Background. Fractured stem of the hip prosthesis is well documented in the literature. Although it is rare, it is considered as a challenging problem. Many techniques have been described to solve ...this problem. Purpose of the Study. Evaluation of the effect of anterolateral bone window for extraction of the cemented femoral stem of hemiarthroplasty in revision total hip replacement. Methods. The study included eight revision hip arthroplasties in eight patients, with a broken stem of cemented (Thompson) hemiarthroplasty, which has been revised by the anterolateral proximal femoral window. All cases received cemented cups and cement-in-cement stems, except one case who received cementless long stem. Clinical follow-up of cases by Harries hip score (HHS) and X-ray. Results. Functional improvement of HHS of all cases, with no signs of loosening, after a mean follow-up period of 1.5 years. Conclusion. Extraction of broken stem is a challenging procedure. Many techniques have been described for revision of cases with a fractured stem of hip prosthesis, but we think that the anterolateral femoral bone window is a reproducible technique due to the characteristics of simplicity, short-time procedure, less invasive, not requiring extra instruments, and can be successful for most patients.
Background and Aim: Maintenance of stability using external fixation devices is an important principle to ensure successful treatment of osteomyelitis (OM). In this study, we report our experience ...with femoral OM treated with acute compression and bone transport using the Orthofix limb reconstruction system (LRS). Patients and Methods: This prospective study included 30 consecutive patients with femoral OM. LRS insertion and corticotomy were done according to the standard technique. Radiographic evaluation was performed every 2 weeks during the distraction phase and every 2-4 weeks during the consolidation phase. The clinical outcome measurements included union time, limb length discrepancy, additional operative procedures, refractare and infection. Results: The present study included 30 patients with femoral OM. They comprised 27 males (90.0%) and 3 females (10.0%) with an age of 28.1 + or - 15.6 years. All, except one, achieved union with a mean union time of 8.6 months (range 4-20 months). The mean union time for acute compression was 7.6 months (range 4-20 months) while for patients with bone transport it was 14.5 months (range 1218 months). The mean limb length discrepancy was 1.8 cm (range 0-4 cm). At the end of the follow=up, two patients were not able to ambulate without support; one due to non-union and one due to paraplegia. Conclusion: The present study identified treatment of femoral OM using LRS as a feasible and effective technique with good outcomes. Reported complications could be adequately managed in most cases. Keywords: osteomyelitis, external fixation, limb reconstruction system
Abstract
Background
Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, ...prolonged hospital stay and increase of chronic pain. Neuraxial block is used for postoperative pain management and decrease analgesic use.
Objective
To compare the analgesic duration of intravenous and perineural administration of Dexamethasone in interscalene block during arthroscopic shoulder surgery.
Patients and Methods
Interventional randomized Double-Blind Study. This study was conducted in Ain Shams University Hospitals’ operating rooms throughout six months. In our study, 60 patients were randomly divided into two equal groups:
Group A (30 patients)
Block with 20 ml Bupivacaine 0.5% (+ 2 ml Dexamethasone ‘8 mg’) & 5 ml normal saline was injected IV.
Group B (30 patients)
Block with 20 ml Bupivacaine 0.5% (+ 2 ml normal saline) & 5 ml Dexamethasone ‘8 mg’ was injected IV.
Results
Our study showed that addition of 8 mg dexamethasone to bupivacaine in interscalene brachial plexus nerve block prolongs post-operative analgesia & reduced numbers of rescue analgesia doses more than injecting dexamethasone intravenously.
Conclusion
Addition of perineural dexamethasone to bupivacaine in interscalene brachial nerve block prolongs post-operative analgesia & reduced numbers of rescue analgesia doses more than injecting dexamethasone intravenously. Dexamethasone was seen to be a potent adjunct to local anaesthetic to prolong post-operative analgesia with negligible side effects.
Background In this study, the biliary-enteric anastomosis following choledochal cyst excision was studied using continuous suture and interrupted suture procedures in a pediatric population. Patients ...and methods In this study, information on 57 children who received continuous suture choledochal cyst surgery at our facility between 2015 and 2020 was gathered retrospectively. The patients that were enrolled were divided into two groups: continuous suture ( n =24) and interrupted suture ( n =33). Anastomotic leakage, anastomotic duration in minutes, hospital stay in days, and cost were all compared between these groups. Results The incidence of anastomotic leakage was higher in the interrupted suture group (4.17 vs. 6.6% for continuous suture and interrupted suture, respectively), but the difference was statistically insignificant ( P =0.63). The groups did not differ regarding hospital stays ( P =0.25). The mean time required to complete the anastomosis in the continuous suture group was 15.3±4.1 min, compared with 23.5±5.2 min in the interrupted suture group ( P <0.0001). The costs were &z.euro;5±0.0 in the continuous suture group and &z.euro;30±6.4 in the interrupted suture group ( P <0.0001). Conclusion The anastomotic leakage and hospital stay did not differ between the continuous suture and interrupted suture groups. In contrast, the continuous suture group had a considerable advantage over the interrupted suture group in terms of anastomotic duration and cost.
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