Surgical Update: International Journal of Surgery and Orthopedics最新文献

{"title":"Treatment of unstable slipped capital femoral epiphysis with a modified Dunn’s procedure-a case report","authors":"Rajiv Kaul, Chander Mohan Singh, Kamparsh Thakur","doi":"10.17511/ijoso.2019.i04.01","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i04.01","url":null,"abstract":"Slipped Capital Femoral Epiphysis (SCFE) is a relatively common disease of adolescents with drastic consequences in adult life if managed inappropriately. A number of surgical techniques are described to reposition the proximal femoral epiphysis and are frequently associated with a high rate of femoral head osteonecrosis. The modified Dunn’s procedure has been shown to be safe and effective in treating unstable SCFE. The incidence of development of osteonecrosis is dramatically reduced by carefully preserving the posterior periosteal sleeve, thereby maintaining the vascularity to the head. We have performed this procedure in a 21-year-old male with bilateral, sequential, unstable SCFEs and achieved a satisfactory functional outcome at the end of one year.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131240638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of topical sucralfate versus honey dressing in the management of diabetic foot ulcer","authors":"M. Reddy, Padmanabh Inamdar, Gogineni Mahesh","doi":"10.17511/ijoso.2019.i04.03","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i04.03","url":null,"abstract":"Background and Objectives: Local wound care is one of the mainstays in the management protocol for diabetic foot ulcers. Sucralfate and honey are inexpensive and easily available agents for local dressing. They are highly efficacious in achieving faster and better healing. Our study compares the effect of topical sucralfate with honey dressings in the management of diabetic foot ulcers. Methods: We conducted a prospective study on 50 patients of Diabetic foot ulcer admitted indoor and were evaluated clinically. Patients were divided into Group A (n=25) and Group B (n=25). Group A patients treated with topical application of Sucralfate and Group B patients were treated with topical honey. Wounds in both groups were inspected at the end of 7 days, 14 days and 21 days. Results in the two groups were compared and interpreted. Results: In our study, mean ulcer size was reduced in both the groups on day 7, day 14, and day21 (p>0.5). The percentage of reduction in mean ulcer size in Group A was 59.53% compared to 55.05% in Group B at the end of 21 days (p value > 0.05). Completely epithelized ulcers were 10 (40%) in Group A and 9 (36%) in Group B respectively. Complete epithelization of ulcer or ulcer bed ready for split skin grafting (primary end point of study) was 21.04 days in Group A and 23.20 days in Group B (P value < 0.05). Conclusion: Even though topical sucralfate and honey were both found to be effective in enhancing the wound healing process in diabetic foot ulcers, topical sucralfate was found to be better when compared to honey for local application.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116250827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of functional outcome and quality of life following treatment of unstable intertrochanteric fractures with intramedullary nailing and dynamic hip screw","authors":"A. Reddy, R. C. Reddy","doi":"10.17511/ijoso.2019.i04.04","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i04.04","url":null,"abstract":"Background: The dynamic hip screw is considered as the standard treatment for Intertrochanteric fracture. The procedure per se requires long term hospitalization and other complications. Researchers have proposed intramedullary nailing as an alternate procedure. The present study aims to compare the radiological and functional outcome following treatment of unstable intertrochanteric fractures with intramedullary nailing and dynamic hip screw and to compare Health-related quality of life between the two treatment methods. Methods: A prospective observational study was conducted during March 2014 to July 2016. Patients presenting with unstable Intertrochanteric fractures were recruited prospectively. The study was conducted in the department of orthopedics, Rajiv Gandhi Institute of medical sciences, Kadapa, which is a tertiary care teaching hospital. The participants were divided into two groups. Group, I constitute 25 patients who underwent DHS and Group II had 23 patients who underwent IHN. The mean age of Group DHS participants were 71.4  5.86 years, and group IMN participants were 69.7  6.13 years. The mean intraoperative bleeding of subjects in DHS group was325.24  67.32 (in ml) and it was 325.24  67.32 (in ml) in IMN group. Results: The mean time taken for the radiological union of subjects in