Ugeskrift for laeger
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Ugeskrift for laeger · Jul 2015
Case Reports[The Masquelet procedure used after an open femur fracture with infection and osteomyelitis].
The treatment of patients with larger bone defects due to infections, trauma or tumours is a challenge in orthopaedic surgery. In 1986 Alain Charles Masquelet introduced a new technique using a two-step procedure, in which cement and bone-graft is used to reconstruct the defect. The Masquelet procedure is an effective alternative to methods formerly used in Denmark, but is still rarely used and unknown by many. In this case report we present a young woman with a large bone defect due to infection after an open femur fracture, who was successfully treated using this method.
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Ugeskrift for laeger · Jul 2015
Review[Challenges when improving surgical conditions by use of neuromuscular blockade].
Neuromuscular blockade (NMB) may pose a clinical dilemma between surgeons' requirements of muscle relaxation and the risk of residual blockade. This review has aimed at describing the challenges when using NMB for optimizing surgical conditions and reasons for inadequate relaxation despite use of NMB. Interdisciplinary collaboration, proper neuromuscular monitoring, knowledge on differences in pharmacodynamics and pharmacokinetics of NMB are essential factors when optimizing surgical conditions by use of NMB.
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Ugeskrift for laeger · Jun 2015
Case Reports[Cerebral infarction can be a consequence of anaesthesia in beach chair position].
Performing orthopaedic surgery in beach chair position (BCP) is a common procedure in Denmark. In this case report we present a patient, who underwent standard procedure with no variations according to the general anaesthesia. ⋯ A. cerebri media infarction was identified, and severe brain damage was the consequence. We question the rationale for using BCP as well as the use of phenylephrine for the cerebral hypoperfusion.
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Ugeskrift for laeger · Jun 2015
Case Reports[Benign paroxysmal positional vertigo in children after head trauma].
We present an eight-year-old boy with benign paroxysmal positional vertigo (BPPV) after a head trauma, successfully treated with Epley's manoeuvre. BPPV is a common cause of vestibular vertigo in adults, but it is rarely seen in children. ⋯ The diagnosis should be suspected in children with a relevant medical history and verified by positional testing. BPPV of childhood is treated with otolith repositioning manoeuvres, and the prognosis is good.
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Optic disc oedema describes the nonspecific, localized swelling of the optic nerve head regardless of aetiology. Therefore, differentiating among the various aetiologies depends on a thorough history and knowledge of the clinical characteristics of the underlying conditions. ⋯ It is usually a bilateral condition and visual function is preserved until late. Optic disc oedema caused by an anterior optic neuropathy is usually unilateral and accompanied by the loss of visual function.