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Biomedical subjects

M J Patzakis

Publications and source records attributed to M J Patzakis.

54 records · Page 3Linked to original sources
PubMed1983

Use of antibiotics in open tibial fractures.

Data concerning 1102 open fractures are presented with bacteriologic and antibiotic considerations analyzed in 363 open tibiae fractures treated in three prospective one-year studies during the period from 1970 to 1980. The highest infection rate was in open tibiae receiving no antibiotics (24%, 6 infections in 25 open tibial fracture wounds), and the lowest was in the group receiving a cephalosporin and an aminoglycoside (4.5%, 5 infections in 109 open tibial fracture wounds).

Anti-Bacterial Agents↗
PubMed1983

Considerations in reducing the infection rate in open tibial fractures.

During the period from 1979 to 1980, 109 patients with open tibial fractures were treated by a cephalosporin and an aminoglycoside, and by saline and topical antibiotic wound irrigation; partial closure was used for Types I and II open tibial wounds, and all Type III wounds were left open. Stabilization was accomplished by plaster alone, external pins in plaster, or an external fixator with full transfixion pins. The overall infection rate was 4.5% (5 of 109 wounds) in this study. This represents a significant reduction from the previous infection rate of 14% in 254 open tibial fractures treated by the authors in previous years by all methods.

Adolescent↗
PubMed1979

Closed biopsy of musculoskeletal lesions.

Five hundred and thirty-one closed biopsies have been done in our general hospital since 1967. Four hundred and eighty-four were for lesions of bone and forty-seven were for soft-tissue lesions. More than half of the lesions were infections or nonspecifically reactive. The procedure was done under local anesthesia in 73 per cent and roentgenographic or image-intensifier control was generally required. The Craig needle was used for cancellous bone near vital structures; the Michele trephine, for cortical or sclerotic bone at a distance from vital structures; and a special needle was used for soft tissue. Closed biopsy provided an adequate specimen that was accurately diagnosed in 66 per cent of bone lesions and in 76 per cent of soft-tissue lesions. This compared favorably with both aspiration and open-biopsy success rates reported by others, and was accompanied by a 1 per cent complication rate, mostly neural and mostly in association with vertebral lesions.

Biopsy↗
PubMed1978

Total hip replacement in children with arthritis.

Fourteen children with juvenile rheumatoid arthritis and two with ankylosing spondylitis received 29 total hip replacements (THR). The ages at THR were 12 to 18 years, the median duration of prior hip disease was 7.1 years, and the minimum followup was one year (range 1--4 years, median 2.2 years). The primary indication for THR was pain in 5 hips and severe malposition or flexion contractures in 24 hips. (Sixteen of these also had some degree of pain.) All 29 hips demonstrated improved postoperative range of motion, and all were free of pain. In children, active rheumatic disease in other joints, prosthesis longevity, and possible lack of adequate motivation all merit special consideration prior to THR, but the results are encouraging.

Adolescent↗
PubMed1978

The effect of antibiotics, primary and secondary closure on clostridial contaminated open fracture wounds in rats.

In a study of experimentally induced open tibial or femoral fractures in rats, after either closing or leaving the wounds open, the animals were given: no antibiotic, cephalothin (Keflin), or penicillin. The rats with wounds closed primarily and receiving no antibiotics had the highest mortality rate (11 of 25) from experimentally produced clostridial myonecrosis. The lowest overall mortality rate (5 of 99) was found in the penicillin-treated groups. The higher mortality rate in the femur fracture groups was probably because of the large muscle mass of the thigh. The importance of ideal anaerobic conditions for producing experimental clostridial myonecrosis is emphasized.

Animals↗
PubMed1977

Antibiotic and bacteriologic considerations in open fractures.

A prospective study involving 581 open fracture wounds was conducted to evaluate the antibiotic and bacteriologic considerations in the treatment of open fractures. Multiple cultures were taken of each wound, and each wound had formal surgical irrigation and debridement. An organism was present in at least one of the multiple cultures in 62.1% of the cases. Open fractures should be considered as contaminated wounds, and antibiotics are given for treatment rather than prophylaxis.

Adolescent↗
PubMed1975

The use of antibiotics in open fractures.

The use of the term "prophylactic antibiotics" is probably not appropriate because we are in fact treating contaminated wounds. Only broad spectrum antibiotics that can be expected to be effective against coagulase-positive Staphylococcus aureus should be selected for antibiotic therapy in open fractures. We have found cephalothin-cephalexin therapy to be effective in significantly reducing the infection rate. However, the final selection of antibiotic treatment should be determined by the previous experience of organisms isolated and sensitivity studies done from open fracture wounds in each institution. These organisms will vary from hospital to hospital.

Anti-Bacterial Agents↗
PubMed1975

The early management of open joint injuries. A prospective study of one hundred and forty patients.

A study of open joint injuries treated at the Los Angeles County-University of Southern California Medical Center from July 1969 through July 1973 showed that the vast majority of these injuries were at the knee. Three types of injury were identified: those associated with fractures, injuries without fracture, and gunshot wounds. All patients were treated with antibiotics, surgical débridement and irrigation, and installation of polyethylene tubes into the joint as a system of postoperative closed irrigation. The over-all infection rate was 2.1 per cent. The results of treatment indicate that the irrigation system can be a source of contamination. Our recommended treatment for open wounds in joints is wide-spectrum systemic antibiotics, surgical débridement, irrigation of the joint and soft tissues, and primary closure. Prolonged suction-irrigation treatment postoperatively should only be done for specific indications: excessive contamination or excessive tissue damage when the wound to the joint should be closed primarily.

Adult↗
PubMedDate not supplied

The incidence of joint involvement with adjacent osteomyelitis in pediatric patients.

Sixty-six patients admitted to our institution over an 8-year period with the diagnosis of osteomyelitis were analyzed to determine the incidence of adjacent joint involvement. Patients with osteomyelitis of the hand, foot, spine, and extraarticular pelvis were excluded from this study. The average age was 5.8 years (range, 1 month to 17 years). Forty-two percent of our patients who had osteomyelitis had evidence of adjacent joint involvement (either septic or nonseptic). One third of our patients had evidence of septic joint involvement. The most commonly involved joint was the knee. There was no difference in the incidence of adjacent joint involvement in those patients who were younger than 18 months compared with the incidence in older children. Our study suggests that the incidence of adjacent joint involvement in children who have osteomyelitis is higher than that suggested in the literature. We believe that careful evaluation of the adjacent joint should be an important part of the evaluation of any child who has osteomyelitis.

Adolescent↗