ABSTRACT
Fournier's gangrene is relatively a rare surgical disease. It is a type of necrotizing fascitis involving the genito-perineal region. Both aerobic and anaerobic pathogens lie behind the pathogenesis. In his original description J.A. Fournier thought that it is an idiopathic disease without any obvious etiology. Many controversial issues exist about the pathogenesis and treatment of the disease. To investigate the possible correlation between the clinical outcomes [hospital stay, morbidity, mortality] and the early wound closure. Retrospective analysis was done from 1997-2000, in Al-Kindy Teaching Hospital. Eleven cases were included, with variable age and sex. Several predisposing and triggering factors for the disease were found in our work. Different techniques of surgical treatment were used in wound closure after initial resuscitation and frequent mini debridements, in order to close the defect as early as possible. The outcome of our study, despite different surgical procedures used to close the wounds, was encouraging. Hospital stay, morbidity and mortality were reduced in comparison with other studies. We found that the earlier the wound was closed; a shorter hospital stay, and less morbidity and mortality could be achieved
ABSTRACT
Osteogenesis imperfecta is an inherited disorder of collagen maturation which results in abnormal skeletal, ligament, skin, sclera, and dentin formation. Management includes focusing on preventing or minimizing deformities and maximizing the individual's functional ability at home and in the community. Physical therapy including early mobilization after fracture is effective in strengthening muscles which in turn, improves bone density. The theory of set-point proposal, a possible causative mechanism in osteogenesis imperfecta presents a special mechanism of skeletal intermediary organization causing many features of the disease. The minimum effective strain is abnormal in osteogenesis imperfecta, so early mobilization is important in prevention of further fractures of the limbs. The prediction of the role of early mobilization in decreasing the incident of fractures of long bones in osteogenesis imperfecta. This is a prospective study of 42 patients with osteogenesis imperfecta for ten years, they were studied and different methods and treatment used, they were divided into two groups. Group I, included 24 patients which included new patients with new fractures of femur and treated by early mobilization, Group II, included 18 patients treated by immobilization [plaster of paris]. For both groups the commonest age group was [0-2 years]. Male to female ratio was 2:1. Radiological classification mostly thick bone type. Sillence classification, mostly sillence I. In group I surgery was done for 33.3%, traction methods for 66.7%. Follow up for 2.5-3 years was done and 4.2% develop fracture in the same femur while 8.75% developed fracture the contra-lateral femur. In group II all patients treated by immobilization for 4-6 weeks using plaster of pairs, during follow up for same period 16.7% develop fracture in the same femur. And 16.7% developed fracture in the ipsi-lateral tibia. Early mobilization in patients with osteogene imperfecta proved to be a good method in preventing and decreasing the incidence of fractures in different tubular bones