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Opis: Purpose: The management of acute patellar dislocation in children and adolescents is controversial. Traditionally,most first time traumatic patellar dislocations have been treated nonoperatively. However, due to new knowledge about medial patellar stabilizers some authors have advocated for surgical repair. The present report describes the midterm subjective and functional results of operative treatment of acute patellar dislocation in children less than eighteen years of age with concomitant osteochondral fracture. Methods: Data on a cohort of sixteen patients (eight girls and eight boys) aged 14.9 years (mean, range12-17 years) with acute patellar dislocation were retrospectively collected. Intraarticular fragments were detected in all patients in conventional radiographs. Operative treatment consisted of arthroscopic removal (12cases) or refixation (4 cases) of the osteochondral fragments and direct repair of the damaged medial patellofemoral ligament (MPFL) if that was still feasible (13 cases). All patients were seen at six months, and a telephone interview with twelve patients (75%) was conductedat four years (mean, range 27 years). Results: Of the sixteen patients, two (12.5%) had a recurrent patellar luxation. The subjective IKDC score at the time of the most recent follow up was 86 (mean, range 63-100), and the Marx Activity Rating Scale score was 9.2 (mean, range 216).Conclusions: Direct surgical repair of the injured MPFLmay be considered an option to prevent subsequent dislocation and subluxation in first time traumatic dislocation of the patella in children and adolescents with osteochondral fractures and substantial disruption of medial patellar stabilizers.
Ključne besede: akutni izpah pogačice, patelofemoralna kostna avulzija, izpah pri otrocih, pediatrične poškodbe, kirurško zdravljenje
Objavljeno v DKUM: 12.04.2024; Ogledov: 156; Prenosov: 8
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Gradivo ima več datotek! Več...
Gradivo je zbirka in zajema 1 gradivo!

Opis: Uvod: Rak dojk je najpogostejši rak pri ženskah in lahko doprinese resne psihološke posledice. Kirurški poseg na dojki povzroči spremembo telesnega videza bolnic, kar močno vpliva na doživljanje samopodobe. Rekonstrukcija dojke po mastektomiji lahko pozitivno vpliva na kakovost življenja bolnic. Namen zaključnega dela je predstaviti, kako ženske doživljajo samopodobo po rekonstrukciji dojk zaradi mastektomije in kako se soočajo s posledicami rekonstrukcije. Metode: V empiričnem delu je bila uporabljena kvalitativna metodologija raziskovanja. Izveden je bil intervju z bolnico, ki je imela totalno mastektomijo obeh dojk in se je odločila za odloženo–takojšno rekonstrukcijo obeh dojk. Intervju je bil posnet, dobesedno zapisan in analiziran. Vsaka vrstica v intervjuju je bila kodirana. Kode so bile smiselno kategorizirane glede na posamezna področja. Uporabljena je bila metoda vsebinske analize. Rezultati: Ugotovljeno je bilo, da ima na doživljanje samopodobe po mastektomiji velik vpliv odnos s partnerjem, z družino in spodobnost soočanja z izzivi. Pomembno pa je tudi sprejetje zdravstvenega stanja. Obravnavana bolnica po opravljeni rekonstrukciji dojk zaradi mastektomije pozitivno doživlja samopodobo in se uspešno sooča s posledicami zdravljenja. Zaradi rekonstrukcije dojk ima izboljšano kakovost življenja na psihosocialnem in telesnem področju. Ugotovljeni so bili štirje negovalni problemi, in sicer bolnica navaja občutke žalosti ob soočanju z boleznijo, negativne občutke zaradi brazgotin na dojkah, zmanjšano gibljivost v ramenih in zmanjšane zmožnosti pri opravljanju vsakodnevnih aktivnosti. Sklep: Rekonstrukcija dojk po mastektomiji uspešno dvigne samopodobo žensk in jim izboljša kakovost življenja na več področjih. Bolnice pridobijo višjo samozavest in izboljšano splošno počutje, kar vpliva na boljši izid zdravljenja in rehabilitacije.
Ključne besede: rak dojke, kirurško zdravljenje, rekonstrukcija dojke, samopodoba ženske
Objavljeno v DKUM: 07.10.2020; Ogledov: 1357; Prenosov: 172
Celotno besedilo (408,30 KB)

Opis: The purpose of the study was to evaluate the results of operative reconstruction of the foot with a musculocutaneous latissimus dorsi free flap. At the Department of Plastic Surgery and Burns, University Medical Centre Ljubijana, 45 feet were treated by surgical repair using a musculocutaneous latissimus dorsi free flap between 1980 to 1994. The condition of the reconstructed foot was evaluated in 8 patients. The assessment was based on the results of a questionnaire completed by the patients, as well as on the results of physical examination (flap status, sensibility), and gait analysis (basic kinematic and kinetic parameters, footprint). Because of the small number of patients the efficacy of reconstruction had to be evaluated for each patient separately. As indicated by the patients' subjective assessment and objective findings, which correlated, reconstruction with a musculocutaneous latissimus dorsi free flap proved successful in all the patients studied. This investigation served as a pilot study for other studies to be carried out on larger series of patients.
Ključne besede: kirurško zdravljenje, medicina, stopalo
Objavljeno v DKUM: 30.12.2015; Ogledov: 1301; Prenosov: 50
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