RESUMO
Twenty patients with displaced intraarticular fractures of the calcaneus treated by open reduction and early postoperative motion exercises were compared after 2-12 years with 19 patients with similar fractures treated closed. The two groups were comparable regarding follow-up time, age, sex-distribution, and preinjury occupation. The pain and disability were almost equal in both groups. Three patients in both groups had marked residual symptoms, and equally many had negligible symptoms. The operated patients had less reduced subtalar motion, better ability to jump and run, longer walking distances on uneven surfaces, and reduced forward tilting of the lateral part of the posterior articular surface, but only a slightly improved Böhler angle. Nine operated and eight conservatively treated patients had radiographic signs of osteoarthrosis. Open reduction of the intraarticular fracture of the calcaneus may provide stability, allowing early motion and eventually improved subtalar function. However, postoperative complications are common, and the overall end results of open and closed treatment are almost equal. Primary operation of the fractured calcaneus should therefore rarely be indicated.
Assuntos
Calcâneo/lesões , Fixação de Fratura/métodos , Fraturas Ósseas/terapia , Adulto , Idoso , Parafusos Ósseos , Moldes Cirúrgicos , Terapia por Exercício , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The case history of a male patient, 62 years old, in preterminal uremia at transplantation with a cadaveric kidney is described. Twelve years before the transplantation he was operated on because of an aortic aneurysm where the abdominal aorta and both iliac arteries were substituted with a Dacron prosthesis. The kidney was anastomosed to this vessel substitute and functioned excellently for more than five years and the patient was completely rehabilitated.
Assuntos
Aorta Abdominal , Prótese Vascular , Transplante de Rim , Aorta Abdominal/cirurgia , Aneurisma Aórtico/cirurgia , Cadáver , Humanos , Artéria Ilíaca/cirurgia , Masculino , Métodos , Pessoa de Meia-Idade , Polietilenotereftalatos , Transplante HomólogoRESUMO
Twenty-two stenoses were discovered at a re-examination of 958 routine angiographies of 367 transplanted kidneys. Two separate types of stenosis could be distinguished- a short one localized to the anastomosis appearing immediately after the transplantation, and a long one distal to the anastomosis appearing three weeks or more after the operation. Hypertension did not appear until the stenosis had reduced the vascular diameter more than 60%. Severe hypertension requiring reconstructive surgery was caused by the long type of stenosis more often than by the short one.
