Acta chirurgica Iugoslavica
-
Femoral neck fractures are one of the most common fractures primarily the elderly, coupled with a high degree of morbidity and mortality. The treatment is applied a number of methods of internal fixation (multiple cannulated screws available, DHS system, cefalomedullary). At the Department of Orthopedics and Traumatology of Nis developed a new method of fixation of femoral neck fracture, which allows stable fixation of dislocated and nondislocated femoral neck fracture. Self-tapping antirotation fixation (SAF) using two cannulated screws to initial compression fractures intraoperative and postoperative dynamic linear compression of the fracture with early full support to the patient. ⋯ Self-tapping screws cannulated antirotation (SAF method) represent a reliable method of fixation of dislocated and nondislocated femoral neck fracture. The main prerequisite for the proper healing of femoral neck fractures with this method is that anatomical fracture reduction is achieved by a closed or open method. This way of fixation allows the early full weight bearing patient operated limb and faster postoperative functional recovery of the fracture healing in optimal time.
-
Coronary artery disease is one of the risk factors for myocardial infarction and it is present in 40% of patients who are undergoing noncardiac surgery. Despite evidence of the benefit of the antiplatelet therapy in patients at risk of cardiac complications, aspirin treatment is often discontinued before surgery due to the risk of perioperative bleeding. ⋯ In perioperative periode aspirin is discontinued only if it is estimated that the bleeding risk is higher than the risk of thrombosis. In the paper authors present a case report of patient who developed a perioperative myocardial in-farction as a consequence of aspirin withdrawal before total colectomy.
-
Case Reports
Case of leptosuccin induced malignant hyperthermia in a patient with GIST of the rectum.
Malignant hyperthermia (MH) is a form of myopathy that is usually triggered by volatile anaesthetics such as halothane, sevoflurane and desflurane and depolarising muscle relaxants such as succinylcholine. Pathologic response in MH include increase in oxygen consumption, increase in endtidal CO2, tachycardia, hyperthermia, hyperkalemia and muscle rigidity. ⋯ Molecular genetic studies have confirmed that ryanodine muscle receptors are responsible for MH. We present a case of leptosuccin induced MH with masseter muscle rigidity, mild pCO2 increase (6.3 kPa), elevated body temperature measured with esophageal temperature probe (39.5 degrees C), tachycardia (115 beats/min) and respiratory and metabolic acidosis (pH was 7,23) in a patient who underwent low anterior resection of the rectum for gastrointestinal stromal tumor (GIST) of the rectum.
-
Ambulatory surgery refers to hospitalization that does not exceed 24 hours, during which a surgical procedure is performed. Inguinal hernia repairs done under local anaesthesia on an outpatient basis are no longer performed exclusively in specialized hernia centers. They are becoming widely accepted by surgeons working in district hospitals, which was significantly contributed to by the publication of the EHS Guidelines on the Treatment of Inguinal Hernia. ⋯ In hernia repairs on an outpatient basis, "one-step procedure" in local anaesthetic administration is reliable, easy, safe, effective, and the type of the surgical technique is not a determining factor. The success rate and treatment outcome depend on the surgical technique and the surgeon's experience in using local anaesthesia in ambulatory surgery.
-
Case Reports
[The selection of best anesthesiological technique for hip fracture surgery in older high-risk patients].
Hip fracture is a pathological condition, more common in older age, i.e. in people over 65 years. The prevalence of this disorder is continuously increasing, simultaneously with higher age limit. In evaluation of risk for operation and anesthesia, older age itself represents higher risk and calls for special attention. In selection of anesthesiological technique, it is more usual to apply neuroaxial block or peripheral nerve block, which is more advantageous over general anesthesia. ⋯ Peripheral nerve blocks are safe and effective anesthesiological technique, which may reduce the mortality in patients with the hip fracture and maintain the hemodynamic stability, both during and after the surgical intervention.