DHS group was22.3  1.73 weeks, and it was 20.6  2.13 weeks in IMN group. Conclusions: The treatment of unstable Intertrochanteric fracture can be done in geriatric patients through surgical intervention without much morbidity and mortality. The postoperative quality of life returns to near normal at","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127954937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profile and complication rate of thyroid surgeries performed in a tertiary care teaching hospital, a prospective observational study","authors":"Dr. Vijaiaboobbathi Sathiah, Dr. Karpagavel Chandrabose","doi":"10.17511/ijoso.2019.i04.08","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i04.08","url":null,"abstract":"Background: One of the most common endocrine disorder is the thyroid diseases. The prevalence and pattern of these conditions depends on sex, age, ethnic and geographic patterns. The incidence of thyroid nodules increases with the age hence benign and malignant thyroid disease is common in the elderly population. Aim: To compare the complication rate of various thyroid surgeries for benign and malignant diseases in a tertiary care teaching hospital. Methods: This study was a prospective observational study, Velammal medical college hospital at Tamil Nadu from December 2018-June 2019. The patients who underwent thyroid surgery for various thyroid disorders were enrolled in the study. Results: Out of117 cases, 107 were women and 10 were men. Multinodular goiter (MNG)was the most common (38.46%) condition, followed by solitary nodule (29.06%) and toxic MNG (18.8%). Among women, 40.19% were identified with multinodular goiter followed by solitary nodule (28.97%). Subtotal thyroidectomy was performed for 88.89% of MNGs, while 91.18% of the solitary nodule were managed by hemithyroidectomy Majority of the patients with toxic MNG underwent subtotal thyroidectomy with 99.91%. While 84.61% of the patients with thyroid cancer were treated by total thyroidectomy. The overall incidence of complications was 27.35%. The incidence rate of complications was high in patients with malignant disease, as compared to benign disease (69.23% in Malignant Vs 36.36% in toxic MNG and 24.44% in MNG). Conclusion: Through the present study, it was concluded that the complications associated with the different thyroid surgeries and various precautions that can be taken to reduce the complications.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132834485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent abdominal pain in school children in a rural tertiary hospital","authors":"S. Prabhu, Consultant Paediatric Surgeon, G. Abraham, L. Nair","doi":"10.17511/ijoso.2019.i04.06","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i04.06","url":null,"abstract":"Background: Recurrent abdominal pain is one of the most common presenting complaints among school going children, with a prevalence of 10-12%. Most of the children with recurrent abdominal pain are not evaluated further, either due to the mild abdominal pain or transient nature of the symptoms. Recurrent abdominal pain requires complete evaluation to look for organic causes. However, in many cases, where no specific organic cause can be identified, a psychosomatic component has been shown to play a role. The aim of the study is to evaluate children with recurrent abdominal pain in the age group 2-12 years for a cause at a tertiary rural hospital, in an attempt to better understand this syndrome. Methods: Retrospectively collected data from 210 consecutive patients aged between 2-12 years from January 2015 to January 2017, who presented to Department of Surgery and Emergency department in MOSC Medical College with recurrent abdominal pain were studied. Data collection included demographic details, symptomatology and clinical details, and response to treatment. Each patient was thoroughly evaluated to identify an organic cause for the pain. All the patients were evaluated by the paediatrician for any underlying medical cause. Results: During the two-year period, 210 patients were evaluated and investigated, and an organic cause was detected in 44 patients, while 166 patients were diagnosed to have RAP. The 44 patients with an organic cause were treated for the primary condition and were asymptomatic on follow up. Investigations revealed that 20 patients suffered from acute appendicitis, 20 patients were diagnosed with habitual constipation Patients without an organic cause were reassured, counselled and treated symptomatically. All the patients were on follow up for the entire period of the study. Of the 166 patients diagnosed with RAP, 110 patients responded to symptomatic measures, while 21 patients were referred to child psychiatry and are on long term follow up. Conclusion: Recurrent