The Ilizarov technique is a good salvage operation for infected nonunion of the femur. Limb salvage is preferable to prosthesis if the limb is viable, adequately innervated and the patient is mentally and financially committed to save the limb.
Short-lasting surgery, single anaesthesia, reduced morbidity and hospital stay as well as costs, an early return to function, high patient satisfaction rate with encouraging results justify single-stage surgery in TSS. Age, blood loss and duration of surgery decide the complication rate and outcome of surgery. Staged surgery is recommended in patients above the age of 60 years.
Careful history taking and examination will help us to identify each condition clinically and appropriate management can be instituted for the well-being of the mother and the fetus.
This study reviews the presentation, etiology, imaging characteristics and reasons for missed diagnosis of Andersson lesion (AL) and analyzes the surgical results of short segment fixation in the thoracolumbar region. This is a retrospective single center study. Fourteen patients (15 lesions) who were operated for AL were analyzed. The study was designed in two parts. The first part consisted of analysis of clinical and radiological features (MRI and radiographs) to highlight, whether definitive characteristics exist. The second part consisted of analysis of outcome of short segment fixation as measured by VAS, Frankel score, AsQoL index, and union, with assessment of complications. The follow-up was 42.33 ± 19.29 months (13 males and 1 female) with a mean age of 61.13 ± 19.74 years. There was predisposing trauma in five patients. There was a delay in presentation of the patients by 5.86 ± 2.50 months. There was misdiagnosis in all the cases, at primary orthopedic level (ten cases were put on anti-tuberculous treatment due to its MRI resemblance to infection) and all but one case at radiologist level. Radiographs and MRI had characteristic features in all cases, and MRI could detect posterior element affection in 14 lesions as against only 8 posterior lesions detected in radiographs. In all patients, there was a patient's delay and/or physician's delay to arrive at a diagnosis. Spinal fusion was seen in all the cases. Outcome measures of VAS, Frankel score, and AsQoL index showed significant improvement (P \ 0.002). No major complications occurred. There is a lack of awareness of AL leading to misdiagnosis. Definite clinico-radiological features do exist in AL and short segment fixation is effective.
In Buerger's disease conservative treatment is questionable. Arterial reconstructive surgery is not feasible and sympathectomy has limited role. Progression of the disease invariably leads to amputation. Ilizarov's method increases the vascularity of the ischaemic limb. Retrospective analysis of Ilizarov's technique in 60 patients was done. Immediate results took into account rest pain, colour of skin, venous return, temperature, pulse oxymeter measured oxygen saturation and ulcer/amputation stump wound healing. Early and late results took into account rest pain, healing of ulcers/amputation stump with or without plastic coverage, claudication distance, resumption of previous occupation and domestic ambulation. The mean follow up of patients was 63 months. Immediate results were promising except two amputations. Early result were excellent to good in 56 and late results were excellent to good in 48 patients. Deterioration had significant correlation with smoking. Ilizarov's method is an excellent and cheap procedure in treatment of Buerger's disease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.