The effect of antibiotic therapy on the incidence of Staphylococcus aureus infections in orthopaedic patients.

BACKGROUND: This paper reports on aetiological factors, including mostly S. aureus infections, and antibiotic use in the pretreatment and treatment of complicating infections in patients hospitalised at the Department of Orthopaedics and Musculoskeletal Traumatology, Gdansk Medical University, between 1995 and 2004. The analysis sought to establish a correlation, via statistical analysis, between the usage of specific antibiotic classes, with special regard to lincosamides, and S. aureus infection rates. MATERIALS AND METHODS: The study population included 22,686 patients admitted for elective surgery (accounting for 86.9% to 75.1% of the sample in different years) or with acute injuries. RESULTS: The rate of infections ranged from 2.79% to 1%, decreasing in a statistically significant manner over time. S. aureus was the dominant pathogen, accounting for 67.3% to 27.6% of the total number of bacterial strains. During the time frame of the study, the incidence of osteitis fell considerably, from 0.8% to 0.05% of the total number of patients. This was paralleled by a major increase in the use of lincosamides, mostly clindamycin. The increase in lincosamide use correlated with the decreasing incidence of S. aureus infections. CONCLUSIONS: The statistical outcome of this 10-year study has been used to develop schemes of antibiotic therapy in the Department, a necessary component of the Hospital's economic policy at the moment.A major fall in the incidence of nosocomial infections can be achieved by focussing on adequate antibiotic prophylaxis, pretreatment and appropriate treatment of acute infections.

[Metacarpal fractures--treatment results]. / Zlamania kosci sródreccza--wyniki leczenia.

In the study we presented the results of treatment of 126 fractures in patients hospitalized between 1994-2003 in the Department of Orthopeadics. The assesment was based on 87 patients that presented for the study, including 62 male and 25 female patients in the 14-57 age. The treatment consisted of stationary reduction combined with cast fixation and stabilization with Kirschner wire. The results were dividet into 5 groups based on the fractured metacarpal bone. The best results have observed the couse of treatment of 2nd, 3rd, 4th metacarpal fracturs and not so good in the 1st and 5th metacarpal fractures.

[Congenital dislocation of the knee with forefoot--adduction deformity]. / Wrodzone zwichniecie stawu kolanowego ze wspólistniejacym obustronnym wrodzonym przywiedzeniem przodostopia.

A two days newborn girl a congenital recurvatum of the right knee and bilateral congenital adduction of forefootwas treated in The Department of Orthopaedics in Gdansk. A slow correction of the knee was performed followed by cast immobilization. A good result was observed.

Posterior interosseous nerve neuropathy in distal radius fracture.

Background. The anatomy of the posterior interosseous nerve, which lies directly on the periostium of the distal epiphysis of the radius, may predispose to nerve migration between fragments after a fracture. This is especially like to be the case in a comminuted fracture of the distal radius, when the runs in the sagittal plane. Case histories. Based on 2 cases of patients treated for distal radius fracture immediately after trauma and 1 case of correction osteotomy, we describe entrapment of the articular branch of the posterior interosseous nerve was observed (DPIN). All these patients had pain syndrome in the narrow fourth compartment of the extensor, which included EIP and EDC. Our clinical observations are supported by cadaver studies and radiological imaging. Results. Good results were obtained after DPIN neurectomy or neurolysis.