Embolismo aéreo tras limpieza del canal endomedular con sistema de lavado a presión de CO2 en fractura de cadera

Martínez, M.R. García; Ruiz, Gerley; Pérez, Joaquín; Pérez, Re.

doi:10.1016/j.redar.2012.07.017

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…So far, the pulsatile pressure cleaning are not exempt of complications, as there have been described the compartmental syndrome [13], pulmonary air embolisms [14], etc., while it has also been observed that these new technologies can reduce the risk of fat embolism and improve the performance of surgical debridement [15] by reducing the recurrent index of infections.…”

Section: Casementioning

confidence: 99%

Intramedullary Gas not Related to Infection

Barquiel¹

2017

J Musculoskelet Disord Treat

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The presence of gas in joints or soft tissues is usually indicative of infectious pathology or degenerative diseases [1]. However, the presence of gas inside the medullary canal in the diaphysis of long bones is an uncommon condition, and it is often associated with fractures or previous surgeries.We present the case of a 29-year-old man who suffered an open supraintercondylar femur fracture, treated with debridement, surgical scrub with saline solution, and stabilization by external fixator, and in a second stage with a definitive osteosynthesis, which after being washed with pressure gun presented abundant intramedullary gas non-related to infectious pathology but possibly related to a pulsatile jet lavage during surgery. CASE REPORTture; 2: articular simple, metaphyseal multifragmentary) supraintercondylar fracture of the right femur with Gustilo-Anderson type IIIA ( Figure 1A), and an AO34-C1 (3: femur; 4: patella; C: complete articular; 1: transverse) non-displaced fracture of the right patella. Extensive wound cleaning was immediately performed at the emergency department, with manual irrigation using saline solution, as well as debridement of the most superficial contaminant material and temporary approximation of the wound edges. According to our hospital open fracture protocol, intravenous antibiotherapy was initiated with cefuroxime 1 g every 8 hours for 3 days and gentamicine 240 mg every 24 h for 3 days.He was taken to the operation room where we conducted first an antegrade intramedullary nailing of the left femur with a Synthes Expert femoral nail, using a traction table. Secondly, on the right femur, we performed a resection of the wound edges according to Friederich, a debridement of the contaminating deep tissue and the fracture focus, manual wound cleaning with saline irrigation, and temporary fixation of the supracondylar fracture with an external fixator (Hoffman II, Synthes). Given the fact that the patella fracture was non-displaced, there were no more surgical procedures.Subsequently, a CT scan of the right knee was performed in order to complete the preoperative studies so we could make a good surgical planning ( Figure 1B), which did not show any intraosseous air bubbles. After CaseThe patient is a 29-year-old man with no history of interest, who was taken to our hospital on November 2015 approximately one hour after suffering a high energy traffic accident. He was a motorbike rider hit by a car riding at high speed. He was received at the emergency department where advanced life support measures were applied. After the stabilization of the patient, the body-CT showed contusive focus in both pulmonary bases, discarding other internal emerging lesions.In the radiological series, we identified an AO32-B2 (3: femur; 2: diaphyseal; B: with a wedge fragment; 2: bending wedge) fracture of the left femur, an open AO33-C2 (3: femur; 3: distal; C: complete articular frac-

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Section: Casementioning

confidence: 99%

Intramedullary Gas not Related to Infection

Barquiel¹

2017

J Musculoskelet Disord Treat

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Does Additive Pressurized Carbon Dioxide Lavage Improve Cement Penetration and Bond Strength in Cemented Arthroplasty?

Knappe

Stadler²,

Innmann

et al. 2021

JCM

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The modern cementing technique in cemented arthroplasty is a highly standardized and, therefore, safe procedure. Nevertheless, aseptic loosening is still the main reason for revision after cemented total knee or cemented total hip arthroplasty. To investigate whether an additional carbon dioxide lavage after a high-pressure pulsatile saline lavage has a positive effect on the bone–cement interface or cement penetration, we set up a standardized laboratory experiment with 28 human femoral heads. After a standardized cleaning procedure, the test implants were cemented onto the cancellous bone. Subsequently, the maximum failure load of the bone–cement interface was determined using a material testing machine to pull off the implant, and the cement penetration was determined using computed tomography. Neither the maximum failure load nor cement penetration into the cancellous bone revealed significant differences between the groups. In conclusion, according to our experiments, the additive use of the carbon dioxide lavage after the high-pressure pulsatile lavage has no additional benefit for the cleaning of the cancellous bone and, therefore, cannot be recommended without restrictions.

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Embolismo aéreo tras limpieza del canal endomedular con sistema de lavado a presión de CO2 en fractura de cadera

Cited by 2 publications

References 5 publications

Intramedullary Gas not Related to Infection

Intramedullary Gas not Related to Infection

Does Additive Pressurized Carbon Dioxide Lavage Improve Cement Penetration and Bond Strength in Cemented Arthroplasty?

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