ABSTRACT
Viral infection is a well-recognized complication of acupuncture therapy. Bacterial infection however is rare. We report a rare case of intra-articular bacterial knee infection due to inadvertent acupuncture needle penetration.
Subject(s)
Acupuncture Therapy/adverse effects , Arthritis, Infectious/etiology , Knee Joint/microbiology , Staphylococcal Infections/etiology , Staphylococcus aureus/isolation & purification , Arthritis, Infectious/microbiology , Female , Fracture Fixation, Internal , Humans , Methicillin/therapeutic use , Middle Aged , Penicillins/therapeutic use , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiology , Tibial Fractures/rehabilitation , Treatment OutcomeABSTRACT
Traumatic posterior dislocation of the hip joint in children is an uncommon injury. It constitutes a true orthopedic emergency. It makes up over 80% of pediatric hip dislocations. In children, it can occur as a result of minimal trauma, which is attributed to a soft pliable acetabulum and ligamentous laxity. In skeletally mature adolescents, a greater force is required to dislocate the hip joint. Delay in reduction is associated with long-term complications such as avascular necrosis and degenerative arthritis. Avascular necrosis is related to the duration of dislocation. A poorer prognosis is associated with delay in reduction beyond 6 hours, advanced skeletal maturity, or multiple traumas. Prompt reduction minimizes complications. We report two cases of traumatic posterior dislocation of hip in children aged 3 and 14 years. Both were reduced within 6 hours of dislocation, and review at 6 months revealed normal examination and no evidence of any post-traumatic changes. Post-reduction treatment remains without a consensus. This review highlights the clinical presentation, management, and time-sensitive complications of the injury.
Subject(s)
Hip Dislocation/etiology , Hip Injuries , Adolescent , Child, Preschool , Emergencies , Female , Hip Dislocation/classification , Hip Dislocation/diagnostic imaging , Hip Dislocation/therapy , Humans , Injury Severity Score , Manipulation, Orthopedic/methods , Patient Selection , Radiography , Range of Motion, Articular , Splints , Traction , Treatment OutcomeABSTRACT
The diffusion coefficient for a particular antibiotic (benzyl penicillin) in various types of bone cement has been calculated from direct measurement of the passage of radio-labelled penicillin through thin sections of cement at intervals over a period of 90 days, assuming the transport processes to be Fickian. Since the concentration gradient across the test sample is not uniform in the earlier stages of the experiment, a finite-difference approximation to the diffusion equation was used to take account of the transient behaviour in determining the coefficient. This method of analysis may also be used to predict the release, as a function of time, from the surface of antibiotic-loaded bone cement and from implanted pre-loaded PMMA beads used to provide antibiotic cover following bone or joint surgery. Our computer-generated predictions appear to agree very well with previously published figures arising from in vivo and in vitro studies and we conclude therefore, that Fick's Law accurately describes the process, even when the cement mix is inhomogeneous. We have by this means a reliable method by which the diffusion coefficients for various combinations of cement, antibiotic and other additives may be retrospectively determined and compared.
