RESUMEN
The morbidity of bone graft harvesting from the iliac crest has been widely discussed in the literature. For some authors, it is considered to be low and for others relatively high. We report on a case of a fracture of the iliac wing after graft harvesting from the anterior iliac crest despite good surgical technique. This complication is well known and most of these fractures heal uneventfully if treated conservatively. However, if anatomical and technical considerations are respected, the patient could be spared this inconvenience. Based on a literature review, we discuss the procedure's potential complications and how to avoid them in an update.
Asunto(s)
Trasplante Óseo/métodos , Fijación de Fractura/métodos , Fracturas Óseas/cirugía , Ilion/lesiones , Ilion/trasplante , Recolección de Tejidos y Órganos/métodos , Anciano , Femenino , Estudios de Seguimiento , Curación de Fractura , Fracturas Óseas/diagnóstico por imagen , Humanos , RadiografíaRESUMEN
Isolated avulsion fracture of the peroneus longus tendon insertion at the base of the first metatarsal is very rare. Similar to most avulsion fractures that result from excessive strain at a tendon or ligament insertion, this type of injury is caused by the strong tension exerted by the peroneus longus tendon. The mechanisms leading to this lesion and treatment options are not clearly defined. We present the case of an isolated minimally displaced intra-articular avulsion fracture at the plantar lateral base of the first metatarsal. Faced with a painful non-union following conservative treatment we considered excision of the bony fragment and first tarsometatarsal arthrodesis. This leads to a favourable functional outcome.
Asunto(s)
Fracturas Intraarticulares/diagnóstico , Huesos Metatarsianos/lesiones , Traumatismos de los Tendones/diagnóstico , Adulto , Femenino , Humanos , Fracturas Intraarticulares/cirugía , Imagen por Resonancia Magnética , Huesos Metatarsianos/cirugía , Traumatismos de los Tendones/cirugía , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
We present a case of a to our knowledge never described before combination of a displaced ulnar head--with an undisplaced radial neck fracture associated with a clinical instability of the distal radioulnar joint (DRUJ). We discuss the management of our atypical case and review the literature.
Asunto(s)
Lesiones de Codo , Fijación Interna de Fracturas/métodos , Fracturas Intraarticulares/cirugía , Inestabilidad de la Articulación/cirugía , Fracturas del Radio/cirugía , Fracturas del Cúbito/cirugía , Traumatismos de la Muñeca/cirugía , Articulación del Codo/diagnóstico por imagen , Articulación del Codo/cirugía , Curación de Fractura/fisiología , Humanos , Fracturas Intraarticulares/diagnóstico por imagen , Inestabilidad de la Articulación/diagnóstico por imagen , Masculino , Traumatismo Múltiple/diagnóstico por imagen , Traumatismo Múltiple/cirugía , Complicaciones Posoperatorias/diagnóstico por imagen , Radiografía , Fracturas del Radio/diagnóstico por imagen , Fracturas del Cúbito/diagnóstico por imagen , Traumatismos de la Muñeca/diagnóstico por imagen , Adulto JovenRESUMEN
We report the direct measurement of the nonadiabatic component of the spin torque in domain walls. Our method is independent of both the pinning of the domain wall in the wire as well as of the Gilbert damping parameter. We demonstrate that the ratio between the nonadiabatic and the adiabatic components can be as high as 1, and explain this high value by the importance of the spin-flip rate to the nonadiabatic torque. In addition to their fundamental significance these results open the way for applications by demonstrating a significant increase of the spin torque efficiency.
Asunto(s)
Coagulantes/uso terapéutico , Factor VIII/uso terapéutico , Hemofilia A/complicaciones , Osificación Heterotópica/complicaciones , Heridas no Penetrantes/complicaciones , Adulto , Hematoma/etiología , Articulación de la Cadera , Humanos , Imagen por Resonancia Magnética , Masculino , Músculo Esquelético/lesiones , Osificación Heterotópica/diagnóstico por imagen , Dolor/tratamiento farmacológico , Dolor/etiología , Pelvis , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Laparoscopy is used increasingly for the management of acute abdominal conditions. For many years, previous abdominal surgery and intestinal obstruction have been regarded as contraindications to laparoscopy because there is an increased risk of iatrogenic bowel perforation. The role of laparoscopy in acute small bowel obstruction remains unclear. METHODS: Since 1995, data from patients undergoing laparoscopic surgery have been entered prospectively into a database. Patients who underwent surgery before 1995 were added retrospectively to the same database. The charts of all patients treated surgically for mechanical small bowel obstruction were reviewed. Univariate analysis was performed to identify factors associated with success or failure, especially intraoperative complications, conversion, and postoperative morbidity. Stepwise logistic regression was used to assess for independent variables. RESULTS: This study included 83 patients (56 women and 27 men) with a mean age of 56 years (range, 17-91 years). Conversion was necessary in 36 cases (43%). Laparoscopy alone was successful in 47 patients (57%). Intraoperative complications were noted in 16% and postoperative complications in 31% of the patients. Eight reoperations (9%) were necessary. Mortality was 2.4%. Duration of surgery (p < 0.001) and a bowel diameter exceeding 4 cm (p = 0. 02) were predictors of conversion. No risk factor for intraoperative complication was identified. Accidental bowel perforation (p = 0. 008) and the need for conversion (p = 0.009) were the only independent factors associated with an increased risk of postoperative complications. CONCLUSIONS: Laparoscopic management of small bowel obstruction is possible in roughly 60% of the patients selected for this approach. Morbidity is lower, resumption of a normal diet is faster, and hospital stay is shorter than with patients requiring conversion. No clear predictor of success or failure was identified, but intraoperative complications must be avoided. If the surgeon is widely experienced in advanced laparoscopic surgery and there is a liberal conversion policy, laparoscopy is a valuable alternative to conventional surgery in the management of acute small bowel obstruction.