ABSTRACT
AIM: The aim of this study was to determine the role of combined mechanical and pharmacological prophylaxis in the prevention of deep venous thrombosis (DVT) after total knee replacement (TKR). DESIGN: prospective case series study. METHODS: Between October 2002 and June 2003, 38 total knee procedures were carried out on 34 patients (4 patients had bilateral TKR). To exclude the presence of a concomitant DVT echo-color-flow of the legs was performed between 2 and 1 week prior to surgery, in the postoperative period (before discharging) and 30 days after surgery. Patients received one daily subcutaneous injection of nadroparin calcium (dosage adapted to body-weight). An intermittent foot sole pump (IFSP) was applied in the recovery room postoperatively, in both feet for about 5 h a day and all night long, and continued at home until the 15(th) day. RESULTS: No major perioperative or rehabilitation phase-related complications were observed (2 patients required manual drainage of blood clots from the wound). The incidence of DVT was 7.9% (3 cases). In one of these cases we observed a previous DVT so it was classified as rethrombosis. All were successfully treated with therapeutic introduced low molecular weight heparin (LMWH) therapy. No pulmonary embolism or deaths associated with the use of LMWH or IFSP were observed. CONCLUSIONS: In our experience the combined prophylaxis with nadroparin calcium and IFSP significantly reduced the incidence of DVT.
Subject(s)
Anticoagulants/therapeutic use , Arthroplasty, Replacement, Knee/adverse effects , Foot/blood supply , Intermittent Pneumatic Compression Devices , Leg/blood supply , Nadroparin/therapeutic use , Venous Thrombosis/prevention & control , Aged , Combined Modality Therapy , Echocardiography, Doppler, Color , Female , Femoral Vein/diagnostic imaging , Femoral Vein/pathology , Humans , Iliac Vein/diagnostic imaging , Iliac Vein/pathology , Incidence , Injections, Subcutaneous , Leg/diagnostic imaging , Length of Stay , Male , Middle Aged , Osteoarthritis, Knee/surgery , Osteonecrosis/surgery , Popliteal Vein/diagnostic imaging , Popliteal Vein/pathology , Prospective Studies , Treatment Outcome , Ultrasonography, Doppler, Color , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/etiologyABSTRACT
It is the purpose of this study to review current trends and guidelines in the treatment of periprosthetic hip fractures, and to report three cases of patients operated on and treated by different types of instrumentation: Modified Mennen plate by De Puy, Dall-Miles trochanteric grip, Zimmer cable-ready plate.
Subject(s)
Arthroplasty, Replacement, Hip , Fracture Fixation, Internal/instrumentation , Hip Fractures/surgery , Accidental Falls , Aged , Aged, 80 and over , Female , Fracture Fixation, Internal/methods , Hip Fractures/classification , Hip Fractures/diagnostic imaging , Humans , Internal Fixators , Practice Guidelines as Topic , Radiography , ReoperationABSTRACT
An unusual case of myositis ossificans secondary to a muscle tendon junction (MTJ) strain of long head of biceps in a young athlete is reported. Plain radiographs, ultrasonography and MRI in association with clinical assessment showed the appearance and the evolution of this pathological entity. This case had a resolution of pain and function after 3 months of conservative treatment. At 6 months follow-up, the athlete became asymptomatic and he gradually returned back to his sports activity.
Subject(s)
Arm Injuries/complications , Muscle, Skeletal/injuries , Myositis Ossificans/etiology , Sprains and Strains/complications , Tendon Injuries/complications , Adolescent , Arm Injuries/diagnosis , Arthralgia/etiology , Arthralgia/therapy , Humans , Magnetic Resonance Imaging , Male , Myositis Ossificans/diagnosis , Myositis Ossificans/therapy , Physical Therapy Modalities , Range of Motion, Articular , Recovery of Function , Sprains and Strains/diagnosis , Tendon Injuries/diagnosis , Treatment Outcome , Wrestling/injuriesABSTRACT
BACKGROUND: To verify statistically the hypothesis that birthdate represents a risk factor for Congenital Hypothyroidism, as proposed by some European Authors. Moreover, to verify the existence of seasonal cyclic trends in TSH levels. METHODS: For the verification of birthdate as a risk factor, we considered retrospectively a data set of all consecutives newborns of Marche Region (Italy) affected by Congenital Hypothyroidism, in the period 1981-1996 (n = 92). For the evaluation of seasonal cyclic trends in TSH, we considered the level of the hormone in all newborns of Marche Region screened in the period 1989-1996. Data were collected from Neonatal Screening Register of Marche Region. All the statistical analyses are based on circular statistics techniques (Rayleigh test, Roger test, estimation of density by kernel method, Mardia test for circular-linear correlation, Maximization of Mean Vector Length). RESULTS: No cyclic trend was pointed out with regard to Congenital Hypothyroidism; neither seasonal rhythms nor other cyclic patterns of TSH levels were evidenced. CONCLUSIONS: Neither the hypothesis of birthdate as a risk factor for Congenital Hypothyroi-dism, nor the existence of seasonal variations in TSH hormone releasing were confirmed.
