The prosthetic episodes, i.e. actual processes of provision, identifying number of prostheses, their maintenance, repairs and replacements were analysed for 104 trans-tibial amputees aged 16 and over, over a 10 year period. The purpose of this investigation was to identify how frequently a new prosthesis is actually required for this group of amputees and what are their maintenance requirements. Variations of requirement between the amputee groups of aged 16–60 and over 60 years are also addressed. In the 10 years period of the study the amputees needed an average of 5.04 new prostheses, 6.25 refits, 2.28 major repairs and 17.04 day repairs. The younger amputees, i.e. below the age of 60 years, required significantly more new prostheses (p=0.003), more refit of sockets (p=0.0012) and more day repairs (p=0.01). Traumatic amputees below the age of 60 years needed significantly more day repairs compared to the non-traumatic amputees in the older age group (p=0.003).
Gas gangrene, though relatively common in the extremities is a relatively rare affliction of the head and neck. However, they warrant prompt recognition and immediate treatment because of their potential risk of rapid spread to the deep neck spaces, thrombophlebitis, mediastinitis and cardiac tampanode. They have been classified based on the causative organism as non clostridial and those due to clostridial perfringens anaerobic gram positive bacilli. Herein we report a case of gas gangrene of the neck and mediastinum in a poorly managed Type II diabetic with concomitant odontogenic infection. Despite the burden of co-morbidities and the gravity of the illness, the patient was successfully treated and remained free of complications in the long term.
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