ABSTRACT
INTRODUCTION: Currently, there is a lack of prospective studies to unify criteria about type and time for postoperative immobilisation in surgical distal radius fractures. The aim of this study is to compare functional and radiological results in two groups of distal radius fractures treated with internal fixation with locking plate, and immobilised with antebrachial splint or compression bandage for 3 weeks. MATERIAL AND METHOD: A randomised clinical trial was carried out with two parallel groups with 3, 6, and 12 weeks of follow-up. Main and secondary functional variables were measured, such as pain on VAS scale, values on PRWE, DASH and MRS scale, range of motion in flexion-extension, complications, etc. In addition, some radiological variables were measured at preoperative period and one week after surgery, such as union time, dorsal displacement, shortening, ulnar variance, etc. RESULTS: A total of 62 patients were evaluated: 27 immobilised with bandage and 35 with splint. Analysis of the results obtained showed significant differences in both groups for almost all radiological variables from pre to postoperative period, and for all functional variables from 3 to 12 weeks after surgery. No significant differences were found between the two groups for any of the radiological and functional variables evaluated (VAS 3-12 weeks: p=.584; PWRE 3-12 weeks: p=.248; flexion range of motion 3-12 weeks: p=.959; extension range of motion: p=.50; union time: p=.89). CONCLUSIONS: We do not find clinical or radiological differences between immobilisation with antebrachial splint or compression bandage for distal radius fractures operated with locking plate. A greater number of patients and follow-up are necessary to extrapolate the results to the general population and to establish criteria for good postoperative management of these fractures.
ABSTRACT
INTRODUCTION: Currently, there is a lack of prospective studies to unify criteria about type and time for postoperative immobilization in surgical distal radius fractures. The aim of this study is to compare functional and radiological results in two groups of distal radius fractures treated with internal fixation with locking plate, and immobilized with antebrachial splint or compression bandage for 3weeks. MATERIAL AND METHOD: A randomized clinical trial was carried out with two parallel groups with 3, 6, and 12weeks of follow-up. Main and secondary functional variables were measured, such as pain on VAS scale, values on PRWE, DASH and MRS scale, range of motion in flexion-extension, complications, etc. In addition, some radiological variables were measured at preoperative period and one week after surgery, such as union time, dorsal displacement, shortening, ulnar variance, etc. RESULTS: A total of 62 patients were evaluated: 27 immobilized with bandage and 35 with splint. Analysis of the results obtained showed significant differences in both groups for almost all radiological variables from pre to postoperative period, and for all functional variables from 3 to 12weeks after surgery. No significant differences were found between the two groups for any of the radiological and functional variables evaluated (VAS 3-12weeks: P=.584; PWRE 3-12weeks: P=.248; flexion range of motion 3-12weeks: P=.959; extension range of motion: P=.50; union time: P=.89). CONCLUSIONS: We do not find clinical or radiological differences between immobilization with antebrachial splint or compression bandage for distal radius fractures operated with locking plate. A greater number of patients and follow-up are necessary to extrapolate the results to the general population and to establish criteria for good postoperative management of these fractures.
ABSTRACT
Esophageal atresia Type III was repaired in 8 children 5-11 y/o. All had stenosis in the esophagus diagnosed by radiology and endoscopy after surgical correction. Dilation was performed until normal lumen was obtained. Motor disfunction in upper and middle part of the esophagus was evidenced in six by manometry. Our findings are suggestive that Esophageal manometry is indicated in the evaluation of repaired esophageal atresia.
Subject(s)
Esophageal Atresia/physiopathology , Esophagus/physiopathology , Child , Esophageal Atresia/surgery , Esophageal Stenosis/etiology , Esophageal Stenosis/physiopathology , Esophagoscopy , Female , Humans , Male , ManometryABSTRACT
A preliminary report is presented regarding the 24 hours continuous pH monitoring of 40 patients from 1 month to 19 years of age with clinical features of gastro-esophageal reflux confirmed by at least one of the diagnostic methods utilized (radiology, endoscopy, esophageal biopsy). The equipment used was a MIC GASTROGRAPH with 1.2 and 3 mm catheters according to age and using the methodology suggested by ESPGAN. Patients with reflux index of more than 10% had all other pH indexes and other diagnostic methods abnormal. The area of the curve below pH 4 correlated directly with the presence of esophagitis. Patients with post history of esophageal atresia and caustic esophagitis had marked alterations of pH. PH monitoring with the modern methodology currently available is of great help to quantify severity of acid reflux, to distinguish between physiologic pathologic reflux and to decide treatment.
