By David A. Spiegel
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Additional resources for Bibliography of Orthopaedic Problems in Developing Countries
Bifocal” treatment involves distraction at one level to gain length, and compression at another level to heal a pseudarthrosis, while “trifocal” lengthening involves corticotomy and distraction at two levels with compression at a third location. The Ilizarov method is comprehensive, and can successfuly manage the host of problems that may be encountered in tibial nonunion (bone loss, angular deformity, limb shortening, pseudarthrosis). Panda M, Ntungila N, Kalunda M, et al. Treatment of chronic osteomyelitis using the Papineau technique.
IVb = Complete destruction of the proximal femoral epiphysis with a small, unstable neck - Problems include trochanteric overgrowth, LLD, and instability Recommend Distal transfer of greater trochanter, LL equalization, and proximal femoral osteotomy/pelvic osteotomy. V = Complete destruction of the head/neck to the intertrochanteric line - Problems include Instability, LLD recommend early trochanteric arthroplasty with varus proximal femoral osteotomy (3 years of age) and distal transfer of the abductors (preliminary adductor release and traction).
Marcus RT, Foster RD. Observations on the clinical features, aetiology, and geographical distribution of pyomyositis in East Africa. East Afr Med J 45:166-176, 1968. Over 2-3 years, 2-4000 cases were registered in 27 hospitals in Uganda, Kenya, and Tanzania. Nearly all reported cases were from low altitude regions with high humidity. The etiology remains uncertain, and most cases involve staphylococcus aureus. Coexisting osteomyelitis was never observed. 44 Renwick SE, Ritterbusch JF. Pyomyositis in children.