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P Soete

Publications and source records attributed to P Soete.

16 recordsLinked to original sources
PubMed1993

[Treatment of trochanteric fractures of the femur using the gamma nail (apropos of a series of 92 cases)].

The authors treat inter- and subtrochanteric fractures with the Gamma nail. This device, which can be placed through the skin, immediately gives a stable internal fixation and offers possibilities of compression during and after surgery without any risk of head perforation. The authors discuss the results and complications of 92 operated cases reassessed after a delay of 6 to 28 months. The average age was 78 years, and 95% of the patients had been injured in home accidents. The surgical technique must be strict. Weight-bearing is complete 48 hours postoperatively, whatever the type of fracture, in 82% of the patients. Early standing postoperatively has allowed a definitive reduction in the general complications which are otherwise frequent in this type of fracture. The authors analyze the various complications they experienced during and after the surgery. Six complications during surgery have been noted and result from technical errors. These include 4 diaphyseal fractures, one case of reamer breakage and one case of drill breakage. Thirteen complications occurred after surgery: 3 diaphyseal fractures, 3 loose screws, one pseudarthrosis and 6 painful diaphyses. The authors also noted that painful diaphysis occurs when the cervical diaphysis angle of the nail is greater than 130 degrees.

Adult↗
PubMed1992

[Aseptic necrosis of the femoral head following renal transplantation: assessment of a 25-year experience].

From June 1963 to December 1988 aseptic necrosis of the femoral head has been treated surgically in 84 renal transplant recipients (150 surgical procedures). The long-term results of drilling of the neck and head of the femur (16), cup arthroplasty (32), cemented cup (1) and hemiarthroplasty (8) were unsatisfactory, as 23 of these 57 hips underwent a secondary procedure. Total hip arthroplasty progressively became the standard procedure for treatment of hip disease in transplanted patients. Since 1971, 63 renal transplant recipients underwent 92 cemented total hip replacement (THR) as a primary (73), secondary (16) or third (3) surgical procedure for severely symptomatic femoral head necrosis. Hospital stay averaged 22 days, and follow-up averaged 53 months. Two deaths related to the surgical procedure occurred in the first 4 years of our experience (one major local sepsis, one pulmonary infection). Other postoperative complications were urinary tract infection (12), pulmonary infection 1, transient sciatic nerve irritation (3), wound hematoma (6), reversible deterioration of renal function (3) and rejection of the graft (2). Thromboembolic complications did not occur. All operated hips showed a marked symptomatic improvement. Loosening of one or both components was definite in one, probable in two and possible in three of the 33 hips followed up more than 5 years. Other late complications included dislocation (6), painful class III heterotopic ossification (4), recurrence of previous sepsis (1) and late hematogenous sepsis. Late hip revision was required in 5 cases (recurrent dislocation, 1, ossification, 2, sepsis, 2). Two renal complications (one graft infarction and one reversible acute tubular necrosis) occurred after these revisions. The functional results of THR compare favourably with the results of other surgical procedures used in our early experience. We conclude that THR has become the treatment of choice for symptomatic established osteonecrosis of the femoral head in renal transplant patients. A relatively high rate of early and late complications is nevertheless to be expected.

Adolescent↗