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Biomedical subjects

S Suso

Publications and source records attributed to S Suso.

At least 19 recordsLinked to original sources

Treatment of acute post-surgical infection of joint arthroplasty.

The best antibiotic regimen for acute prosthetic joint infection, treated without removal of the implant, has not been well-defined. This study describes the use of a protocol based on oral rifampicin combinations to treat 47 cases that were followed prospectively for a 2-year period. The regimen used most commonly was levofloxacin 500 mg/24 h plus rifampicin 600 mg/24 h for a mean duration of 2.7 +/- 1 months. The cure rate was 76.9%, and the only independent risk-factor associated with treatment failure was infection caused by methicillin-resistant Staphylococcus aureus or Enterococcus spp. (OR 17.6, p 0.003). Overall, the results suggested that use of oral antibiotics, including rifampicin, for 2-3 months was a good treatment option.

Acute Disease↗

Arthrodesis of the talonavicular-cuneiform joints in Müller-Weiss disease.

Several surgical treatments have been proposed to correct the deformity associated with MWD and alleviate the pain; however, no technique can be named the gold standard. TNC arthrodesis is a safe and effective technique for the treatment of the MWD and can be performed with a dorsal or medial approach;we recommend the dorsal approach. We believe that autologous bone graft provides sufficient stability and internal fixation is not needed. Treatment of MWD is not well-documented in literature; more studies are needed to determine the optimum surgical treatment for this rare disease.

Arthrodesis↗

Allograft reconstruction of the distal humerus after resection of a breast solitary metastasis: eleven years follow-up.

Resection is a rare indication for the treatment of solitary skeletal metastasis (SSM), and provides an opportunity to cure the oncologic patient. Reconstruction after resection can imply a difficult problem depending on the size and the location of the metastasis. In the reported case, an en-bloc resection of a SSM of a breast cancer located in the distal humerus was performed in 1990. Reconstruction of the osteoarticular defect has been achieved with a massive allograft. At eleven years follow-up the patient remains free of illness and shows a good functional result. With the result obtained in the reported case, we suggest that osteoarticular allograft can be of considerable value for reconstruction after excision of SSM in the distal humerus, and that cure can be achieved with the radical resection of a SSM of breast cancer.

Journal Article↗

[Spinal tuberculosis: early surgical treatment combined with medical treatment].

BACKGROUND: Spinal tuberculosis can produce kyphosis with neurologicaldeficit, despite antibiotic treatment. When there is no response to medical treatment, the recommended procedure is debridementand interbody fusion with bone autograft. The biological characteristicsof Mycobacterium tuberculosis do not prevent osteosynthesisof the infected bone from being performed. PATIENTS AND METHOD: Five patients with spinal tuberculosis and neurological deficitunderwent debridement, interbody fusion and anterior osteosynthesisin addition to medical treatment. In order to ensure stability, posterior fusion was also performed in three patients. All 5 patientsdisplayed weakness and paralysis of their lower extremities, two patients suffered an L4 radiculopathy, one developed paraparesiaand one was excluded due to a short follow-up. Mean value of vertebralkyphosis was 22,8 degrees and mean follow-up was 3,1 years. RESULTS: No patient had septic loosening or progression of the disease. Correction of kyphosis was 104,5% postoperatively and 80,5% atthe end of follow-up. All patients, apart from one with an L4radiculopathy, exhibited neurological recovery. CONCLUSIONS: Anterior instrumentation allows spinal decompression, septic focusdebridement, deformity correction and autologous bone grafting. In severe kyphotic flattening, it is advisable to associate alimited posterior arthrodesis. When pathological fractures appearor there is no response to antibiotic treatment, the combinationof medical and surgical treatment improves patients' outcome.

Adult↗

The use of proximal femoral allografts in revision total hip arthroplasty.

The implant of a proximal femoral structural allograft is one of the possibilities to restore circumferential defects of multiply revised total hip arthroplasties. A review of 7 patients who underwent proximal femoral reconstruction with an allograft-prosthesis composite to restore bone loss in revision hip replacements is presented. The average follow-up period was 50.2 months. Two patients developed an infection and in one case an instability of the prosthesis appeared. Incorporation in the remaining 5 cases was/achieved in an average period of 8.2 months. Neither fractures nor high rate of resorption appeared in our series. The majority of patients have improved in the functional assessment. Despite the rate of complications, structural femoral allografts can be used with success in this difficult challenge of reconstructing major segmental bone loss of the proximal femur in revision hip surgery.

