Entrapment of the Sciatic Nerve Over the Femoral Neck Stem After Closed Reduction of a Dislocated Total Hip Arthroplasty.

Sciatic nerve injury is a rare but potentially extremely disabling complication of posterior dislocated total hip arthroplasty. Initial closed reduction is recommended followed by a careful neurovascular examination. This procedure and the following stability testing are usually safe and typically associated with a very low complication rate. We report the case of sciatic nerve entrapment around the neck of the femoral stem after closed reduction of a posteriorly dislocated total hip arthroplasty. Immediate postreduction palsy led to surgical exploration, identification, neurolysis of the sciatic nerve and safe reduction was performed. Patient outcome was marked by complete sensitive sciatic nerve recovery, but complete loss of motor sciatic nerve function. This case highlights the importance of careful postreduction neurovascular assessment and prompt surgical exploration when indicated.

A descriptive study on the surgery and the microbiology of Gustilo type III fractures in an university hospital in Switzerland.

OBJECTIVE: To describe the epidemiology, the surgical treatment, the microbiology, the antibiotic prophylaxis and the outcome of patients with the most severe type of open fractures. METHODS: Retrospective chart reviews of patients with Gustilo type III open fracture admitted to an university hospital in Switzerland between January 2007 and December 2011. The patient's and fracture's characteristics, surgery, antibiotic prophylaxis, and microbiology findings at the initial and at the revision surgery were described. RESULTS: Thirty patients were included (83% male, mean age 41 years). More than half of the patients had polytrauma. In all patients, debridement and stabilization surgery (70% using external fixation) were performed at admission. Soft tissue reconstruction was performed in 87% and in 23% immediate bone graft was performed. Antibiotic prophylaxis were given in all patients for a median duration of 9 days (60% received amoxicillin/clavulanic acid). Positive bacterial culture was found in 53% of the patients at initial surgery and in 88% at revision surgery. At initial and revision surgery, 47% and 88% of the pathogens were amoxicillin/clavulanic acid-resistant. Treatment outcome was favorable in 24 of 30 patients (80%) and in six cases (20%) an amputation had to be performed. None of the patients had chronic bone infection. CONCLUSIONS: Positive cultures were found often in open fractures. Amoxicillin/clavulanic acid which is often mentioned in many guidelines as prophylaxis in open fractures does not cover the most common isolated organisms. The combination of surgery and antibiotic prophylaxis leads to good outcome in Gustilo type III fracture.

Child safety driver assistant system and its acceptance.

Farming machinery incidents frequently cause the injury and death of children on farms worldwide. The two main causes of this problem are the driver's view being restricted by construction and/or environmental factors and insufficient risk awareness by children and parents. It is difficult to separate working and living areas on family farms, and the adult supervision necessary to avoid work accidents is often lacking. For this reason, additional preventive measures are required to reduce the number of crushings. Electronic tools that deliver information about the presence of children in the blind spots surrounding vehicles and their attached machines can be very effective. Such an electronic device must cover all security gaps around operating agricultural vehicles and their attached machines, ensure collision-free stopping in risk situations, and be inexpensive. Wireless sensor network and electrical near-field electronic components are suited to the development of low-cost wireless detection devices. For reliable detection in a versatile environment, it is necessary for children to continuously wear a slumbering transponder. This means that children and adults must have a high acceptance of the device, which can be improved by easy usability, design, and service quality. The developed demonstrator achieved detection distances of up to 40 m in the far field and 2.5 m in the near field. Recognized far-field sensor detection weaknesses, determined by user-friendliness tests, are false alarms in farmyards and around buildings. The detection distance and reliability of the near-field sensor varied with the design of the attached machines' metallic components.