RESUMO
Thirty patients with infected non-union of long bones were treated with radical resection of the necrotic bone and bone transport or compression/distraction osteosynthesis. Non-union, infection, deformity, bone gap and shortening were all addressed simultaneously using the Ilizarov principles. There were 15 cases with bone loss ranging from 4 to 12 cm (median bone gap of 7 cm), 10 cases of stiff non-union (six of which had an associated deformity) and five cases of mobile non-union. The median time in the Ilizarov frame was 150 days. Median follow up time after frame removal was 23.5 months. Bone grafting at the docking site was only required in three cases (10%). There were three cases of refracture (10%) and three cases of recurrence of infection (10%). The bone result was excellent in 21 patients (70%), good in three (10%), fair in none (0%) and poor in six (20%). The functional results were excellent in eight patients (26.7%), good in 12 (40.0%), fair in three (10%) and poor in seven (23.3%). It is difficult to precisely define the indications for preservation and reconstruction of severe injuries. The surgical team has to take into account the length, disability, complications and cost of treatment. Patients must be aware of the limitations of functional results and the possible difficulty of return to work despite the reconstructive attempt.
Assuntos
Fraturas não Consolidadas/cirurgia , Técnica de Ilizarov , Traumatismos da Perna/cirurgia , Infecção dos Ferimentos/cirurgia , Adolescente , Adulto , Idoso , Criança , Feminino , Seguimentos , Fraturas não Consolidadas/diagnóstico por imagem , Fraturas não Consolidadas/reabilitação , Humanos , Técnica de Ilizarov/reabilitação , Traumatismos da Perna/diagnóstico por imagem , Traumatismos da Perna/reabilitação , Masculino , Pessoa de Meia-Idade , Osteonecrose/cirurgia , Complicações Pós-Operatórias , Radiografia , Estudos Retrospectivos , Resultado do Tratamento , Infecção dos Ferimentos/diagnóstico por imagemRESUMO
Audit of phototherapy aims to examine their efficacy and functioning. Twenty-four centres providing neonatal care were visited by a team of two persons. Data form were completed with information regarding age of phototherapy units, its buildup in relation to number of tubelights, type of light and irradiance provided. Total of 58 units examined had a wide variety in relation to their build. There were only 21 units (36.2%) in which all the lights were in working order. Only five of the units (8.6%) had the recommended special blue lights. Only 18 of the units (31%) provided an acceptable level of irradiance. Phototherapy demonstrates a dose response relationship. By not providing optimum irradiance, the efficacy is compromised. This prolongs hospital stay and treatment costs. Acceptable standards should be insisted upon in purchase and maintenance of medical equipments.