abdominal pain is a significant cause of functional impairment in the life of a child. Thorough evaluation of the patient to rule out organic causes is vital. Majority of the children diagnosed with recurrent abdominal pain respond to counselling. Acknowledging the existence of the symptoms instead of dismissing it, and empathising with the child is often all that is required in the management of these patients","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121140617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical tip: fixation of extra-articular fractures of distal humerus with modified distal tibial locking plate","authors":"Rajul Gupta, Vaibhav Maheshwari, S. Gour, Narendra Kumar, Avtar Singh","doi":"10.17511/ijoso.2019.i03.02","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.02","url":null,"abstract":"Introduction- Treatment of extra-articular distal humerus fractures is often difficult using conventional plates. Plates having enough screws (three to four) in the distal fragment either impinge on the olecranon fossa, or gain purchase by placing screws in the lateral or medial column of the distal humerus avoiding the olecranon fossa. Objectives- This study was to ascertain the effectiveness of modified distal tibial locking plate for use in distal third shaft humerus fracture. Methods- By using a modified distal tibial locking plate, a six to eight locking head screws can be easily placed in the in the limited length of distal fragment proximal to the olecranon fossa. Fourteen cases treated in such manner were followed up for a minimum of 24 months. Results- Union was achieved in all cases with no loss of reduction or implant failure. No patient complained of hardware complication, functional limitation or infection. Conclusion- Modified distal locking plate can be safely used in the limited space above olecrenon fossa in distal thirds humerus shaft fractures","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122591930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectra of bacterial growth in ulcers","authors":"Va Bhagat, S. Brahmachari","doi":"10.17511/ijoso.2019.i03.06","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.06","url":null,"abstract":"Objectives: To study the spectra of bacterial growth in ulcers in patients and to compare the range and efficacy of Povidoneiodine, Nitrofurazone and silver sulphadiazine with Metronidazole with sucralfate as topical agents. Methods: 100 patients with different types of ulcers with either foul smell or showing response to systemic or local treatment were selected and divided into two groups. Study Group or Group A: 1% Metronidazole gel with sucralfate. Control group or Group B: for burns and scalds silver sulphadiazine, for trophic ulcers nitofurazone (Furacin ) in remaining types of ulcer/wounds Povidone iodine (Betadine) ointment was used. Periodic debridement of ulcer/wound was done in both the groups as per requirement. Other general and specific treatment of the patient with regard of his illness was same in both the groups. Systemic antibiotics were given, bacteriological and clinical assessment was daily done. Results: 93% of cases in Group A and 42% in Group B showed grade III healing within 35 days. Healing was over all faster in Group C and 95% reached grade III within 35 days. One patient in Group B died after 24 days with no signs of healing and remaining 18 patients were converted to Group C after 45 days of treatment. In Group C one patient absconded with grade II healing. Conclusion: It was observed that results with topical Metronidazole with sucralfatewere definitely superior as compared to Povidone iodine, Nitrofurazone or Silver sulfadiazine.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127682876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of grade 3a and 3b compound tibial fractures with external fixation and primary immediate bone grafting","authors":"Rajul Gupta, Vaibhav Maheshwari, S. Gour, Deepak Nadkarni, K. Verma","doi":"10.17511/ijoso.2019.i03.01","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.01","url":null,"abstract":"Introduction- The present study report results of a series of type 3A and 3B open fractures treated with debridement and fracture fixation and immediate bone grafting. Methods- Twenty one patients were treated from January 2017 to January 2018. All fractures were treated with a modular external fixator. Nine fractures were type 3A and 12 were type 3B. All fractures received debridement, external fixation, bone grafting and flap or skin graft coverage. All fractures were analyzed for time to fracture union, incidence of pin tract infection, incidence of wound infection, flap complications, and delayed or non union. Results- After a mean follow up period of 14 months (range 12 to 16 months), it was concluded that the time to fracture union was 22 weeks, and all fixators were removed only after radiological evidence of fracture union. 