ABSTRACT
The best recognised and most widespread example of tissue necrosis is the 'bed sore'. This is said to be the commonest iatrogenic disease and the bed has been called the most dangerous splint yet devised by mankind. Factors which may play a significant part in tissue necrosis are discussed, followed by the logistics of a programme to prevent the development of bed sores. It is suggested that the problem is one of economic feasibility rather than lack of preventive knowledge.
Subject(s)
Pressure Ulcer/etiology , Pressure Ulcer/prevention & control , Humans , Necrosis , Posture , Pressure Ulcer/pathology , Risk Factors , Skin/blood supply , Skin/pathologyABSTRACT
The author outlines the basic aim of lumbar spine fusion and the indications for it as well as the methods that are best for such underlying pathology as kyphosis, lordosis and lordoscoliosis, injury, infection and degeneration.
Subject(s)
Lumbar Vertebrae/surgery , Spinal Fusion/methods , Humans , Kyphosis/surgery , Lordosis/surgery , Lumbar Vertebrae/injuries , Orthopedic Fixation Devices , Scoliosis/surgeryABSTRACT
This paper reports on 41 immature patients whose scoliosis was treated by fixation of ribs on the convexity. All had progressive scoliosis, the curve deteriorating at more than 10 degrees p.a., or the rib-vertebra angle difference being greater than 20 degrees. Of the 24 with infantile idiopathic scoliosis examined 5 years after operation, 10 maintained the improvement obtained at operation and in a further 19 the rate of deterioration had been slowed. Factors leading to a favourable outcome included: 1) An initial rib-vertebra angle difference of less than 30 degrees. 2) Success in achieving convex rib fusion. 3) The use of the operation in patients with infantile idiopathic scoliosis. There was a less favourable outcome in congenital and adolescent scoliosis. Spirometric volumes were diminished immediately after operation. Costodesis is therefore contraindicated in patients with precarious respiratory function.
