ABSTRACT
We report a case of false iatrogenic aneurism of the femoral artery observed after external fixation for septic malunion of the femur subsequent to emergency plate fixation. This false aneurysm ruptured, requiring femoropopliteal arterial repair. In the septic context, the vascular sutures failed making it necessary to ligature the femoral artery. Vascularization was maintained by satisfactory collateral circulation.
Subject(s)
Aneurysm, False/etiology , Femoral Artery/injuries , Femoral Fractures/surgery , Fracture Fixation/adverse effects , Iatrogenic Disease , Adult , Aneurysm, False/surgery , Collateral Circulation , External Fixators/adverse effects , Humans , Ligation , Male , Surgical Wound Infection/complicationsABSTRACT
This article is based on the retrospective study of 4 cases of necrotic fasciitis of the upper extremity, in adult patients with a mean age of 57 years (range: 36 to 78 years) and with a male predominance (3 M/1 F). Presenting signs were variable: pain, febrile and inflammatory oedema, ecchymoses with inflammatory masses containing clear or haemorrhagic fluid. Treatment with antibiotics and anti-inflammatory drugs did not prevent progression to painless, necrotic ulcers. Rapid medical and surgical treatment constitutes an element essential of the prognosis and must include wide large debridement, antibiotics and intensive care.
Subject(s)
Arm/surgery , Fasciitis, Necrotizing/surgery , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Critical Care , Debridement , Disease Progression , Ecchymosis/physiopathology , Edema/physiopathology , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/drug therapy , Fasciitis, Necrotizing/physiopathology , Female , Fever/physiopathology , Humans , Male , Middle Aged , Pain/physiopathology , Prognosis , Retrospective Studies , Ulcer/physiopathologyABSTRACT
Rigid ureteroscopy has become a common tool for the diagnosis and management of several diseases of the upper urinary tract. Between April 1990 and April 1996, 92 ureteroscopy procedures were performed in 88 patients in the B Urology Department of Avicennes hospital for diagnostic or therapeutic purposes. The commonest therapeutic procedure was stone manipulation (72 cases). The overall success rate was 90.8% (Distal ureter: 89.6%, mid ureter: 80%, lumbar ureter: 100%) and the complication rate was 4%. Therapeutic ureteroscopy was also used to dry ureterovaginal fistula (4 cases) and ureteral fistula with retroperitoneal urinoma (2 cases), and to remove a double J stent which had migrated into the pelvic ureter (3 cases). Diagnostic ureteroscopy was performed for 7 ureteral strictures including 3 extrinsic compressions and 4 ureteral strictures all treated with dilatations after biopsy. One false passage was observed among diagnostic ureteroscopy procedures. Rigid ureteroscopy is a minimally invasive and reliable technique for the management of ureteric calculi and for the diagnosis and treatment of other ureteric lesions.
Subject(s)
Ureteroscopy/methods , Adolescent , Adult , Constriction, Pathologic/diagnosis , Constriction, Pathologic/therapy , Dilatation , Female , Foreign-Body Migration/therapy , Humans , Male , Middle Aged , Minimally Invasive Surgical Procedures , Reproducibility of Results , Retroperitoneal Space , Stents/adverse effects , Treatment Outcome , Ureteral Calculi/therapy , Ureteral Diseases/diagnosis , Ureteral Diseases/therapy , Ureteroscopes , Ureteroscopy/adverse effects , Urinary Fistula/therapy , Urine , Vaginal Fistula/therapyABSTRACT
Fifty two cases of transverse and T fractures associated with a posterior wall fracture of the acetabulum were followed after conservative and surgical treatment. The mean follow-up was 3.5 years. There was marked displacement in 71% of cases, and a transverse fracture of the acetabular roof in 48% of case. There was no joint congruence in 50% of cases. The conservative and surgical results are the same without anatomical reduction, but the functional result seems better after surgical treatment with perfect reduction. However conservative management is necessary when anatomical reduction is impossible.
