RESUMO
BACKGROUND: Infections that occur after the surgical management of pelvic fractures may involve potentially devastating complications. The broader approaches involving soft tissue dissection and a long operative time may increase the infection rate when compared with more conservative approaches. This incidence may be reduced with a better understanding of the approaches, lymph node sparing and antibiotic use. The purpose of this study is to assess the incidence and severity of local infections in a series of adult patients with pelvic ring lesions treated surgically. MATERIAL AND METHODS: This is a prospective observational descriptive study. A total of 49 patients operated on by a single surgeon from 2004 to 2008 were included. RESULTS: Forty-four patients (90%) had no signs of infection during the treatment period. In the remaining 5 cases (10%), 5 episodes of infection were documented. CONCLUSIONS: The identification of a local postoperative infection warrants an aggressive and urgent assessment of the patient. The devitalized tissue should be removed and empiric antibiotic therapy should be instituted after taking culture samples. A deep infection rate after pelvic fixation ranging from 0 to 10% has been published. The prevalence is higher among the surgical teams with less expertise. The incidence rate in our review was similar to the one reported in the literature.
Assuntos
Infecções Bacterianas/epidemiologia , Fraturas Ósseas/cirurgia , Ossos Pélvicos/lesões , Complicações Pós-Operatórias/epidemiologia , Adulto , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
BACKGROUND: Dislocation is one of the major complications after a total hip replacement and several treatment alternatives have been described for it. One of them is the use of restrained acetabular implants, which led us to conducting an analysis of the failures of this type of components implanted in our center, focusing on the association between relapsing dislocation and the malpositioning of the locking ring. MATERIAL AND METHODS: A total of 41 restrained components were implanted in 39 patients to treat the relapsing dislocation of total hip replacements. Mean postoperative follow-up was 24 months. The patients' demographics, the history of the causes for the dislocations and the treatment provided prior to the use of the restrained implant were all considered. The complications were also reviewed, with major ones being the revision rates and the re-dislocation of the prostheses and the acetabular insert locking ring, as well as the probable causes of failure of the antidislocation device. RESULTS: A total of 10 re-dislocations occurred during the follow-up; 70% of them in patients with malpositioning of the locking ring, with a statistically significant difference (p < 0.05). At the end of the follow-up period periacetabular radiolucent lines were seen in 9.09%. CONCLUSIONS: There are no papers in the literature that analyze the relation between malpositioning of the locking ring and repeated dislocations. The failure rate reported in our series was high. Restrained implants represent an alternative for relapsing dislocation, but they have to be very carefully placed.