Titre du document / Document title

Mittelfristige Ergebnisse nach postoperativen Infektionen an der Schulter = Results in the treatment of postoperative septic arthritis of the shoulder

Auteur(s) / Author(s)

ATTMANSPACHER W. ⁽¹⁾ ; DITTRICH V. ⁽¹⁾ ; SCHÄTZLER A. ⁽¹⁾ ; STEDTFELD H.-W. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Klinik für Unfallchirurgie, Klinikum Nürnberg Süd, Nürnberg, ALLEMAGNE

Résumé / Abstract

Between 1 January 1986 and 31 December 1997, in the traumatology department of Nuremberg hospital,a total of 46 patients with postoperative infections of the shoulder were treated.The primary surgical procedure was carried out for various reasons.The diagnosis of infection was found on clinical parameters such as pain, redness, and swelling, in combination with laboratory parameters and diagnostic aspiration of joint fluid. The period between operation and infection ranged between 4 days and 9 months.The main question was whether a local infection or an infection of the glenohumeral joint, called empyema,was involved. Some cases required diagnostic aspiration. Macroscopic inspection of the fluid was helpful, as was cell counting and analysis of fluid pH [14]. The fluid was given to a gram preparation. In case of infection of the joint, diagnostic arthroscopy was performed with a saline lavage (10-15 l). Local synovectomy was carried out when local synovitis was found. Similar to the therapy of the knee, antibiotic collagen (Sulmycin-Implant©) (no PMMA chains as former) was applied.We compared patients who were operated as usual, i.e., by great incision and open wound-drain (group 1,21 patients), with patients who were operated arthroscopically assisted (group 2,25 patients). We saw an earlier reconvalescence in the second group. Of the 46 patients, 25 were followed-up for an average of 4 years. The results were rated according to the Constant score. The mean total score of 25 patients was 61 points (range 43-78 points). Positive intra-articular bacterial culture was an important prognostic factor; in spite of an arthroscopical procedure, results were not as good as without joint infection. Generally, the arthroscopic procedure with application of the Sulmycin Implant© leads to better results than the open procedure with application of PMMA chains.

Revue / Journal Title

Der Unfallchirurg   ISSN 0177-5537   CODEN UNFAE2 

Source / Source

2000, vol. 103, n^o12, pp. 1048-1056 (24 ref.)

Langue / Language

Allemand

Editeur / Publisher

Springer, Heidelberg, ALLEMAGNE  (1985) (Revue)

Mots-clés anglais / English Keywords

Arthritis ; Shoulder ; Infection ; Complication ; Postoperative ; Empyema ; Microbiological investigation ; Biochemical analysis ; Treatment ; Antibiotic ; Local administration ; Comparative study ; Reoperation ; Technique ; Prognosis ; Human ; Chemotherapy ; Upper limb ; Diseases of the osteoarticular system ; Arthropathy ; Bacteriosis ; Orthopedic surgery ; Endoscopic surgery ;

Mots-clés français / French Keywords

Arthrite ; Epaule ; Infection ; Complication ; Postopératoire ; Empyème ; Exploration microbiologique ; Analyse biochimique ; Traitement ; Antibiotique ; Voie locale ; Etude comparative ; Réintervention ; Technique ; Pronostic ; Homme ; Chimiothérapie ; Membre supérieur ; Système ostéoarticulaire pathologie ; Arthropathie ; Bactériose ; Chirurgie orthopédique ; Chirurgie endoscopique ;

Mots-clés espagnols / Spanish Keywords

Artritis ; Hombro ; Infección ; Complicación ; Postoperatorio ; Empiema ; Análisis microbiológico ; Análisis bioquímico ; Tratamiento ; Antibiótico ; Vía local ; Estudio comparativo ; Reintervención ; Técnica ; Pronóstico ; Hombre ; Quimioterapia ; Miembro superior ; Sistema osteoarticular patología ; Artropatía ; Bacteriosis ; Cirugía ortopédica ; Cirugía endoscópica ;

Localisation / Location

INIST-CNRS, Cote INIST : 6342, 35400009341521.0030