Subject(s)
Gastroesophageal Reflux/diagnosis , Adolescent , Adult , Child , Child, Preschool , Esophagus/physiopathology , Female , Gastroesophageal Reflux/physiopathology , Humans , Hydrogen-Ion Concentration , Infant , Infant, Newborn , Male , Monitoring, Physiologic , Time FactorsABSTRACT
The purpose of this study was to investigate the motor function of the esophagus in patients with chronic caustic esophagitis. We evaluated 7 patients between 2 and 10 years of age, who had ingested caustics between 15 months and 3 years of age. The method we used was radiology with fluoroscopy vision and manometry. There was no correlation between radiologic and manometric findings. Esophageal transit was normal in all patients, even in those that had small stenosis while manometry showed motor disfunction in patients with severe esophageal damage.
Subject(s)
Burns, Chemical/physiopathology , Caustics/adverse effects , Esophagitis/physiopathology , Esophagus/injuries , Burns, Chemical/etiology , Child , Child, Preschool , Chronic Disease , Esophageal Stenosis/chemically induced , Esophageal Stenosis/physiopathology , Esophagitis/chemically induced , Esophagoscopy , Esophagus/physiopathology , Humans , Manometry , PeristalsisABSTRACT
Los pólipos rectales se presentan con relativa frecuencia en la infancia constituyendo una de las principales causas de hematoquezia en esta etapa de la vida. Habitualmente son tratados con múltiples medicamentos antes de establecerse el diagnóstico correcto. Presentamos nuestra experiencia con el uso de la rectoscopia y colonoscopia en el diagnóstico y tratamiento de 214 pacientes con pólipos de rectosigmoides y otras localizaciones de colon, estudiados entre los años 1982-1988. La mayor incidencia estuvo entre 3 y 6 años de edad (63,8%), siendo la localización más frecuente en rectosigmoides 253 pólipos (91%) e histológicamente el 99,7% fueron pólipos juveniles. La polipectomía endoscópica constituye un método valioso de fácil realización y pocas complicaciones para resolver los pólipos del colon, evitándose de esta manera las intervenciones quirúrgicas
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Endoscopy, Gastrointestinal , Intestinal Neoplasms/surgery , Intestinal Polyps/surgery , Intestinal Neoplasms/diagnosis , Intestinal Neoplasms/pathology , Colonic Neoplasms/surgery , Colonic Neoplasms/diagnosis , Colonic Neoplasms/pathology , Colonic Polyps/surgery , Colonic Polyps/diagnosis , Colonic Polyps/pathology , Rectal Neoplasms/diagnosis , Rectal Neoplasms/pathology , Rectal Neoplasms/surgeryABSTRACT
Rectal polyps are relatively frequent in infancy and constitute one of the main causes of hematoquezia during this time of life. They are usually treated with multiple drugs before the correct diagnosis is made. We report our experiences with the use of rectoscopy and colonoscopy for the diagnosis and treatment of 214 patients with rectosigmoid polyps, including other sites in the colon, studied between 1982-1988. The highest incidence was between 3 and 6 years of age (63.8%), and the most frequent location in 253 rectosigmoid polyps (91%) and histologically (99.7%) were juvenile polyps. Endoscopic polypectomy proved to be a valuable method, easy to perform and with few complications to treat colon polyps, thus eliminating the surgical interventions.
Subject(s)
Endoscopy, Gastrointestinal/methods , Intestinal Neoplasms/surgery , Intestinal Polyps/surgery , Child , Child, Preschool , Colonic Neoplasms/diagnosis , Colonic Neoplasms/pathology , Colonic Neoplasms/surgery , Colonic Polyps/diagnosis , Colonic Polyps/pathology , Colonic Polyps/surgery , Colonoscopy/methods , Female , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Humans , Infant , Intestinal Neoplasms/diagnosis , Intestinal Neoplasms/pathology , Intestinal Polyps/diagnosis , Intestinal Polyps/pathology , Male , Rectal Neoplasms/diagnosis , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Recurrence , Retrospective StudiesABSTRACT
46 of 74 children with chronic diarrhea of unknown etiology between the ages of 44-627 days were studies. They were assigned, by single randomization, to 3 dietary treatments: a) cow's milk, b) a sucrose- free (SED-S), and c) a sucrose containiNG semi-element diet (SED+S), for 15 days. The authors registered the daily increase of body weight, daily amount of ingested kcal, and the increase of body weight/1000 kcal. The number of days with diarrhea before hospitalization, the age and weight of each child before treatment were recorded and analyzed as covariates. Maltase, sucrase, and lactase activity values were compared before treatment, but were not different among the 3 groups. A significant increase of body weight/1000 kcal ingested was observed in children fed the SED-S diet compared to that observed in children on cow's milk (P=.013 in ANCOVA; P+.053 in RANCOVA), and those fed SED+S (P=.009 in Ancova; p.001 in RANCOVA). The covariates did not have any apparent effect on these results. Only 7 of 24 children receiving cow's milk completed the assigned diet. The carbohydrate composition of the semi-elemental diets proved to be fundamental in the nutritional recovery of these patients.
