ABSTRACT
We report the transmission of group A streptococci by a human bite leading to severe necrotising fasciitis. Rapid surgical and antibiotic treatment led to healing without fractional loss of the patient's infected leg.
Subject(s)
Bites, Human/complications , Fasciitis, Necrotizing/diagnosis , Wound Infection/diagnosis , Adult , Anti-Bacterial Agents/therapeutic use , Debridement , Diagnosis, Differential , Fasciitis, Necrotizing/etiology , Fasciitis, Necrotizing/therapy , Humans , Male , Skin Transplantation , Wound Healing , Wound Infection/etiology , Wound Infection/therapySubject(s)
Dracunculiasis/diagnosis , Joint Diseases/parasitology , Knee Joint/parasitology , Adult , Animals , Dracunculiasis/diagnostic imaging , Dracunculus Nematode/isolation & purification , Female , Humans , Joint Diseases/diagnosis , Joint Diseases/diagnostic imaging , Knee Joint/diagnostic imaging , RadiographyABSTRACT
The IVUS system allows for a complete, only slightly invasive assessment of the femoral, pelvic and abdominal vessels in cross-section within the framework of intraoperative diagnostics and quality control. This method provides clear information concerning the vascular walls and internal structure. In our experience so far, it provides an ideal form of intraoperative control in cases of venous thrombectomy, embolectomy in the abdominal and pelvic vessels, following half-closed and open thromboendarterectomy and after intraoperatively performed angioplastic interventions.
Subject(s)
Monitoring, Intraoperative , Ultrasonography , Vascular Surgical Procedures , Embolism/surgery , Evaluation Studies as Topic , Humans , Peripheral Vascular Diseases/surgery , Quality Control , Thrombosis/surgeryABSTRACT
Implantation of endoprostheses with bone cement is followed by alterations of the circulation. Intoxication, caused by the monomer of bone cement or pulmonary embolism by intramedullary contents constitute the two mostly accepted pathophysiological hypotheses. Because of the lack of pulmonary and circulatory physiological data a clinical decision concerning the value of the hypotheses was not possible until now. Hip prosthesis implantation was analyzed in 15 patients by measuring equipment controlled by an on-line-computer. The device allowed a high rate of data retrieval. The bone cement implantation syndrome reveals itself as cardiorespiratory sequelae of a disseminated pulmonary embolism which is originating in intramedullary contents, squeezed intravasal. Usual prophylactic methods are revisited.
Subject(s)
Bone Cements/adverse effects , Pulmonary Embolism/physiopathology , Respiration Disorders/physiopathology , Adult , Aged , Blood Pressure , Cardiac Output , Femoral Fractures/surgery , Hip Prosthesis , Humans , Middle Aged , Pulmonary Embolism/etiology , Pulmonary Embolism/prevention & control , Respiration Disorders/etiology , Respiration Disorders/prevention & control , Syndrome , Vascular ResistanceABSTRACT
Because of anterior softening of the trachea due to thyroid swelling a patient was intubated with a "Lanz-" endotracheal tube with low-pressure cuff after thyroidectomy. The awake, eating patient developed severe endotracheal haemorrhage during the 17 days of intubation. Thoracotomy revealed a 2 cm long horizontal rupture probably at the site of the tube tip at the anterior wall of the trachea. The opening was connected to a rupture of the right brachiocephalic trunk at its bifurcation. Interpositions of dacron prostheses between the trunk, the subclavian artery and the carotid artery and suture of the tracheal wall controlled the situation. However, the patient died from acute hepatic failure, as shown at post-mortem examination. This case report is a warning against long-term intubation of awake patients, as sometimes recommanded.
Subject(s)
Fistula/etiology , Intubation, Intratracheal/adverse effects , Trachea/injuries , Brachiocephalic Trunk/injuries , Female , Goiter/surgery , Humans , Middle AgedSubject(s)
Cholangiography/adverse effects , Liver Diseases/etiology , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
1000 operative treatments of fractured neck of the femur in hospital in 25 years were analyzed. In addition to a rise in frequency of admission, a progressive aging of the patients was observed. The operative technique developed into osteosynthesis, principally with the Pugh nail and hip joint alloplasty. 19% of the patients died.
