Clinical orthopaedics and related research
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The management of snake bites once the patient reaches the hospital should be to obtain the necessary blood parameters (type and cross-matched blood, complete blood count, platelets, PT, PTT, fibrinogen and fibrin split products, electrolytes and calcium), to evaluate the fang marks and the neurovascular status of the involved extremity and to monitor systemic signs and symptoms. These steps are extensively described in the literature, and are commonly agreed upon. ⋯ If intracompartment pressures are less than 30 mm Hg, surgical intervention is not necessary; antivenom is continued as necessary and the wick catheter measurements are repeated if indicated. If pressures are greater than 30 mm Hg,immediate surgical decompression is advisable.
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Clin. Orthop. Relat. Res. · May 1979
Case ReportsCoccidioidomycosis of the spine: unusual roentgenographic presentation.
Vertebral osteomyelitis is a frequent consequence of disseminated coccidioidomycosis. In a 25-year-old man, the sequela was a single level unilateral osseous bridge between the second and third lumbar vertebra. A review of previous cases has disclosed one case with a similar roentgenographic picture. The occurrence of a single level unilateral reactive process should arouse suspicion of a localized chronic bone infection.
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Clin. Orthop. Relat. Res. · May 1979
Case ReportsThe use of the Vidal-Adrey external fixation system. Part 2: The treatment of infected and previously infected pseudarthrosis.
A total of 23 infected or previously infected non-unions were treated by the Vidal-Adrey modification of the Hoffmann apparatus. The external fixators were applied after decortication and bone grafting either immediately in cases with no evidence of infection or later in cases of draining, infected wounds. ⋯ Union occurred in 21, although union did not necessarily mean a good result overall when all other factors (shortening, etc.) were considered. This fixation device, when correctly applied and in conjuction with adequate debridement and bone grafting is an excellent method for the treatment of severe non-unions where infection is or was a problem.