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

{"title":"To compare the clinicoradiological outcome of various operative techniques and fixation devices in treatment of subtrochanteric fractures","authors":"Dr. Nirnay Pandey, D. Chaurasia","doi":"10.17511/ijoso.2019.i03.08","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.08","url":null,"abstract":"Background: There are various operative techniques and fixation devices in treatment of subtrochanteric fractures. The objective of treatment is restoration of optimal functions in the shortest possible time by the safest and most dependable method of treatment. Aim: To compare the clinicoradiological outcome of various operative techniques and fixation devices in treatment of subtrochanteric fractures and its variants. To compare the efficacy of various operative techniques in management of subtrochanteric fractures and its variants. To assess efficiency of various fixation devices in different (A-O) types of subtrochanteric fractrues and to compare our results with those available in literature. Methods: This prospective study was conducted in department of orthopedic surgery, in a span of two years. 38 Cases of subtrochanteric fractures and two types of extensions of subtrochanteric fractures admitted in orthopedics wards and treated by various operative methods were included in the study. Results: Malunion was seen in 3 cases and infection in 2 cases. Excellent and good results were seen in most of the cases fixed with intramedullary devices 35% & 39% respectively) and these using closed techniques (38% & 43% respectively). Majority of excellent result (52%) were seen in cases fixed with Proximal Femoral Nail. Most of the cases fixed using Dynamic Condylar Screw and Dynamic Hip Screw had fair to good results. Conclusion: Successful management of a case of subtrochanteric fracture is an exercise in balancing mechanical and biological consideration in maximize the likelihood of rapid healing and full restoration of function with minimal risk of complications at the least cost to the patient and society","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"25 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":"125286436","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":"Spontaneous giant popliteal artery aneurysm","authors":"Chawan Amba Prasad, P. Manjunath","doi":"10.17511/ijoso.2019.i03.11","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.11","url":null,"abstract":"A 60 year old male presented with sudden onset of pain in right lower limb, difficulty in standing and antalgic gait since 3 days. There was no history of trauma. Examination showed a non-tender, compressible, pulsatile 10 x 6 cm swelling in the right popliteal fossa. His blood investigations were within normal range. Arterial duplex ultrasonography of right lower limb showed right sided popliteal artery aneurysm (PAA) with foci of thrombus in it. CT-angiography confirmed the findings. He underwent popliteal artery aneurysmectomy and interposition of graft. He was discharged on postoperative day 5. We will be describing a case of spontaneous giant PAA and discuss the protocol that we follow.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"7 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":"129834384","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":"Buccal mucosa: is it ideal for long segment stricture urethroplasty?","authors":"Atul Kumar, Praveen Singh Baghel, S. Hussain, F. Solanki, D. Sharma","doi":"10.17511/ijoso.2019.i03.13","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.13","url":null,"abstract":"Background: Reconstruction of male urethra poses a continuing urological challenge. The ideal material for substitution urethroplasty remains controversial. Candidate tissues have included split and full thickness skin graft from scrotum, penis and extra-genital areas like bladder mucosa and buccal mucosa. This study was done to evaluate the short term and long-term results of buccal mucosal urethroplasty and analyzed them with different variables like etiology of stricture, length of stricture, operative procedure and associated complications and success rate. Material and Methods: All the Cases of anterior stricture urethra who had stricture length more than 1 cm and who underwent buccal mucosal substitution urethroplasty were included in this study. The short term and long-term results of buccal mucosal substitution urethroplasty were assessed. Patients were divided into two groups according to their length, patients with stricture length up to 6 cm and 7 cm or more and the results of buccal mucosal substitution urethroplasty were assessed in terms of etiology of stricture, length of stricture, operative procedure and its associated complications and success rate. Results: In the present study, the success rate of long segment strictures was inferior (77%). The success rate of two staged BMGU for long segment strictures was satisfactory (80%) if not associated with proximal urethral stenosis. Success rate of urethral strictures associated with BXO was lower (75%) as compared to others. Success rate of BMGU with almost tube (50%) was very poor. Conclusion: Buccal mucosa gives a good and viable option for substitution urethroplasty for long segment stricture. It is easy to harvest and handle, is resilient to infections and accustomed to a wet environment. As of date, it provides good material for substitution for treating all types of strictures with fairly good results and fewer complications.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"15 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":"115949187","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":"3 D Laparoscopy: A Review","authors":"R. Sharda, Pratibha Sharda","doi":"10.17511/ijoso.2019.i03.05","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.05","url":null,"abstract":"Background: Restricted depth perception in laparoscopy with two-dimensional imaging has been reported to be a major disadvantage of minimally invasive procedures. Three-dimensional imaging have been available for almost 2 years and are slowly being integrated into endoscopic surgery. Methods: A systematic search of the literature was conducted to identify randomized controlled trials that compared 3D with 2D laparoscopy. Some review articles were also searched. No language or year of publication restrictions was applied. Data extracted were cohort size and characteristics, skill trained or operation performed, instrument used, outcome measures, and conclusions. Two independent authors performed the search and data extraction. Results: Many articles were screened for eligibility, and RCTs were included in the review. Time was used as an outcome measure in all of the trials, and number of errors was used in 19 out of 16 trials. Seven out of 11 trials (71%) showed a reduction in performance time, and 10 out of 16 (63%) showed a significant reduction in error when using 3D compared to 2D. Conclusions: This study aims to show that 3D technology in laparoscopy promises to be an indispensable tool. The feasibility and safety of this surgical innovation has been shown. Overall, 3D laparoscopy appears to improve speed and reduce the number of performance errors when compared to 2D laparoscopy. Most studies to date assessed 3D laparoscopy in simulated settings, and the impact of 3D laparoscopy on clinical outcomes has yet to be examined. ………………………………………………………………………………………………………………………………... Scenario- al studied 3D laparoscopy: technique and initial experience in 451 cases. This study aims to show that 3D technology in laparoscopy promises to be an indispensable tool. The feasibility and safety of this surgical innovation has been shown. The tactile feedback is retained; the precision, accuracy, and depth perception are remarkable. The learning curve is short (less than five cases). The initial investment and recurring cost are low compared to robotic-assisted laparoscopies. The time taken for surgery as well morcellation is less than in 2D HD laparoscopy.