ABSTRACT
We report an appendicitis complicated by a splenic abscess in a patient with polycystic kidneys and multiple cystic lesions in the liver. Clinical decision making for operative intervention was made difficult by the extensive intra-abdominal abnormalities seen on computer tomography. Finally curation was achieved by splenectomy and appendectomy.
Subject(s)
Abdominal Abscess/etiology , Appendicitis/complications , Splenic Diseases/etiology , Abdominal Abscess/diagnosis , Abdominal Abscess/surgery , Adult , Appendectomy , Appendicitis/diagnosis , Appendicitis/surgery , Follow-Up Studies , Humans , Male , Polycystic Kidney Diseases/diagnosis , Splenectomy , Splenic Diseases/diagnosis , Splenic Diseases/surgery , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Thirty-one patients with 33 displaced intra-articular fractures of the calcaneus were treated with open reduction and internal fixation in our hospital between 1989 and 1995. The fractures were classified according to the CT-classification of Crosby [Crosby, L. A. and Fitzgibbons, T., Computerized tomography scanning of acute intra-articular fractures of the calcaneus. The Journal of Bone and Joint Surgery, 1990, 72A, 852-859] and Hannover [Zwipp, H. and Tscherne, H. et al., Osteosynthesis dislozierter intraartikulärer calcaneusfrakturen. Unfallchirurg, 1988, 91, 507-515]. The minimal follow-up was 2 years. Functional results were assessed at 6 and 12 months and in February 1997 using the Creighton calcaneal score. Overall results improved during follow-up, especially in the first year. At the final control the overall results were: excellent/good 73%, fair 21% and poor 6%. The results are comparable with larger series in the literature. The average range of motion in the subtalar joint was 65% of normal. No correlation was found between clinical outcome and the subtalar range of motion. Two patients received a secondary arthrodesis for painful arthrosis.
Subject(s)
Calcaneus/injuries , Fracture Fixation, Internal/methods , Fractures, Bone/surgery , Adolescent , Adult , Aged , Ankle Joint/diagnostic imaging , Bone Plates , Bone Screws , Calcaneus/diagnostic imaging , Calcaneus/surgery , Female , Follow-Up Studies , Fractures, Bone/diagnostic imaging , Humans , Male , Middle Aged , Radiography , Treatment OutcomeABSTRACT
Sweet's syndrome is a rare clinical disorder consisting of eruptive skin lesions accompanied by malaise and high fever. It is often associated with an underlying disease. Dermal granulocytic infiltration without leukocytoclastic vasculitis is the pathological hallmark of the syndrome. The pathophysiology, diagnosis and therapy are illustrated by 2 cases.
Subject(s)
Sweet Syndrome/physiopathology , Adult , Female , Humans , Male , Middle Aged , Sweet Syndrome/diagnosis , Sweet Syndrome/therapyABSTRACT
OBJECTIVE: To evaluate the benefits of preoperative physical therapy and instruction of patients with primary coxarthrosis to be subjected to a total hip arthroplasty. SETTING: University Hospital Maastricht. DESIGN: Controlled trial. MATERIAL AND METHOD: During 14 months the effects were measured of preoperative physical therapy and instruction of 64 patients divided into two populations; one group (n = 31) received preoperative instruction and physical therapy, the other did not (n = 33). Effects were measured with the Visual Analog Scale, the Harris Hip Score and the days patients could stand, walk, climb a stair and be discharged. RESULTS: The Harris Hip Score showed a significant difference (p < 0.05) favouring the instructed group on day 14 after the operation and at the moment the patients were discharged. The other parameters showed no significant differences between the groups. Differentiation by age, gender and type of arthroplasty showed the same results. CONCLUSION: Preoperative exercise and instruction is not useful for patients who in the near future will be treated with a total hip arthroplasty for primary coxarthrosis.
