What are the dangers of retained gauze after surgery? Inrare cases the textiloma may be expelled spontaneously,but aside from infection, which occurred in our patient, retainedgauze may be fatal. On the other hand, the retainedgauze is usually discovered soon because of infection andfistula formation (). After this, it may cause other complicationsincluding pseudotumors. In fact, gossypibomainduce two types of reactions in the body: exudative andaseptic fibrous (). In cases in which no purulent reactionoccurs, granuloma and capsulization will be induced andthe presentation may be postponed for years. Again, retainedgauze may cause bone resorption, pathologic fracture,visceral perforation and vascular occlusions (,).In some cases the possibility of malignant changes due toretained gauzes has been raised in humans and dogs(, ). The bone may show several reactions and erosionand periosteal reaction to osteoblastic (bone forming)changes may be observed. In our patient, erosion occurredas well as a very late presenting infection, which is a veryrare event as infection usually occurs early. It may be assumedthat in this case, the in place implant has been afactor in preventing further bone resorption and pathologicfracture, although it may have aided in infection occurrence.
Physeal fracture of the distal femur has at least a 30% chance of developing a growth arrest, 36% have a leg length discrepancy of more than 2cm.
33% have angulation more than 5o
What Is a Diaphyseal Fracture? (with pictures) - wiseGEEK
Types - Weber A 4%
- Weber C 33%
- Displaced large posterior malleolar Any OA develops in first 2 years Causes - articular damage at time of injury
- non anatomical reconstruction
- complications i.e.
card - emergency medicine updates
The patient was placed in supine position on a Watson Jone's fracture table under epidural anesthesia. Conventional cleaning and draping of operative site was done. Abdomen was covered with lead sheet from all around to avoid radiation exposure. Entry site for nail was obtained by locating the piriform fossa with the gloved finger and an awl was used to gain access to the proximal end of the intramedullary canal. Limited shots of fluoroscopy were used to locate entry point of nail. A blunt tipped 2 mm guide wire was introduced into the proximal fragment. Closed reduction of fracture was done with help of guarded fluoroscopy. Guide wire was advanced to the distal fragment. The intramedullary canal was reamed over the guide wire with hand-held, hollow reamers to size 10. Interlock Intramedullary nail size 9 mm/34 cm was inserted over the guide wire. Distal interlocking holes were localized by keeping same size nail externally over lateral aspect of thigh. An incision was made to expose lateral cortex of the distal femur. Lateral cortex was drilled after confirming the localized distal holes of the nail. Then a 2 mm K wire was passed through the cortex and distal interlock hole of the nail. Position of the K wire in the hole was checked by putting guide wire which should abut K wire in the hole. Then distal locking bolt was put after drilling both the cortices across the hole with K wire. Position of bolt was again checked with the help of a guide wire that abutted at the interlock bolts producing an audible and palpable metallic sound. Proximal locking was done using Jig. Postoperative radiograph showed good reduction and implant position . Intra and postoperatively patient's vitals were stable. Blood loss was minimum.