Acta clinica Croatica
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Acta clinica Croatica · Sep 2017
Treatment of Periprosthetic Femoral Fractures after Total Hip Arthroplasty Vancouver Type B.
The rate of periprosthetic femoral fractures following total hip replacement has been growing steadily in the last 20 years and ranges from 0.1% to 2.1%. These fractures are mostly related to older patients with the presence of chronic diseases and frequently poor bone quality. The treatment is surgically very complex and demanding, followed by a series of complications. ⋯ In conclusion, Vancouver classification has been widely accepted and using the protocols makes decision making during treatment much easier. During treatment of this type of fracture, we used various implants, wire cerclage, DCP and LCP, as well as long stem revision. In certain cases, we applied surgical techniques, implants that are not recommended by the Vancouver protocol by which we treated periprosthetic femoral fractures; in these case, we recorded nonunion bone, malunion and breaking of implants, which resulted in poor treatment outcome.
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Acta clinica Croatica · Sep 2017
Case Reports Randomized Controlled TrialEffects of Pressure-Controlleda Volume-Controlled Ventilation on Hemodynamic and Respiratory Parameters in Patients During Laparoscopic Cholecystectomy.
Many papers have been published investigating the effects of intraoperative mechanical ventilation on the incidence of intra- and postoperative respiratory complications. The potential advantages of protective pressure over volume-controlled ventilation mode during laparoscopic surgery have yet to be proven. This study included 60 patients aged between 18 and 70 with ASA score 1-3, body mass index (BMI) ≤35 kg/m2, and without prior history of chronic respiratory diseases, who were scheduled for laparoscopic cholecystectomy under general anesthesia. ⋯ Other measured parameters were of similar characteristics. It is concluded that PCV and volume-controlled ventilation were equally effective in maintaining adequate ventilation, oxygenation and hemodynamic stability in the groups of patients observed. However, comparison of obese patients revealed some advantages of PCV which, given the present pace of change, should be additionally investigated.