RESUMEN
Although there have been significant advances in surgical methods of limb preservation and various injury scores produced to predict the outcome after severe lower limb injury, there is common belief amongst surgeons that patients rehabilitate rapidly and well after amputation. There is however little evidence in the literature supporting this view of functional outcome of amputation following injury. A subjective assessment of post-injury lower limb amputees implied that there was a similar functional outcome in above- and below-knee amputations. Furthermore, there was little functional difference between early and delayed amputations, the delayed group being more satisfied with the end result.
Asunto(s)
Amputación Quirúrgica/rehabilitación , Actitud , Traumatismos de la Pierna/cirugía , Adolescente , Adulto , Anciano , Amputación Quirúrgica/psicología , Miembros Artificiales , Niño , Preescolar , Femenino , Humanos , Pierna , Masculino , Persona de Mediana Edad , Morbilidad , Satisfacción del Paciente , Factores de Tiempo , Resultado del TratamientoRESUMEN
In 20 children with multiple epiphyseal dysplasia, an objective assessment of epiphyseal size was made to determine its value in early diagnosis of this condition. All had wrist radiographs taken at age less than 15 years, and 16 children had knee radiographs. Before the epiphyses become fully ossified, abnormalities of size and shape may be difficult to assess, but carpal length/width ratios were abnormal in 60%, and distal femoral epiphyseal/metaphyseal ratios were abnormal in 56%. When both measurements were combined, 80% could be classified as abnormal. Objective radiologic assessment of epiphyses is of value in early diagnosis of multiple epiphyseal dysplasia.
Asunto(s)
Epífisis/patología , Osteocondrodisplasias/diagnóstico por imagen , Adolescente , Factores de Edad , Antropometría , Huesos del Carpo/diagnóstico por imagen , Huesos del Carpo/patología , Niño , Preescolar , Epífisis/diagnóstico por imagen , Fémur/diagnóstico por imagen , Fémur/patología , Humanos , Osteocondrodisplasias/patología , RadiografíaRESUMEN
One hundred shoulders were assessed in 50 patients with multiple epiphyseal dysplasia, of which one-third were found to have bilateral symptoms. Two distinct clinical and radiological groups emerged. Those with minor epiphyseal abnormalities developed painful osteoarthritis in middle age, but retained shoulder movement until the secondary changes were advanced. Those with 'hatchet head' shoulders likewise became painful in the fifth and sixth decades but had minimal glenohumeral movement from an early stage.
Asunto(s)
Osteocondrodisplasias/diagnóstico por imagen , Articulación del Hombro/diagnóstico por imagen , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteocondrodisplasias/clasificación , Osteocondrodisplasias/complicaciones , Dolor/etiología , RadiografíaRESUMEN
Experience in managing 33 lower limb fractures in 25 chronic spinal injured patients is described. An increased awareness among patients and medical staff is required to avoid misdiagnosis. Effort should be made to ensure bone union in satisfactory position, recognising the different requirements of ambulant and non-ambulant patients. 'Soft pillow splints' were found to give the best results in all fractures other than those of the femoral neck. Operative treatment with antibiotic prophylaxis is only indicated to correct important deformity.
