[Treatment of acute pyogenic arthritis of large joints of the limbs. Apropos of 79 cases].
In reference to 79 cases of primary acute pyogenic arthritis involving large joints of the extremities, the authors analyze respectively the results of medical and surgical treatments. After tapping, the medical treatment combining antibiotics and cast immobilisation, has enabled recovery in more than one out of two cases with "restitutio ad integrum" of the joint. In the absence of rapid improvement, an arthrotomy, performed in 23 instances, has enabled, with irrigation and drainage of the joint, to control in a large number of cases, the infectious process. At the stage of purulent synovitis, a synovectomy was performed in 14 instances, at the price of a frequent decrease of the subsequent mobility. At the osteoarthritis stage, resection or arthrodesis were necessary (10 times) in order to obtain drying of the lesions. All things considered, 50 out of 79 joints recovered completely. We will stress the frequency of iatrogenic etiological factors (16 cases) and the immediate mortality (13 deaths). Finally, at the knee, arthroscopy (12 cases) enables to properly visualize the lesions and an effective irrigation-drainage, while decreasing immediate mortality and subsequent stiffening of the joint.
Travers
V
V
Service de Chirurgie Orthopédique, Hôpital Saint-Antoine, Paris.
Norotte
G
G
Roger
B
B
Apoil
A
A
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D001182:Arthroscopy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
Traitement des arthrites aiguës à pyogènes des grosses articulations des membres. A propos de 79 cas.