RESUMEN
The results of treatment of 417 patients with pseudoarthroses of the tibia (aged from 17 to 71 years) with the use of various methods: by internal fixation with auto- and allografts, metal plates as well as in the use of extranidal (extralocal) osteosynthesis were analysed. The number of consolidation failures was minimal after autoplasty by Khakhutov and bone autoplasty. The rate of healing after osteosynthesis was substantially lower in internal fixation, than in extranidal (extralocal) osteosynthesis. Inflammatory complications occur less frequently when osteoplasty by Khakhutov was used. The highest rate of complications was observed in tibialization and in bilocal osteosynthesis.
Asunto(s)
Fijación Interna de Fracturas/métodos , Seudoartrosis/cirugía , Fracturas de la Tibia/cirugía , Adolescente , Adulto , Anciano , Trasplante Óseo , Estudios de Evaluación como Asunto , Femenino , Humanos , Fijadores Internos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Seudoartrosis/etiología , Fracturas de la Tibia/complicacionesRESUMEN
Under analysis were results of treatment of 141 patients with infected pseudoarthroses of the tibia. Among them there were 10 women and 131 men aged from 18 to 62 years. The long-term results were followed-up during the period from 2 to 20 years. The analysis allowed a supposition that a combination of tibia segment resection and plasty with local tissues completed by suturing the wound, drainage and external fixation with the Ilizarov device leads to deterioration of the outcomes. A careful approach to treatment of such patients including the division of treatment into the stages of debridement and reconstruction seems to be more productive.
Asunto(s)
Seudoartrosis/complicaciones , Fracturas de la Tibia/complicaciones , Infección de Heridas/etiología , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Curación de Fractura , Humanos , Masculino , Persona de Mediana Edad , Seudoartrosis/patología , Seudoartrosis/cirugía , Recurrencia , Estudios Retrospectivos , Fracturas de la Tibia/patología , Fracturas de la Tibia/cirugía , Factores de Tiempo , Resultado del Tratamiento , Infección de Heridas/patología , Infección de Heridas/cirugíaRESUMEN
After some surgical interventions it's need to regenerate a part of bone. The new bone formation in the external fixation apparatus is the result of elongation and maturation of the bone callus, originated in pre-destructive period between bone fragments. The mathematical model of bone callus is proposed. Its main structural elements are osteogeneous and cartilage cells, osteoblasts, matrix, blood vessels. The derived equations take account of matrix production, dependent on the stress in tissue, and transformation of one kind of cells into another in accordance with O2 concentration is more or less than some critical value. The material of the callus is considered as a growing elastic body with growth coefficients, dependent on the structural tensor and Ca concentration. The structural tensor represents the anisotropy of fibrils orientation that take place during deformation. The concentrations of O2 and Ca are connected with the density of blood vessels whose propagation is related to the diffusion of a hypothetical substance. The formulated boundary problem allows to define changes in the growing zone of the callus and to define its size as a function of the rate of elongation.
Asunto(s)
Callo Óseo/patología , Técnica de Ilizarov , Modelos Teóricos , HumanosAsunto(s)
Infarto/etiología , Obstrucción Intestinal/complicaciones , Intestino Grueso/irrigación sanguínea , Enfermedad Aguda , Adenocarcinoma/complicaciones , Adenocarcinoma/cirugía , Humanos , Infarto/cirugía , Obstrucción Intestinal/etiología , Obstrucción Intestinal/cirugía , Intestino Grueso/cirugía , Masculino , Persona de Mediana Edad , Neoplasias del Colon Sigmoide/complicaciones , Neoplasias del Colon Sigmoide/cirugíaRESUMEN
It is not advisable to prescribe any types of the diet to patients with acute surgical diseases of the abdominal cavity in the early postoperative period because of membranous digestion disturbances and intestinal motility dysfunction. The fasting of the patients with the normal nutritional status may be based physiologically in such cases till the recovery of digestive function, since it favours significant desensitization, namely a decrease of the number of postoperative complications and creation of functional rest for the intestine.
Asunto(s)
Digestión/fisiología , Enfermedades del Sistema Digestivo/cirugía , Ayuno/fisiología , Absorción Intestinal/fisiología , Obstrucción Intestinal/dietoterapia , Síndromes de Malabsorción/dietoterapia , Complicaciones Posoperatorias/dietoterapia , Enfermedad Aguda , Enfermedades del Sistema Digestivo/etiología , Enfermedades del Sistema Digestivo/fisiopatología , Humanos , Obstrucción Intestinal/etiología , Obstrucción Intestinal/fisiopatología , Síndromes de Malabsorción/etiología , Síndromes de Malabsorción/fisiopatología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Factores de TiempoRESUMEN
The article describes the technique of the application of fasting-diet therapy, specific features of the clinical course of the postoperative period in the treatment of 75 patients by this method, the composition and caloric value of the restorative diet used.