131/187. Hazards of retained third molars in older persons: report of 15 cases. A total of 15 representative cases of retained embedded third molars in persons older than 40 years are presented. Surgical difficulties and postsurgical complications and morbidity that occurred would have been greatly reduced if these teeth been removed earlier in life. ( info) |
132/187. Microvascular osteocutaneous groin flap in the treatment of an ununited tibial fracture with chronic osteitis. A case report. A 37-year-old man with an ununited tibial fracture combined with a significant skin defect underwent a microvascular transfer of an island osteocutaneous flap of groin skin and iliac crest bone. The bone component of the flap was shown to be a living transplant by the observation of brisk cancellous bone bleeding when the flap was isolated on its vascular stalk; by rapid fracture healing (weight-bearing 15 weeks postoperatively); and sequential bone scan investigations. Various aspects of the flap blood supply, particularly to bone, are discussed, and reference is made to the use of a more suitable vessel system. ( info) |
| A six-part scheme for the treatment of osteitis complicating tibial fractures is presented: (1) wound excision; (2) external fixation; (3) open irrigation drainage; (4) cancellous bone grafting; (5) split skin grafting; (6) full weight bearing in a plaster cast. Of 20 cases, 14 of which were ununited, remission of the infection was achieved in 17 with in 27 months (mean 10.8 months). All 14 ununited fractures went on to union within 20 months (mean 9.5 months). ( info) |
134/187. osteomyelitis of the symphysis pubis: a separate disease from osteitis pubis. Report of three cases and review of the literature. We reviewed the case of three of our own patients who had osteomyelitis of the symphysis pubis, as well as those of twenty-five patients described in the literature. The early symptoms of osteomyelitis of the symphysis mimic those of osteitis pubis. osteomyelitis almost invariably is preceded by urological or gynecological surgery (often when a technical complication has occurred), and does not respond to shortterm antibiotic treatment. Characteristic radiographic findings develop. osteomyelitis of the symphysis pubis should be treated by debridement and curettage, together with long-term treatment with an appropriately high dose of antibiotics. ( info) |
135/187. The treatment of osteitis pubis with heparin. We treated 7 patients with osteitis pubis by heparinization. Of the 7 patients 2 had a dramatic improvement. Small doses of heparin given routinely preoperatively and postoperatively were not found to prevent the development of osteitis pubis. In view of these results as well as the fact that there presently is no effective method of treatment of this disorder, it is considered justifiable to subject all patients with postoperative osteitis pubis to a therapeutic trial with heparinization. ( info) |
136/187. osteitis pubis: treatment by heparinisation. Three cases of osteitis pubis following prostatectomy, herniorrhaphy and combined prostatectomy and herniorrhaphy are presented. Each case was successfully treated by intravenous heparin after other treatments had failed. ( info) |
137/187. Ghost infantile vertebrae and hemipelves within adult skeleton from thorotrast administration in childhood. In 2 adults who had received thorotrast intravenously at ages 2 and 3 years, respectively, radiopaque outlines of their infantile vertebrae were seen in the adult vertebrae. Similar "ghosts" of the hemipelves were present in the pelvis of 1 patient. autopsy findings and autoradiographs in 1 patient strongly suggest that persisting thorotrast deposits in the infantile vertebrae and pelvis have produced a chronic radiation osteitis and dense thickened bone trabeculae, which are more radiopaque than the surrounding adult bone. ( info) |
138/187. osteitis pubis: an unusual complication of herniorrhaphy. osteitis pubis is a well known complication of urologic and gynecologic procedures but its association with herniorrhaphy is poorly documented in the literature. A 55-year-old man underwent herniorrhaphy for a direct inguinal hernia, followed in 48 hours by herniorrhaphy for a femoral hernia. One week later he complained of pain in the pubic area and over the ischial tuberosities, had intermittent fever and an elevated erythrocyte sedimentation rate. Roentgenograms showed changes typical of osteitis pubis with widening of the symphysis pubis, loss of definition of the adjacent cortical surfaces and involvement of the ischial tuberosities. There ws no evidence of infection in the urinary tract or elsewhere. The patient was treated with indomethacin and showed clinical and radiologic improvement over the next 6 months. It is possible that in this case two operative interventions involving structures inserting into the pubic bones and performed within a short time of each other exposed this patient to an unusual complication. ( info) |
| pasteurella multocida is often found in local infections after animal bites. Septic conditions however are rare. A case of late infection by P. multocida at the site of the osteosynthesis 1 year after a primarily healed pertrochanteric fracture is described. The patient had a cat. After extraction of the plate and screws and treatment with penicillin the infection healed uneventfully. ( info) |
140/187. Infectious osteitis pubis. osteitis pubis is a well-recognized painful inflammation involving the structures of the anterior half of the pelvic girdle, but its cause remains controversial. biopsy and culture of the pubic bone in 3 patients with osteitis pubis after implantation of a urinary anti-incontinence device were consistent with pubic osteomyelitis which responded to antibiotic therapy. infection was also found in almost all previously reported cases of osteitis pubis subjected to similar biopsy and culture. Bone biopsy and culture should be strongly considered before initiating frequently unsuccessful empirical therapy in patients with osteitis pubis. ( info) |