Precautions and measures taken in the wards limited the spread and dissemination of the isolates as demonstrated by the heterogeneity and the absence of predominant clones. These findings further reiterate the value of the low-cost, standard preventive procedures to control nosocomial infections in a high-risk orthopaedic department.
The cause was RTA in 13 pts, accident at work in six and in one patient the result of a reconstruction osteotomy and external fixation. The opening of the compartments was done in nine pts but in two of them we caught the condition at an early stage on time. The consequences were a dropped foot in 13 pts, a club foot in two pts, cavus foot in eight pts, clawing of toes in 13 pts, ankle stiffness in six pts, plantar numbness anaesthesia in 12 pts, plantar callosities in five pts and chronic infections in eight pts. The number of reconstructive operations was from one to ten with a hospitalization duration from one month to five years. Only two pts were able to work an easy job and two pts went back to their previous job, those in whom we had opened the compartments in time. In one pts an amputation below the knee was done. The rest of the pts are unemployed or work as assistant.
We evaluated the clinical outcome of IM nailing for the treatment of femoral shaft pseudarthrosis in patients who had multiple failed plate osteosyntheses. From January 2000 untill April 2001, 20 (19 male-1 female, mean age 28) patients were treated because of femoral shaft non-union in our institution. All patients had two or more failed plate osteosyntheses. There were no septic non-unions in this group. Eight patients had an established non-union on an average of nine months post-op and the remaining eleven had radiological and clinical evidence of implant failure. There was no segmental bone loss, hi all patients the implants were removed and nailing was performed. Extensive periosteal stripping, bone necrosis and soft-tissue scaring were constant findings in all patients. Twelve patients received interlocking nails. Eight femurs were grafted with iliac crest bone graft. All patients were followed by serial x-rays until union. There were no postoperative complications. All pseudarthroses were healed within an average of 9.7 months (8–12). Non-unions which received bone graft (eight out of twenty) in day one, were healed faster than those which didn’t. There were no re-operations among these patients. Among the remaining ten patients five were grafted five to six months postoperatively and three had had nail dynamization. IM nailing for femoral shaft non-unions after multiple failed plate osteosyntheses is a safe and effective method of treatment. Autologous bone graft reduces healing time and re-operation rate.