1 (5%) patients developed deep wound infection, one experienced delayed union. Conclusion- Along with early wound coverage and external fixation, primary bone grafting can be employed in grade 3 open fractures of tibia with good results and without any increased risk of wound complications ………………………………………………………………………………………………………………………...............","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131563537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A real life experience with novel biosimilar InfimabTM in biologic naive patients with active rheumatoid arthritis","authors":"N. Kaura, A. Ray, Amit Kumar, India. Nicobar Islands","doi":"10.17511/ijoso.2019.i03.09","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.09","url":null,"abstract":"Objective: To determine the efficacy and safety of novel infliximab biosimilar, Infimab TM (IFB) in rheumatoid arthritis (RA) patients. Materials and Methods: Eight patients with active RA who failed to demonstrate clinical improvement with methotrexate were enrolled. Post consent, patients were administered infliximab biosimilar 3mg/kg body weight as intra venous infusion at weeks 0, 2, 6 then every 8 weeks on demand. Patients were assessed for Health assessment questionnaire (HAQ, India Score), disease activity score 28 (DAS 28), Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC), erythrocyte sedimentation rate (ESR) and Visual Analogue Scale (VAS) score at baseline and at each visit. They were also observed for any adverse effects or tuberculosis infection. Wilcoxon sign rank test was used to assess the change between baseline to each follow-up visit. Results: On any average 3 infusions were administered to patients. At visit 3 there was significant improvement in HAQ score (p=0.046), WOMAC score (p=0.018), Tender joints count (p=0.027), swollen joints count (p=0.027) and also in general health (p=0.043). Though the VAS scores and ESR values decreased at visit 3, they were not significant. At the end of visit 5, there was considerable decrease in the tested parameters, except in tender joint count. None of the patients reported any adverse effects, indicating that infliximab biosimilar was well-tolerated in tested patients. Conclusion: In this preliminary trial conducted in eight RA patients, treatment with IFB improved clinical outcomes and was well-tolerated in RA patients who failed initial treatment with methotrexate","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131003389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study on the degree of correction and type of complication between modified French and dome supracondylar osteotomy in a tertiary care centre of West Bengal","authors":"S. Mitra, Saswata Ghosh","doi":"10.17511/ijoso.2019.i03.03","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.03","url":null,"abstract":"Introduction: Cubitus Varus is one of the most common deformity around the elbow. Malunited supracondylar fracture of humerus is the most common cause of the deformity in children. This study was conducted to compare the degree of correction and type of complication between modified French and dome supracondylar osteotomy. Materials and Methods: The present study is a prospective study of 61 children with Cubitus Varus treated surgically between January 2017 to May 2018. In our series of 61 cases, 31 were treated with modified French osteotomy and 30 with dome osteotomy. The patients were followed up periodically. Results: At final follow-up by Flynn’s criteria for functional outcome 19 had excellent outcome, 9 had good result, 3 had fair result and none had poor result in modified French group. In dome osteotomy group 15 had excellent result, 10 had good result, 5 had fair result. There was 1 case of infection, 1 case of delayed union, 1 case of implant failure and no nerve injury. In modified French group. There were 2 cases of infection, 1 case of delayed union, 2 cases of implant failure, and 1 case of nerve injury in dome osteotomy group. Conclusion: The present study found that the degree of correction was same, but rate of complication was less in modified French treated group than in dome osteotomy group. Though lateral prominence was corrected in dome osteotomy it was associated with more complication, inadequate correction, nerve palsy, loss of motion and circulatory compromise. KeywordsCubitus Varus, Dome osteotomy, Modified French osteotomy ...................................................................................................................................................","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128890334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}