RESUMO
We evaluated the results of transfer of the tibialis anterior in the management of calcaneus deformity in young patients who had myelodysplasia; fifteen patients (twenty-two feet) were operated on between 1978 and 1985. The neural deficit was at the fourth and fifth lumbar levels. The average age at the time of the operation was seven years and two months (range, two to nineteen years). The average age at the latest follow-up was thirteen years (range, five to twenty-four years). The average duration of follow-up was five years and ten months (range, two to eleven years). Seventeen feet (twelve patients) had a good result (no ulceration of the heel or osteomyelitis and correction of the calcaneus deformity), and five feet (three patients) had a poor result (persistent ulceration, signs of osteomyelitis, recurrent or persistent calcaneus deformity, or the need for additional operative intervention). Children who were less than five years old had a better outcome, as determined by the Fisher exact test (p less than 0.5).
Assuntos
Calcâneo/anormalidades , Calcâneo/cirurgia , Defeitos do Tubo Neural/complicações , Transferência Tendinosa/métodos , Adolescente , Criança , Pré-Escolar , Seguimentos , Humanos , Satisfação do Paciente , Resultado do TratamentoRESUMO
This study reviews the medical records of 29 patients that were submitted to 29 spinal fusion procedures with the purpose to evaluates the efficacy of using predeposited autologous blood transfusions to replace operative blood loss. The patients age ranged from 8 to 25 years. Each patient was started on oral iron supplement as soon as surgery was scheduled. The phlebotomies were performed at the American Red Cross Blood Services Puerto Rico Chapter. Blood was drawn 1 unit every 6 days if the hematocrit was above 34%. The last phlebotomy was performed at least 7 days before surgery. The average amount of blood donated was 3.17 units (1,427 ml). The whole blood was stored using the adenine saline solution (ADSOL) as preservative for as long as 35 days. The average preoperative hematocrit value was 35%. In 89% of the cases only autologous blood was transfused. In the rest of the cases family donated homologous blood was required. The use of pre deposited autologous blood for replacement of operative blood loss has proven to be a safe, easy and well accepted method for the pediatric age patients. It also reduced the need for homologous blood and helps to increase the blood reserve at banks.