RESUMEN
Se realizó un estudio retrospectivo para determinar la prevalencia de la pseudoartrosis séptica diafisaria en el Servicio de Ortopedia y Traumatología del Hospital Comandante Pinares en un período quinquenal, con el objetivo de determinar la causa más frecuente de contaminación séptica de las fracturas iniciales y la efectividad del tratamiento implantado. La prevalencia de pseudoartrosis séptica diafisaria en el servicio fue de 5,1 por ciento, el tratamiento inicial más empleado resultó la fijación externa ósea con el fijador RALCA, seguido de la osteosíntesis AO. La causa más frecuente de contaminación de fracturas diafisarias fue la exposición ósea focal aguda y la contaminación posquirúrgica en fracturas cerradas. Los resultados alcanzados fueron buenos en 46,7 por ciento de los casos, mientras que en 20 por ciento resultaron malos, lo que demostró la gravedad de las lesiones combinadas.
A retrospective study was conducted to determine the prevalence of septic diaphyseal pseudoarthrosis in the Orthopedics and Traumatology Service of Comandante Pinares Hospital in a 5-year term to know the most common cause of septic contamination of the initial fractures and the effectiveness of the treatment. The prevalence of septic diaphyseal pseudoarthrosis was 5.1 percent. The most used initial treatment proved to be the external osteal fixation with RALCA fixator, followed by AO osteosynthesis. The most frequent cause of contamination of diaphyseal fractures was the focal acute osteal exposure and the postsurgical contamination in closed fractures. The results attained were good in 46.7 percent of the cases, whereas 20 percent were poor, which showed the severity of the combined injuries.
Asunto(s)
Humanos , Fracturas no Consolidadas/complicaciones , Fracturas no Consolidadas/etiología , Fracturas no Consolidadas/tratamiento farmacológicoRESUMEN
Broad spectrum antibacterial effect of electrically generated silver ions has been fully established. Present work consists of clinical evaluation of beneficial antibacterial effect of silver ions liberated electrically with the help of locally manufactured power pack in 920 proved cases of chronic osteomyelitis with or without pathological fractures and septic non-unions. Wound debridement, silver iontophoresis, proper immobilisation and subsequent wound care yielded not only control of bone infections in 85% cases, but also produced healing of pathological fractures in 83% patients. Results remained unaffected by age or sex of patient, type of bone involved, duration of previous illness or type of previous treatment. Follow-up varied from 6 months to 10 years. This technique is likely to open a new chapter in treatment of chronic resistant bone infections and septic non-unions due to open fractures particularly in developing countries of the world.