Subject(s)
Femoral Neck Fractures/surgery , Adult , Aged , Bone Nails , Bone Plates , Female , Fracture Fixation, Internal , Hip Joint , Humans , Joint Prosthesis , Male , Middle Aged , Statistics as TopicABSTRACT
Among 300 gastrointestinal operations performed with mechanical suture techniques 2% deadly complications due to the sutures occurred. Mechanical sutures seen to be a preferable method in the gastrointestinal region. They are limited by specific local and at the colon general contraindications.
Subject(s)
Digestive System Surgical Procedures , Surgical Staplers , Suture Techniques , Aged , Colon/surgery , Duodenum/surgery , Follow-Up Studies , Gastrectomy , Humans , Jejunum/surgery , Postoperative Complications , Pylorus/surgery , Suture Techniques/adverse effects , Suture Techniques/instrumentationABSTRACT
At the present time various materials and methods of manually suturing the gastrointestinal tract are used in parallel. While these methods satisfy basic standards, there is scarcely any detectable difference in the results. Further development in manual suturing with reference to security from failure and reduction of the expenditure of time is unforeseeable. Adhesive methods cannot achieve any importance in the gastrointestinal tract. Presently only the fully mechanical suture methods described at the end of the sixties show promise of possible future development in the gastrointestinal tract. They are suitable for as much as 80% of plastic gastrointestinal operations, but still need statistical comparison of results.
Subject(s)
Digestive System Surgical Procedures , Suture Techniques , Gastrointestinal Diseases/surgery , Humans , Suture Techniques/instrumentation , Sutures/adverse effectsABSTRACT
An operative procedure is described for the treatment of periprosthetic fractures of the femur after total knee replacement. The special problems of osteosynthesis are being discussed. In case of technical contraindications the partial replacement of the distal femur is being recommended as an alternative procedure.
Subject(s)
Femoral Fractures/surgery , Joint Prosthesis , Knee Joint , Arthroplasty/methods , Femoral Fractures/complications , Fracture Fixation, Internal , Humans , Postoperative ComplicationsABSTRACT
This is to report as an example of 2 such cases, the indications and operative procedures of total hip-femur-knee joint alloplastics for malignant fractures of the femur. This is an alternative to the exarticulation of the femur in the case of impossibility to fix the osteosynthesis material on the remaining femur. The higher radicality of this method in comparison to the common femur-saving way might lead to a wider usage.
Subject(s)
Femoral Fractures/surgery , Femoral Neoplasms/complications , Fracture Fixation/methods , Joint Prosthesis , Adenocarcinoma/complications , Biomechanical Phenomena , Bone Neoplasms/complications , Breast Neoplasms , Female , Femoral Neoplasms/surgery , Fractures, Spontaneous/etiology , Hemangiosarcoma/complications , Hip Joint/surgery , Humans , Knee Joint/surgery , Middle Aged , Neoplasm Metastasis , Prognosis , Prosthesis DesignABSTRACT
The surgical treatment of malignant fractures of the extremities includes a wide range of methods today. The intramedullary Küntscher nailing of the femur and tibia by the AO (Society for Osteosynthesis) method, Hackethal's multiple nailing in the upper arm and fore arm, and the bone glue-plate compound osteosynthesis methods are described. The alloplastic joint prostheses for hip and knee are extended to proximal and distal femur prostheses. Total femur prosthesis with simultaneous hip and knee joint alloplasty seems to be full of prospect.
Subject(s)
Bone Neoplasms/complications , Fracture Fixation/methods , Fractures, Spontaneous/surgery , Bone Cements/therapeutic use , Bone Nails , Bone Plates , Femoral Fractures/etiology , Femoral Fractures/surgery , Fracture Fixation, Intramedullary/methods , Fractures, Spontaneous/etiology , Hip Joint , Humans , Humeral Fractures/etiology , Joint Prosthesis , Knee Joint , Male , Neoplasm Metastasis , Plasmacytoma/complications , Postoperative Care , Prostatic Neoplasms/complicationsABSTRACT
Out of a total of 140 gastro-intestinal procedures performed with mechanical suture techniques 25 partial gastrectomies (according to Billroth I or II) are discussed. Provided the operating instructions are followed and possible complications are avoided, these mechanical techniques have proved advantageous.
