Work-related traumatic spinal cord lesions in Chile, a 20-year epidemiological analysis.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To describe the characteristics of patients with work-related traumatic spinal cord injuries (TSCI) in Chile. SETTING: Hospital del Trabajador in Santiago, Santiago, Chile. METHODS: Patients suffering from TSCI incurred at the workplace from 1986 to 2005 were identified through records of the Asociación Chilena de Seguridad (ACHS, Chilean Safety Association). RESULTS: The medical records of 173 patients, 172 men and 1 woman, were analyzed. The yearly average incidence was 7.8 per million workers. Age at TSCI onset was 38.2 ± 12.1 years. The principal external causes for TSCI incurred at the workplace were falls from a height in 86 cases (49.7%) and trauma blows to the vertebral spine in 61 cases (35.3 %). More falls occurred in the field construction, and other traumas occurred as a result of traumatic blows caused by tree trunks and stones in forestry and mining sectors. Mortality in this series was 8.7%, and the worst prognosis was for older patients with complete tetraplegia. The paraplegia:tetraplegia ratio was 3.2:1. CONCLUSIONS: The characteristics of workplace TSCI are specific to this population. It is important therefore to develop prevention programs for specific work-related TSCI.

Proximal amputation of inferior extremity secondary to recurrent pressure ulcers in patients with spinal cord injuries.

STUDY DESIGN: Descriptive case series study. OBJECTIVE: To describe the course of five spinal cord injury (SCI) patients who underwent proximal amputation of the inferior extremity, secondary to recurrent, complicated pressure ulcers (PU) and the clinical impact this intervention had in these patients. PLACE: Trabajador Hospital in Santiago, Chile. METHOD: Revision of five clinical cases of patients who underwent partial hemipelvectomy or hip disarticulation with amputation of the extremity as treatment for pelvic recurrent PU with chronic secondary osteomyelitis. The clinical impact was quantified as days of hospital stay, number of surgeries and previous and post surgery PU. RESULTS: After the proximal amputation of the extremity, patients significantly decreased number of days of hospital stay (P=0.035), number of surgeries (P=0.015) and PU (P=0.0065). CONCLUSION: Partial hemipelvectomy and hip disarticulation with proximal amputation of the inferior extremity are rescue procedures that can be last resource treatment for chronic recurrent pelvic PU secondary to chronic osteomyelitis.