is a frequent complication after open abdominal surgery. Prophylactic mesh implantation in the onlay or sublay position requires dissection of the abdominal wall, potentially leading to wound-associated complications. OBJECTIVE To compare the incidence of incisional hernia among patients after prophylactic intraperitoneal mesh implantation with that among patients after standard abdominal closure. DESIGN, SETTING, AND PARTICIPANTS An open-label randomized clinical trial was performed in 169 patients undergoing elective open abdominal surgery from January 1, 2011, to February 29, 2014. Follow-up examinations were performed 1 year and 3 years after surgery. The study was conducted at
Transient synovitis is the most common hip joint disorder in children. Perthes disease occurs around the same age and may not be distinguishable to an episode of transient synovitis in the early stage. Therefore all children in our clinic with transient synovitis underwent a follow-up X-ray 3 months later to detect Perthes disease at an early stage. The aim of the study was to evaluate, if a follow-up X-ray is necessary for all children with suspected transient synovitis or if the clinical follow-up can lead to the indication for a follow-up X-ray. Retrospective study including all children treated with the diagnosis of transient synovitis between 2004 and 2010. 198 patients with the diagnosis of a transient synovitis were included. We analyzed the radiological and clinical findings initially and after at least 3 month follow-up. In the time between the episode of transient synovitis and follow-up 20 children did not remain symptom-free (10.1%). Of these patients 16 had a normal radiological follow-up and 4 (2%) were diagnosed with Perthes disease. All children which remained symptom-free between the episode of transient synovitis and the follow-up had a negative follow-up X-ray (sensitivity 0.2, specifity 1.0). A follow-up X-ray in detection of Perthes disease for children with transient synovitis appears to be necessary only if they have recurrent or persisting symptoms in the clinical course between the episode of transient synovitis and the 3-months-follow-up. A good patient history and an expert clinical follow-up examination are mandatory to decide whether a follow-up X-ray is needed.
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