An investigation was performed following two methicillin-resistant Staphylococcus aureus surgical-site infections in a 946-bed French general hospital. The investigation revealed that the outbreak involved 7 patients in 2 surgical wards and that infections were probably contracted in the operating theater from a healthcare worker suffering from chronic sinusitis.
We are reporting the one-year follow-up for a case of traumatic atlantoaxial dislocation associated with an odontoid fracture. This injury combination is rare and serious because of its resulting instability. After an unsuccessful attempt at closed reduction with traction, an open reduction with occipitocervical fixation was performed using a posterior approach. Based on our experience and a review of the published literature, the method for managing such an injury is discussed. If closed reduction with traction is successful, subsequent treatment is based on the algorithms for isolated odontoid fractures. If the closed reduction fails, surgical treatment consists of an open reduction using a posterior or lateral retropharyngeal approach, and then fixation of C1-C2, which is the key procedure.
Four cases of operated odontoid process fractures associated with a fracture of the posterior arch of the atlas are presented. Three types of surgery were performed: atlas-axis fusion, occipitocervical fusion, and odontoid process screw fixation. Based on a literature review and our experience, the therapeutic management is discussed according to the type of odontoid fracture and the presence of neurological involvement, with a reminder that wiring is not indicated when C1 posterior arch continuity is compromised.
Claw toe deformity after posterior leg compartment syndrome is rare but incapacitating. When the mechanism is flexor digitorum longus (FDL) shortening due to ischemic contracture of the muscle after posterior leg syndrome, a good treatment option is the Valtin procedure in which the flexor digitorum brevis (FDB) is transferred to the FDL after FDL tenotomy. The Valtin procedure reduces the deformity by lengthening and reactivating the FDL. Here, we report the outcomes of FDB to FDL transfer according to Valtin in 10 patients with posttraumatic claw toe deformity treated a mean of 34 months after the injury. Toe flexion was restored in all 10 patients, with no claw toe deformity even during dorsiflexion of the ankle.
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