RESUMO
We analyzed 37 patients who underwent segmental wide resection of bone tumors and reconstruction with a modular titanium endoprosthesis at the Orthopaedic Oncology Group, between 1992 and 1998. Twelve patients were male and 25 were female, with a mean age of 30 years (9 - 81). The mean follow-up was 14 months (2 - 48). The diagnoses were: osteosarcoma (14 cases), metastatic carcinoma (10), Ewing's sarcoma (4), giant cell tumor (4), malignant fibrous histiocytoma (3), chondrosarcoma (1), and aneurysmal bone cyst (1). Eleven articulated total knee, 8 partial proximal femur with bipolar acetabulum, 8 partial proximal humerus, 3 total femur, 2 partial proximal tibia, 2 diaphyseal femur, 2 diaphyseal humerus, and 1 total proximal femur with cementless acetabulum endoprosthesis implant procedures were done. The complications related to the procedure included: infection (5 cases), dislocation (3), module loosening (1), and ulnar nerve paresthesia (1). We used the following criteria for the clinical evaluation: presence of pain, range of motion, reconstruction stability, surgical and oncologic complications, and patient acceptance. The results were good in 56.8% of the cases, regular in 32.4% and poor in 10.8%.
Assuntos
Neoplasias Ósseas/cirurgia , Implantação de Prótese/instrumentação , Titânio , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese/métodos , Resultado do TratamentoRESUMO
The authors analyze the randomized use of three ankle arthrodesis techniques. Indications for this procedure, which are pain, instability, deformity and articular degeneration, are common to the three groups. In group I the Gatellier-Adams technique was used by transfibular approach. In group II the Kenneth-Johnson technique was adopted, using Calandruccio external fixator. The same surgical procedure was adopted in group III, using crossed canulated screws as fixation device. The specific advantages and disadvantages of each method are discussed. The criteria for evaluation of the results are the final roentgenographic position of the foot and the achievement of union. The critical analysis conclude that the major indications for group I technique are cases of "in situ" arthrodesis, for group II infected cases and for group III cases with severe malalignment.
Assuntos
Articulação do Tornozelo/cirurgia , Artrodese/métodos , Adolescente , Adulto , Idoso , Articulação do Tornozelo/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos RetrospectivosRESUMO
A antibioticoterapia profilatica pode ser eficiente se o farmaco se espalhar adequadamente nos tecidos da ferida cirurgica, no momento da operacao. Para lograr tal objetivo basta utilizar o antibiotico durante as 24 horas pos-operatorias, em doses elevadas e por via parenteral. O esquema utilizado nesta investigacao (penicilina sintetica aplicada por via intramuscular, na sala de operacoes e nas primeiras 24 horas, seguida da administracao, por vi oral, durante 5-7 dias) nao exerce o efeito buscado de impedir infeccao.Com efeito, a incidencia de infeccao no grupo estudado e, em outro, controle, foi semelhante, sem diferenca significativa