Bibliography of Orthopaedic Problems in Developing Countries by David A. Spiegel

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By David A. Spiegel

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41 cases (7-78 years old) in Kinshasa were treated by a 3 stage technique including debridement, grafting, and finally skin grafting if necessary. The etiology was traumatic in 53% and hematogenous in 44%, and 83% of cases were in the femur or tibia. External fixation was used in 44%, and casting in 39%. Control of infection and bony healing were observed in 89% at short term followup. Initially, multiple drill holes were used to facilitate saucerization, and the cavity was cleansed with Dakin’s solution and packed with vaseline gauze impregnated with 1% framycetine.

Results based upon Harris hip scores included 6 excellent, 1 good, and 2 poor. The authors question the value of reconstructive surgery for the hip itself, but epiphysiodesis should be considered to treat the coexisting leg length discrepancy. VI. Pyomyositis Pyomyositis represents a pyogenic intramuscular infection which is seen most commonly in tropical regions. The differential diagnosis is extensive, and includes muscle strain injury, hematoma, thrombophlebitis, osteomyelitis, septic arthritis, and neoplasia.

A tibial corticotomy is performed (either proximally or distally) and completed by manual osteoclasis. 25 mm). This transports a segment of bone through the gap. Fibular osteotomy is performed when the transported segment has been brought across the gap, to aid with healing at the docking site. Loss of length without bone loss is treated by external lengthening, and in this case the fibular osteotomy is performed at the same time as corticotomy. Bone loss and loss of length may be treated simultaneousely.

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