RESUMO
A retrospective study to assess the long-term results of the treatment of supracondylar fractures of the humerus was undertaken to provide guidance on the management of these troublesome injuries. In our experience as long as there was less than 25% displacement on an anteroposterior (A/P) or lateral x-ray, and less than 10 degrees angulation on an A/P or lateral x-ray, it is not essential to achieve an anatomical reduction, and good elbow function could be expected. Although children do not appear to correct for valgus or varus deformity there was no functional deficit from this deformity in this series. It was found that major displacements were more likely to have a worse result than undisplaced or minimally displaced fractures. These results would support a conservative approach to the management of these fractures--closed reduction followed by three weeks in a collar and cuff. If the position proved unstable, closed reduction was re-attempted or internal fixation performed. Conservative treatment was safe and effective, and the results comparable with other series that advocate internal fixation.
Assuntos
Lesões no Cotovelo , Fraturas do Úmero/terapia , Criança , Pré-Escolar , Articulação do Cotovelo/diagnóstico por imagem , Feminino , Seguimentos , Fixação Interna de Fraturas , Consolidação da Fratura/fisiologia , Fraturas Expostas/diagnóstico por imagem , Fraturas Expostas/terapia , Humanos , Fraturas do Úmero/diagnóstico por imagem , Lactente , Masculino , Radiografia , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , ContençõesRESUMO
Our experience with the procedure of meatal advancement and glanuloplasty (MAGPI) is reviewed with a note on the technique. It was found that MAGPI can improve the position of the urethral meatus, correct meatal stenosis, release associated skin chordee and produce the aesthetic appearance of a normal penis. The fistual rate was zero and there were no other complications. It is recommended as the operative procedure of choice for glanular, coronal and selected cases of subcoronal hypospadias.
Assuntos
Hipospadia/cirurgia , Pré-Escolar , Humanos , Lactente , Masculino , Métodos , Pênis/cirurgia , Uretra/cirurgiaRESUMO
A retrospective study was made of 9 patients with congenital lobar emphysema who presented over the past 13 years. The ages of the patients at diagnosis ranged from 2 weeks to 10 years. The earlier the presentation, the more severe were the symptoms. Two patients were misdiagnosed initially at the referring hospitals with near disastrous results. Pitfalls in diagnosis are outlined and the various investigative procedures discussed. A flow chart for the diagnostic approach is presented. Treatment was usually by lobectomy but 2 older children presenting late with mild symptoms were managed conservatively with satisfactory results.
