[Early reoperation for infection in orthopedic surgery of the leg (arthroplasties and hip surgical procedures excluded)].
The authors report 32 cases of post-operative infections reoperated before the first month of which 12 articular fractures of the tibia. 6 tibial osteotomies of valgisation, 6 tibial diaphyseal fractures, 2 fractures of the lower extremity of the femur, 2 bimalleolar fractures, 1 serious knee sprain, 1 patellar fracture, 1 calcaneum fracture and an arthroscopic arthrolysis of the knee. Twelve of them had an articular infection. Globally, they have obtained 22 satisfactory results (very good or good) and 10 non satisfactory results out of which 2 deaths and 1 amputation. The bad results were due either to a particularly aggressive germ (streptococcus and gas gangrene), or to an articular infection insufficiently controlled: 5 out of the 10 arthrites on infected articular fractures have had a non satisfactory result. As for metaphyseal infections, a simple cleaning has given 4 very good results out of 6, the 2 excluded being very serious and special cases. For the 6 diaphyseal leg infections after osteosynthesis, the early reoperation has not avoided a secundary graft in a picture of infected pseudoarthrosis. In view of this series, the authors propose to adapt the cleaning operation to the localisation and to the presence or not of an articular infection.
Lortat-Jacob
A
A
Service de Chirurgie Orthopédique, Hôpital Ambroise Paré, Faculté de Médecine Paris-Ouest, Boulogne.
Hardy
P
P
Benoit
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000601:surgery; D001170:Arthritis, Infectious / Q000209:etiology* / Q000601:surgery; D005260:Female; D005264:Femoral Fractures / Q000601:surgery; D005592:Fracture Fixation / Q000009:adverse effects; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects; D010329:Patella / Q000293:injuries; D012086:Reoperation; D013203:Staphylococcal Infections / Q000150:complications*; D013530:Surgical Wound Infection / Q000150:complications / Q000601:surgery*; D013978:Tibial Fractures / Q000601:surgery
La réintervention précoce pour infection en chirurgie orthopédique du membre inférieur (en dehors des arthroplasties et des interventions sur la hanche).