ABSTRACT
The incidence of venous thromboembolic disease after hospitalization for elective total hip arthroplasty (THA) was evaluated in a prospective pilot study of 42 patients. Before discharge from the hospital, all patients were free of deep venous thrombosis (DVT) (bilateral lower extremity ascending venography, 38 patients; duplex ultrasonography, two patients; or a combination of both, two patients). After discharge from the hospital, each patient had bilateral duplex ultrasonography and clinical evaluation monthly for three months. Venography was performed when the noninvasive test suggested the presence of DVT. Four (10.5%) of 38 completed patients (95% confidence interval, 4.4-24.8%) developed proximal DVT after hospitalization. Two episodes occurred during the first month after discharge and two during the second month. Three of the four episodes involved the surgically treated extremity. This pilot experience suggests that a significant risk of DVT continues for at least two months after THA. This observation adds support for the emerging clinical trend to continue DVT prophylaxis for at least two months after hospitalization. Further study regarding the incidence of late DVT and its effective prophylaxis seems warranted.
Subject(s)
Hip Prosthesis , Postoperative Complications/epidemiology , Thrombophlebitis/epidemiology , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Hip Prosthesis/statistics & numerical data , Humans , Incidence , Male , Middle Aged , Pilot Projects , Postoperative Complications/diagnosis , Postoperative Complications/prevention & control , Thrombophlebitis/diagnosis , Thrombophlebitis/prevention & control , Time FactorsABSTRACT
As of 1980, approximately 1,800,000 people reached the age of 65 each year in the United States. It may be estimated that each year 35,000 of these people would benefit from total hip replacement surgery and are medically fit for it. Numbers for knee replacement are similar. Other joint replacements are much less in number but may be equally done when indicated. With the constant improvement of surgical technique, prostheses, and medical expertise, these people can be offered significant improvement in the quality of life by replacement of painful disabling joints.
Subject(s)
Joint Prosthesis , Aged , Ankle Joint/surgery , Elbow Joint/surgery , Hip Prosthesis , Humans , Knee Prosthesis , Metacarpophalangeal Joint/surgery , Metatarsophalangeal Joint/surgery , Middle Aged , Shoulder Joint/surgery , Wrist Joint/surgerySubject(s)
Hallux Valgus/surgery , Hallux/anatomy & histology , Hallux/surgery , Humans , Metatarsus/surgery , Muscles/surgeryABSTRACT
Sixty-two cases of pathologic fractures occurring in 53 patients treated at Scott and White Memorial Hospital from 1966 to 1976 are reviewed and analyzed with regard to type of neoplastic lesion, location, mode of therapy initiated, functional stability of therapy selected, and average length of survival after orthopedic procedure. Pertinent literature is reviewed, and our results are compared with those of other series.
Subject(s)
Femoral Fractures/therapy , Neoplasms/complications , Breast Neoplasms/complications , Female , Femoral Fractures/etiology , Fracture Fixation/adverse effects , Fracture Fixation, Intramedullary , Humans , Humeral Fractures/surgery , Humeral Fractures/therapy , Life Expectancy , Male , Quality of Life , Tibial Fractures/surgery , Ulna Fractures/surgeryABSTRACT
Extremity surgery requires sound anatomical knowledge and adherence to principles of exposure: (1) Position of patient should be optimal for surgery and compatible with adequate and safe anaesthesia; (2) Provide access to the involved areas for suitable surgical procedure; (3) Avoid damage to functional important structures; (4) Produce as little tissue damage as possible; (5) Be adaptable to enlargement or change; (6) Be so done that functional continuity can be restored and the possibility of complications minimized; (7) The healed surgical wound should produce as acceptable cosmetic appearance as possible.
