RESUMEN
We compared the effectiveness of absorbable polylactic acid (PLA) screws and polydioxanone (PDS) pins with that of ASIF cannulated screws in stabilizing Salter-Harris IV fractures in goat distal femur. Eighteen juvenile goats were randomly divided into control (cannulated screw), PLA screw, and PDS pin groups. A Salter-Harris IV medial femoral condyle fracture was created and stabilized, and the goats were sacrificed 8 weeks postoperatively. Articular cartilage displacement < 1 mm was considered anatomic. All PLA screws were anatomic as compared with 83% (five of six) of the controls and 17% (one of six) of the pins. Absorbable PLA screws stabilized Salter-Harris IV fractures as well as cannulated screws and better than PDS pins.
Asunto(s)
Clavos Ortopédicos , Tornillos Óseos , Fracturas del Fémur/cirugía , Fémur/cirugía , Fijación Interna de Fracturas/métodos , Ácido Láctico , Animales , Biodegradación Ambiental , Femenino , Fracturas del Fémur/patología , Fémur/patología , Cabras , Lactatos , Masculino , Polidioxanona , Poliésteres , Polímeros , Resistencia a la TracciónRESUMEN
We compared fibrin sealant, polydioxanone (PDS) pins and Kirschner wires in the fixation of osteochondral fractures in rabbit knees. Standardised osteochondral fractures of the right medial femoral condyle were made in 56 adult New Zealand white rabbits. There were equal groups of control knees, and those which had Kirschner-wire, fibrin-sealant or PDS-pin fixation. No external immobilisation was used. One animal from each group was killed at two, three and four weeks. The remaining rabbits were killed at six weeks. A fracture which healed with less than 1 mm of displacement was considered a success. There was successful healing in 29% of the control group, in all of the Kirschner-wire group, in 50% of the fibrin-sealant group, and in 86% of the PDS-pin group. The use of PDS pins appears to be a reliable alternative to the use of metal in the fixation of osteochondral fractures in rabbits.
Asunto(s)
Clavos Ortopédicos , Hilos Ortopédicos , Cartílago Articular/lesiones , Fracturas del Fémur/cirugía , Adhesivo de Tejido de Fibrina/uso terapéutico , Fijación Interna de Fracturas/métodos , Traumatismos de la Rodilla/cirugía , Polidioxanona , Animales , Cartílago Articular/patología , Cartílago Articular/cirugía , Estudios de Evaluación como Asunto , Femenino , Fracturas del Fémur/patología , Fijación Interna de Fracturas/instrumentación , Traumatismos de la Rodilla/patología , Masculino , Conejos , Cicatrización de HeridasRESUMEN
A 19-year-old man, who was involved in a motorcycle accident, sustained a combined bony and vascular injury to his right lower extremity that required emergency surgery. Postoperatively, the patient developed a life-threatening, necrotizing, soft-tissue infection and sepsis. Hyperbaric oxygen therapy was used with surgery and antibiotics to control this rapidly progressive infection and to limit the extent of debridement needed. It was found to reverse the patient's deteriorating status and to halt the progression of the necrotizing infection. The scientific evidence for the use of hyperbaric oxygen in such cases is discussed.