RESUMEN
BACKGROUND: The fracture of femoral neck in adults is very common. Most of them can be cured by operation or conservative treatment, but a few can develop into old fracture. At present, there is no clear and effective treatment for old fracture of femoral neck in adults. OBJECTIVE: To explore the clinical effect of sartorius pedicle iliac bone flap combined with proximal femoral locking plate in the treatment of old femoral neck fracture in adults. METHODS: Twelve adult patients with old femoral neck fracture were treated with sartorius pedicle iliac bone flap combined with proximal femoral locking plate, 9 males and 3 females, aged 18-47 years, with an average age of 33. 5 years. Garden classification: Type I in 0 cases, type II in 1 case, type III in 7 cases, and type IV in 4 cases. All of them were incised by Smith Petersen (S-P) approach. The 2/3 sartorius pedicle iliac bone flap of the anterior superior iliac spine was chiseled with a bone knife, about 4. 0 cm×1. 0 cm×1. 0 cm in size. After reduction, the proximal femur was fixed with steel plate and screw. Finally, the sartorius pedicle iliac bone flap was implanted into the defect of the femoral neck and fixed. At 3, 6, 12, and 24 months after the operation, X-ray films were reexamined to evaluate the fracture healing and Harris score of hip joint was used to evaluate the recovery of hip joint function. RESULTS AND CONCLUSION: (1) Twelve patients were followed up for at least 24 months. (2) Harris scores of hip were significantly higher at 3, 6, 12, and 24 months after surgery (54. 4±6. 4, 68. 7±6. 8, 82. 3±4. 2, 90. 3±4. 6) than those before surgery (46. 3±6. 1) (P < 0. 05). (3) There were no complications, such as wound nonunion, infection, or venous thrombosis. Finally, 11 patients finally achieved bony healing at the fracture site. One patient had nonunion at 28 months postoperatively with avascular necrosis of the femoral head (ARCO stage IV), followed by artificial hip replacement. Harris score before operation was 38, and Harris score at 3 months postoperatively was 98. (4) The results show that the combination of sartorius pedicle iliac bone flap and proximal femoral locking plate is a good method for the treatment of old femoral neck fracture in adults, with high healing rate and low necrosis rate of femoral head.
RESUMEN
<p>After vascular surgical procedures, complications of the wounds in the groin region may sometimes lead to prosthetic graft infections or prolonged hospital stays. While some wounds heal completely during re-suture and VAC therapy, healing of other wounds that involve refractory graft infection, lymphorrhea, or a dead space, is extremely difficult. We performed tissue coverage using a Sartorius muscle flap for such difficult cases. The muscle is twisted onto itself to fill the dead space with some blood supply. Tissue coverage using a Sartorius muscle flap with adequate blood flow was effective in improving lymphorrhea and infection. We report four such cases where complications in the groin region were managed using a Sartorius muscle flap for wounded coverage.</p>
RESUMEN
PURPOSE: The purpose of this study was to review the natural history, clinical outcome and safety in patients undergoing sartorius muscle flap (SMF) for groin infection, including lymphocele. MATERIALS AND METHODS: We retrospectively reviewed the records of patients who underwent SMF in a single center between 2000 and 2009. RESULTS: Thirty patients (17 male, 13 female) underwent SMF for groin infection, which included infections of 22 artificial femoral bypass grafts (including 2 cryoveins) and 5 common femoral patch grafts, and 3 lymphocele infections (2 cardiac catheterizations and 1 penile cancer lymph node dissection). Wound isolates were most commonly Gram-positive organisms (n=22) with Gram-negative isolates and mixed infections accounting for 4 and 3 cases, respectively. In 9 patients there was no growth of organisms. Adjunctive wound vacuum-asssisted wound closure therapy was performed in 18 patients. Follow-up duration ranged from 8 days to 56 months (mean 14.1 months) after SMF. Reoperation was performed in 3 patients due to wound bleeding (n=1) and reinfection (n=1). One patient underwent graft excision with external bypass operation. There was 1 mortality case due to sepsis during the study period. CONCLUSION: We found that muscle flap surgery provides successful single-intervention therapy for groin infections including lymphocele. Graft ligation or aggressive excision with bypass surgery should be reserved for patients requiring rapid control of sepsis for lifesaving.
Asunto(s)
Humanos , Masculino , Cateterismo Cardíaco , Catéteres Cardíacos , Coinfección , Estudios de Seguimiento , Ingle , Hemorragia , Ligadura , Ganglios Linfáticos , Linfocele , Mortalidad , Historia Natural , Neoplasias del Pene , Reoperación , Estudios Retrospectivos , Sepsis , Trasplantes , Heridas y LesionesRESUMEN
As causas da síndrome de ressalto no joelho relatadas com maior frequência são relacionadas a anormalidades meniscais, ao tendão do músculo bíceps femoral e aos tendões grácil e semitendíneo. Neste trabalho é descrito um caso de ressalto no canto posteromedial relacionado à junção miotendínea do músculo sartório em um paciente do sexo masculino, de 58 anos de idade, com hiperextensão do joelho.
The most frequently reported causes of snapping knee syndrome are related to abnormalities of the meniscus, biceps femoris tendon, gracilis and semitendinosus tendons. The present report describes a case of snapping in the posterior-medial corner of the knee related to the myotendinous junction of the sartorius muscle in a 58-year-old male patient with knee hyperextension.