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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 315 - 315
1 Sep 2012
Pemoff A Alegri C Sicardi M Blanchetiere H Balan S Gitard M Douglas Price A Caviglia H
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INTRODUCTION

Musicians' hand problems are as old as music itself. These problems involve functional motor disorders which have been underestimated by musicians, who do not want to accept the possibility of reducing their professional activity and doctors who are either not knowledgeable about musicians' characteristics or underestimate this artistic activity.

The aim of this study is to determine the causes of the pathologies instrumentalist musicians have, and their distribution according to age group, instrument and type of music, and thus infer the main risk factors in the occurrence of medical problems related to musicians' activity.

MATERIALS AND METHODS

We consider musicians those who devote themselves to the study, teaching and playing of a musical instrument. In Argentina there are about 50.000 instrumental musicians.

Since over 14 years the members of “Las Manos del Músico” have treated 574 musicians. The 84% of the medical problems related to the playing of the instrument. Ages are between 13 and 78 years.

The musicians treated belong to different conservatories, symphonic and popular orchestras. Each musician was studied with the same protocol, filled in by the same professional.

Variables such as type of music, age, sex, instrument, dominance andrelated variables were taken into account.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 42 - 42
1 Sep 2012
Douglas Price A Cuestas N Cambiaggi G Vazquez M Caviglia H
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Objective

To assess the beneficial use of polypropylene mesh impregnated with vancomycin in an experimental model open fractures Gustilo IIIa in rabbits.

Material and Method

We worked with 15 New Zeland White rabbits. All of them were carried out under general anaesthetic, a 5-cm incision longitudinal was made at the back of the right thigh. The femur was aproached and a fracture was performed with a shear, giving rise to a multifragment fracture. The wound remained open for 6 hours with the bone exposed, in a non-surgical ambient. Subsequently underwent surgical cleaning of the open fractures in two stages. The fracture was stabilized with an intramedular pin. The animals were sorted in 3 different therapeutic groups:

Group 1: (5 rabbits) without other treatment.

Group 2: (5 rabbits) a polypropylene mesh was placed around the fracture.

Group 3: (5 rabbits) a polypropylene mesh with vancomycin was placed around the fracture.

The wound was closed with nylon stiches.

Three weeks postoperative, the animals were intervened surgically under general anesthesia, after aseptic cure and placement of surgical fields, femoral bone biopsies, soft tissue and mesh were taken. The rabbits were sacrified. The samples were sent to pathology and bacteriology labs.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 43 - 43
1 Sep 2012
Douglas Price A Blanchetiere H Pemoff P Cuestas N Caviglia H
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Introduction

Monomicrobian necrotizing cellulitis affects the skin and subcutaneous tissue as starting point the deepest level of the superficial fascia. The pathogen inoculation is by skin disruption, abrasions, burns, injections or bites. The free base cocaine is used with homemade pipes that generate pulps fingers skin microabrasions. We present 3 patients (one bilateral) with cellulitis necrotizing of the thumb caused by pricking and dermoabrasive trauma secondary to different manipulation methods for drogue use.

Material and Method

Experience in 3 patients free base cocaine addicts treated in our Hospital. Medical examination shows febrile syndrome (corporal temperature over 38C), and elevation of heart rate. They present cellulitis in thumb's first and second phalanx, with thenar swelling and digital necrosis with abundant purulent discharged. All of them had a pricking trauma 36 to 48 hours before. They were under surgical intervention, by surgical cleaning with necrotic and devitalized tissue's debridement. In 3 of the 4 patients amputation of the distal phalanx was mandatory. Tissue and bone culture was made in all patients. Intravenous antibiotic was performed. Two patients miss total antibiotic treatment by early no medical discharged.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 241 - 241
1 Jul 2008
CAVIGLIA H
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Purpose of the study: Hemophilic pseudotumor is actually an extended encapsulated hematoma which produces clinical symptoms related to its anatomic position. It is more a clinical entity than a pathological lesion. From 1990, precutaneous aspiration was proposed for significant cysts and pseudotumors treated at the Mariano R. Castex Institute. After aspiration, the cavity was filled with a bone graft for larger tumors or with spongostan or fibrin glue for smaller defects. The pseudocapsule was not removed. We report here results obtained in 17 patients.

Material and results: The 17 patients (all males) presented 19 cysts, mean age 21 years. All had hemophilia (16 A, 1 B), five were HIV-positive, nine were seropositive for hepatitis C and two presented inhibitors. All patients received coagulation factors. One patient died from histoplasmosis. Cure and successful filling of the bone defect was achieved in 15 patients. Revision for conventional resection was required in one case of recurrence.

Discussion: Percutaneous aspiration is a minimally invasive method which enables restoration of the bone tissue. We have not observed any difference between HIV-positive and HIV-negative patients.