RESUMO
Occult fractures of the hip are rare; they are almost absent from published medical literature and the studies that are reported concern fractures in the elderly population. In this paper the cases of two children, nine and 16 years old are presented who suffered occult fractures of the femoral head during high-energy traumatisms. Conventional X-ray did not reveal bone lesions, although it did show a discrete eccentration of the cephalic nucleus and the diagnosis was delayed until more specific image techniques were applied: bone scanning with Tc99, CT and MRI, revealed fracture from compression in Case 1 and osteochondral fracture in Case 2. The treatment consisted of non-weight-bearing of the joint in the first case and removal of the fragment by arthroscopy in the second. The outcome was good in both patients who had no pain in the hip and complete mobility one year later. (Hip International 2004; 14: 34-8).
RESUMO
Subacute osteomyelitis has a very anodyne symptomatology and is, therefore, difficult to diagnose. We studied 21 cases treated between 1984 and 1998 with subacute osteomyelitis of variable location and a mean diagnostic delay of 158.5 days. Of these, 10 cases could not be placed in the current classification. Diagnosis was radiologic in all cases, although in a few patients confirmation by isotopic bone scan and magnetic resonance imaging was required. Treatment was surgical in the first 11 cases to become, currently, predominantly conservative. The causal microorganism was only isolated in nine cases. Complete healing without sequelae was achieved in all but one case, which was of very tardy diagnosis and developed coxarthrosis.
Assuntos
Osteomielite/diagnóstico , Osteomielite/terapia , Doença Aguda , Adolescente , Antibacterianos/uso terapêutico , Aspergilose/complicações , Aspergillus fumigatus , Criança , Pré-Escolar , Doença Crônica , Terapia Combinada , Desbridamento , Drenagem , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Osteomielite/classificação , Osteomielite/microbiologia , Osteotomia , Estudos Retrospectivos , Infecções Estafilocócicas/complicações , Staphylococcus aureus , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Obstetrical sciatic palsy have been frequently seen in our hospital, but bibliography about this subject is rare, not only in Spanish but also in other languages. We review our experience about this pathology, and if it is possible, to contribute to prevent its occurrence.
