ABSTRACT
This case report describes a 55-year-old male patient with type II necrotizing fasciitis (NF) of the hand and forearm. The rapid progression of the tissue infection could be successfully stopped with radical surgical débridement and antibiotic therapy. For the reconstruction of the extensive loss of soft tissue a combination of split-thickness skin graft (STSG) and the synthetic dermal substitute MatriDerm® was used. In cases of NF, MatriDerm® and STSG provide a rapidly available and simple alternative to other reconstruction techniques.
Subject(s)
Collagen/administration & dosage , Elastin/administration & dosage , Fasciitis, Necrotizing/surgery , Skin Transplantation , Skin, Artificial , Soft Tissue Infections/surgery , Anti-Bacterial Agents/therapeutic use , Debridement , Fasciitis, Necrotizing/drug therapy , Forearm , Hand , Humans , Male , Middle Aged , Soft Tissue Infections/drug therapyABSTRACT
Dislocation of the sternoclavicular joint is an uncommon injury. Especially posterior dislocations with potentially life-threatening complications present a challenging situation for the treating surgeon regarding diagnosis and therapy. Reduction and fixation of the joint is the treatment of choice. We present the case of such an injury in an adolescent judoka who was treated by open reduction and reconstructive surgery using the gracilis tendon graft technique.
Subject(s)
Athletic Injuries/surgery , Joint Dislocations/surgery , Martial Arts/injuries , Sternoclavicular Joint/injuries , Tendons/transplantation , Adolescent , Fracture Healing/physiology , Humans , Joint Dislocations/diagnostic imaging , Male , Radiography , Range of Motion, Articular/physiology , Sternoclavicular Joint/diagnostic imaging , Sternoclavicular Joint/surgery , Suture TechniquesABSTRACT
Treatment of medial femoral fractures in elderly patients with cemented hip hemiarthroplasty (HEP) is a widely established procedure. The main problems with this procedure are complications associated with soft tissue damage and prolonged immobilization. The aim of this study was to compare the clinical and radiological results after HEP implantation using either an anterior minimally invasive (MIS) approach or a regular transgluteal (TG) approach. In this retrospective study the results of 55 consecutive MIS and 54 consecutive TG approaches for implanted HEP after medial femoral fracture were compared. The time of successful mobilization, duration of the i.v. analgesia as well as the occurrence of any perioperative complications were recorded. The femoral offset, leg length and the femoral alignment were analyzed radiologically. The MIS group could be mobilized earlier (MIS 2. pod vs. TG 4. pod, p <0.01) but the need for i.v. applied analgesia was prolonged (MIS 4.4 pod vs. TG 3.5 pod, p=0.04). In the MIS group the number of perioperative complications was less than in the TG group (MIS 7% vs. TG 17%, p <0.05). The early functional advantages of MIS after HEP implantation for medial femoral fractures are evident also within an elderly group of patients.