RESUMO
Ninety open fractures of the tibia treated at the authors' institution between 1985 and 1994 were retrospectively reviewed. There were 38 Grade I, 35 Grade II, and 17 Grade III fractures. All patients had debridement and lavage of the wound under general anesthesia. Seventeen wounds (19.8%) were closed primarily and 69 (80.2%) were left open. Forty fractures (45.0%) were stabilized in casts, 31 (34.8%) in an external fixator, and 18 (20.2%) with casts and internal fixation. Six patients (7.1%) had superficial infection occur, 2 had vascular injuries, 1 of whom required an amputation, and only 1 had a neurologic injury. The average time to union was 4.5 months (range, 1.2-28.3 months). there were 10 delayed and 7 nonunions. Multiple regression analysis showed that only age of the patient and grade of the fracture were significantly associated with union time. Open fractures of the tibia in children older than 12 years of age have a high risk of developing delayed or nonunion when compared with the same injuries in children younger than 6 years of age.
Assuntos
Fraturas Expostas/terapia , Fraturas da Tíbia/terapia , Adolescente , Moldes Cirúrgicos , Criança , Pré-Escolar , Fixadores Externos , Feminino , Fixação Interna de Fraturas , Consolidação da Fratura , Fraturas Expostas/classificação , Fraturas Expostas/complicações , Fraturas não Consolidadas/etiologia , Humanos , Masculino , Estudos Retrospectivos , Fraturas da Tíbia/classificação , Fraturas da Tíbia/complicações , Resultado do TratamentoRESUMO
On ultrasonography, an 18-week-old fetus was found to have his left hand attached to an amniotic band. The child was born with typical anomalies of the amniotic band syndrome. This observation tends to support an extrinsic theory for the pathogenesis of the amniotic band syndrome.
Assuntos
Síndrome de Bandas Amnióticas/diagnóstico por imagem , Feto/anormalidades , Deformidades Congênitas do Pé/diagnóstico por imagem , Deformidades Congênitas da Mão/diagnóstico por imagem , Ultrassonografia Pré-Natal , Adulto , Âmnio/diagnóstico por imagem , Feminino , Humanos , Recém-Nascido , Masculino , GravidezRESUMO
Intraarterial streptokinase was used in the treatment of leg vessel thrombosis following free-flap closure of a large, open wound. Attention is focused on the coagulation anomalies present in such cases and the successful use of local thrombolytic therapy to salvage the limb.
Assuntos
Perna (Membro)/irrigação sanguínea , Complicações Pós-Operatórias/tratamento farmacológico , Estreptoquinase/uso terapêutico , Retalhos Cirúrgicos , Trombose/tratamento farmacológico , Adolescente , Artérias , Humanos , Traumatismos da Perna/cirurgia , MasculinoRESUMO
Low-voltage electrical burns were studied in 25 pigs submitted to bilateral thigh burns using 500 volts AC for 10 seconds. In a group of 6 animals, the wounds were observed and histologic specimens obtained at different intervals during the first week. The burn measured approximately 4 cm in diameter and extended through two muscle layers. This tissue underwent further necrosis during the first 48 hours. After 2 days there was no further necrosis. In a second group, the wounds were debrided and covered with either a split-thickness skin graft or a rectus abdominis musculocutaneous flap. All wounds with flap coverage healed primarily and there was no deep necrosis. From our findings we conclude that debridement and definitive closure can safely be performed 2 days after low-voltage electrical burns.
