RESUMO
Fibrin adhesive proved to be useful in the reattachment of chondral and osteochondral fragments. Its use is based on sound biological principles. It offers a number of advantages over internal fixation; it causes no further damage to the cartilage, even small chondral fragments can be reattached and a second operation for the removal of metalwork is unnecessary. Its bonding strength provides only contact stability, so that immobilization in plaster for 3 weeks is always necessary. In the last 5 years we have used fibrin adhesive in 28 patients for the fixation of 39 chondral or osteochondral fragments. Of these, 26 cases were followed up for periods of 6 months to 5 years. Twelve patients were examined arthroscopically; 9 of them showed complete healing of the fragments, and only 3 slight localized degenerative changes. In 15 cases we were able to see radiological healing. All except two showed union of the fragments and restoration of the joint surface. In view of our results fibrin adhesive can be recommended for the operative management of cartilage injuries.
Assuntos
Aprotinina , Cartilagem Articular/lesões , Fator XIII , Fibrinogênio , Trombina , Adesivos Teciduais , Adolescente , Adulto , Animais , Moldes Cirúrgicos , Criança , Combinação de Medicamentos , Feminino , Adesivo Tecidual de Fibrina , Fixação de Fratura , Humanos , Traumatismos do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Coelhos , CicatrizaçãoAssuntos
Fraturas do Fêmur/cirurgia , Fraturas Expostas/classificação , Fraturas do Úmero/cirurgia , Fraturas da Tíbia/cirurgia , Acidentes , Adulto , Idoso , Placas Ósseas , Feminino , Fraturas do Fêmur/diagnóstico por imagem , Fixação Interna de Fraturas/métodos , Fraturas Expostas/diagnóstico por imagem , Fraturas Expostas/cirurgia , Humanos , Fraturas do Úmero/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia , Terminologia como Assunto , Fraturas da Tíbia/diagnóstico por imagemAssuntos
Doenças das Cartilagens/patologia , Patela/patologia , Artroscopia , Doenças das Cartilagens/classificação , Doenças das Cartilagens/cirurgia , Humanos , Osteocondrite/patologia , Osteocondrite/cirurgia , Osteocondrite Dissecante/patologia , Osteocondrite Dissecante/cirurgia , Patela/cirurgiaRESUMO
The term 'deux étages fracture' is used in different meanings. Therefore, an exact definition seems necessary. 38 own cases of this kind treated in the last 5 years are analysed. Special problems of diagnosis and treatment of this type of fracture are dealt with. Because of the risky complications primary definitive treatment is emphasized especially in cases of compound fractures and in cases with severe simultaneous lesions.
