important factors associated with poor results included a delay of definite treatment lasting longer than 5 days and the presence of osteomyelitis of the proximal femur.
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Arch Orthop Trauma Surg · Oct 2001
Risk factors for long-term treatment of whiplash injury in Japan: analysis of 400 cases.
We studied the risk factors for long-term treatment of 400 patients with whiplash injury in Japan. Most of the patients were injured in rear-end car collisions, but none had cervical bone lesions or spinal cord or root lesions. We evaluated the following risk factors: sex, age, degree of vehicle damage, and admission or non-admission to the hospital. ⋯ Damage to more than half of the car was associated with a longer treatment. Patients who were admitted to the hospital need treatment longer than the non-admission group. Thus, age over 30 years, a large amount of damage to the vehicle, and admission to the hospital are predictors of long-term treatment for whiplash injury in Japan.
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Arch Orthop Trauma Surg · Oct 2001
Complications of K-wire fixation of fractures and dislocations in the hand and wrist.
Kirschner wire (K-wire) fixation of fractures and dislocations of the hand and wrist is a common procedure. Of the 590 K-wire fixations performed on 236 patients, 36 (15.2%) experienced complications which included osteomyelitis, tendon rupture, nerve lesion, pin tract infection, pin loosening or migration. ⋯ K-wire fixation is a simple but demanding procedure that cannot be left to an inexperienced resident. Elimination of technical failure, supervision in the operating room, close monitoring, prompt treatment upon discovery of a complication, and improvement of patient compliance can reduce the rate of complications.
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Arch Orthop Trauma Surg · Sep 2001
Randomized Controlled Trial Clinical TrialLumbar micro disc surgery with and without autologous fat graft. A prospective randomized trial evaluated with reference to clinical and social factors.
Epidural scarring is one of the possible complications after lumbar disc surgery. Perineural scar tissue has been considered responsible for recurrent neurological symptoms in patients operated on for disc herniation and leads to a high rate of unsatisfactory results. In addition, postoperative scars may increase the technical difficulty and risk of subsequent procedures. ⋯ A total of 92 patients received an implantation of autologous fat graft, 94 did not. After a median of 24.2 months after their surgery, an objective examinator compared various clinical parameters and the social situation of patients in both groups without knowing the operation method used. We found no significant differences between the fat-graft group and the control group regarding either the clinical outcome or the social aspects.
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Arch Orthop Trauma Surg · Sep 2001
Case ReportsUse of vascularized pedicle iliac bone graft in the treatment of avascular necrosis of the femoral head.
A vascularized pedicle iliac bone graft was performed in patients with extensive necrosis in whom the necrotic area occupied more than two-thirds of the femoral head. The purpose of this procedure is to supply vascularity and mechanical strength to the avascular femoral head. Our series consisted of 18 hips. ⋯ Stage progression was noted in 3 of 4 joints in the group who underwent iliac bone graft alone. In the group who underwent the combined procedure, stage progression was noted in 2 of 10 joints at more than 1 year after operation. A vascularized pedicle iliac bone graft to treat avascular necrosis of the femoral head is considered promising for joint preservation.