Patients undergoing endoprosthetic replacement for various orthopedic oncologic conditions have high infection rates. The present study allows early identification of such patients in view of the high morbidity associated with this condition. This report also highlights the high rate of multi-drug-resistant infections, especially methicillin-resistant strains of S. aureus and CoNS encountered, which complicates further the management of these patients.
Background. Periacetabular resections with reconstruction has high rates of complications due to the complexity of the reconstruction. We have improvised a novel technique of reconstruction for type II and type II + III pelvic resections with the use of a commercially available acetabulum reconstruction cage (gap II, Stryker) and threaded rods. Objectives. The aim of our study is to determine the biomechanical strength of our reconstruction compared to the traditional cemented total hip replacement (THR) designs in normal acetabulum and establish its mode of failure. Methods. Five sets of hemipelvises were biomechanically tested (Instron® 3848, MA, USA). These constructs were subjected to cyclic loading and load to failure. Results. The reconstructed acetabulum was stiffer and required a higher load to failure compared to the intact pelvis with a standard THR. The mean stiffness of the reconstructed pelvis was 1738.6 ± 200.3 Nmm−1 compared to the intact pelvis, which was 911.4 ± 172.7 Nmm−1 (P value = 0.01). The mean load to failure for the standard acetabular cup construct was 3297.3 ± 117.7 N while that of the reconstructed pelvis with the acetabulum cage and threaded rods was 4863.8 ± 7.0 N. Conclusion. Reconstruction of the pelvis with an acetabular reconstruction cage and threaded rods is a biomechanical viable option.
A study aims to evaluate the timing of close surgical treatment in supracondylar humeral fractures in pediatric patients and to know the radiological outcome of its management, through measuring the mean delay per hour and assessing post-surgical radiological outcome for reduction. A cross- sectional hospitals based study carried out in Khartoum state, through randomized cluster sampling, both data sheets and pre/post-surgical images were filled and collected. A well-constructed criteria were developed to assess the radiological outcome. With sample size of 41 cases, we found that the mean delay from trauma to surgery was 99 hours [SE, 13], equivalent to 4.13 days. The reduction outcome criterion was significant when comparing it with the surgeon level P value of 0.015, but when comparing it with the delay more than 32 hours and Gartland classification both weren’t significant with P values of 0.383 and 0.501 respectively. These results are refuting the current concepts about the impossible reduction after a delay more than 32 hours and filled the current gap of knowledge about the outcome of supracondylar humeral fractures Gartland III with delayed presentation.
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