Arthroplasty, Replacement, Hip↗

The procurement team as a factor of bone allograft contamination.

We studied the effect of the procurement team on the risk of contamination in 270 large bone allografts retrieved from 53 non-living donors under strictly aseptic conditions.The overall contamination rate was 8.1%. When the procurement team was constituted by three or less members the contamination rate was 5.6%, while if there were four or more members the rate was 12.9%; this difference was significant in the statistical analysis.We conclude that a procurement team constituted by three or less trained members is a determinant factor in decreasing the bacterial contamination rate of bone allografts.

Journal Article↗

Use of bone allograft in tibial plateau fractures.

To determine the behaviour of bone allografts in the treatment of tibial plateau fractures, 20 recipients of frozen bone allograft for a depressed tibial plateau fracture were studied. Incorporation of grafts took place in all cases, and no complication secondary to the allograft use has been detected. To avoid donor site morbidity associated with harvesting iliac crest, the use of frozen bone allograft is a good alternative in the treatment of depressed tibial plateau fractures.

Adult↗

Bone allograft contamination in multiorgan and tissue donors.

Multiorgan and tissue donors offer a larger quantity and high quality of bone allograft that cannot be obtained from living donors. The risk of bone contamination must be borne in mind if secondary sterilization is not performed. The bacteriological cultures of 270 bone segments obtained from 53 multiorgan or tissue donors were analysed to study the relationship between previous organ and tissue procurements and bone retrieval contamination. We concluded that no significant differences in bacterial contamination percentage were found for each type of previous organ and tissue procurement, nor in the number of teams per donor.

Animals↗

Periosteal chondroma of the clavicle.

We report a case of periosteal chondroma of the clavicle. To our knowledge, this benign cartilaginous tumor has never been previously reported in this location. Clinical, radiographic and pathological investigations were necessary to establish the diagnosis. Marginal excision proved an effective treatment.

Adolescent↗

Wrist denervation. Anatomical considerations.

In 1966, Wilhelm published a technique of denervation of the wrist joint based on his own anatomical studies of 1958. Other authors have published their experience in wrist denervations with similar results, but there are some discrepancies in descriptions of the innervation of the wrist. We have studied the innervation of the wrist by dissection under magnification on 20 cadaver limbs and by histological examination of five human foetal wrists. Based in our anatomical findings, we have demonstrated that Wilhelm's technique does not achieve total denervation of the wrist.

Cadaver↗

Wrist denervation. Surgical considerations.

We have analyzed the results of 22 total wrist denervations following Wilhelm's technique and a series of 30 patients treated with denervation of the posterior interosseous nerve alone. Results of denervation have been classified depending on the pain (visual analogue scale) as other parameters (mobility and strength) have not been found to have any statistical significance. Results after partial denervation are worse than results achieved by total denervation.

Adult↗

Pubic osteolysis simulating a malignant lesion: case report.

A case of posttraumatic osteolysis of the pubic bone simulating a malignant lesion in a 55-year-old woman is reported. A review of the literature revealed that all reported cases occurred in post-menopausal women, associated with radiologic evidence of osteoporosis and a history of slight trauma. Biopsy was performed because of the possible malignant nature of the lesion, which should be suspected in all post-menopausal women with a destructive lesion of the pubic bone.

Accidental Falls↗

Comminuted intra-articular fractures of the distal end of the radius treated with the Hoffmann external fixator.

In 1985 we began a prospective study of the use of external fixation in the treatment of intra-articular comminuted fractures of the distal end of the radius. A total of 30 patients have been treated by this method, representing 1.3% of the total number of patients treated in the Emergency Unit for a fracture of the distal epiphysis of the radius. The use of external fixation in instable fractures of the distal end of the radius improves the anatomic results. These correlate closely with the overall functional results obtained, which were excellent or good in 82.1% of cases, according to the rating system of Gartland and Werley. The main indications are fractures with a high degree of comminution, displacement, and articular affectation (unstable fractures) in young patients, corresponding to Frykman grades VII and VIII.

Adult↗