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"10 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":"134569939","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":"Study on efficiency of locking compression plate for fracture of upper end of tibia","authors":"D. Rao, K. Kanth","doi":"10.17511/ijoso.2019.i03.10","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.10","url":null,"abstract":"Background: Fractures of proximal end tibia have historically been difficult to treat because of its subcutaneous location of the anteromedial surface of the tibia. Locking compression plate device offers potential biomechanical advantage over other methods. Locking compression plate has added advantage of the ability to manipulate and reduce the small and often osteoporotic fracture fragments directly. The present study objective was to compare the efficiency of locking compression plate in treatment of fractures with other standard methods of treatment. Method: In the present study, 20 patients with closed fracture of upper end of tibia were studied. All the cases were treated at GSL General Hospital, between 2015 & 2017 and followed for a minimum of 6 months.The method used for fracture fixation was closed or open reduction and internal fixation with locking compression plate. The duration of follow up was 6 months. Result: In the present study the commonest mode of injury being the road traffic accident 90%. There was Left sided predominance, compared to the right side. Most of the patients fall into type III, type IV, type V and type VI schatzker’s classification. 14 (70%) patients showed excellent result and 5 (25%) patients showed good outcome. Conclusion: Locking Compression Plate is an important armamentarium in treatment of fractures around knee especially when fracture is severely comminuted and in situations of osteoporosis.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"11 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":"128222052","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":"Total thyroidectomy in management of benign thyroid disease","authors":"V. Naik, Srikanth K. Aithal","doi":"10.17511/ijoso.2019.i03.15","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.15","url":null,"abstract":"Background: The use of total thyroidectomy in benign thyroid disease treatment is not universal. A total of 60 total thyroidectomies performed for benign thyroid diseases. The Aim of the study was to evaluate the role of total thyroidectomy in patients with presumed bilateral benign thyroid disease, with special emphasis on the incidence of two major post-operative complications namely hypoparathyroidism and recurrent laryngeal nerve palsy. Methods: It was a prospective study, A total of 60 patients who underwent total thyroidectomy for benign thyroid diseases between January 2016 to January 2018 were studied in department of general surgery at St Martha’s hospital, Bangalore. The patients were followed up for a period of nine months for post-operative complications. Results: Most of the patients were in the fifth decade of life, Female outnumbered males. Female: male ratio was 4.5:1. Amongst the 60 patients in the present study, the incidence of transient recurrent unilateral laryngeal nerve palsy was seen in 5 %, temporary hypocalcemia in 20%, permanent hypocalcemia in 3.3%, and permanent unilateral laryngeal nerve palsy in 1.66%. Malignancy detected after histopathological examination was in 8.33% of the patients. There was no wound infection, hematoma, bilateral RLN palsy and post-operative mortality. Conclusion: Total thyroidectomy for benign thyroid disease can eliminate any subsequent risk of malignant change in thyroid glands. A low complication rate can be achieved with meticulous surgical technique. Total thyroidectomy can be performed safely and can be considered as valuable option for treating benign bilateral thyroid diseases.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"6 2 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":"128234786","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":"Morbidity and mortality after ileostomy in small bowel perforations","authors":"S. Raj, Rajesh Lonare","doi":"10.17511/ijoso.2019.i03.07","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.07","url":null,"abstract":"Background: The aim of the present study was to study the morbidity status of patients of small bowel perforations undergoing ileostomy. To study the intra operative findings determining the construction of type of ileostomy and the effectiveness of various ileostomy appliances in maintaining skin integrity after ileostomy. Methods: The study population consisted of 60 patients of surgically verified ileal perforation in which ileostomy was made. Patients were studied for etiology, site, operative technique, appliance used and complications if any. All the data was presented in the observation tables, analysed and interpretation was done. Results: In our series maximum number of perforations occurred in third decade of life. The youngest patient was 7 years old and oldest patient was 80 year old. Mean age is 29.75 years. The Male: Female ratio is 1.6:1.Abdominal pain was the most prominent symptoms and was found in all patients. Etiologically, typhoid accounts for 63.3% of all perforation cases, with tuberculosis and traumatic perforation sharing 10% and 6% cases each respectively. Out of 60 cases, in which ileostomy was made, 31 patients (51.6%) had solitary ileal perforation. Out of 30 patients in whom the Romson's bag was applied, skin excoriation was present in 23 patients (76.6%). Out of 30 patients in whom the Hollister's bag was applied, only 12 patients (40%) had skin excoriation. Conclusion: There is a definite reduction in the mortality of the patients of small bowel perforation after ileostomy as compared to primary closure of perforations. Early diagnosis and meticulous surgical interventions of the cause of small bowel perforation and proper post op care is mandatory.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"41 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":"125446462","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 dilemma over percutaneous catheter drainage or percutaneous needle aspiration as first-line management of liver abscess","authors":"Atul Kumar, Shivani Sinha, Praveen Singh Baghel","doi":"10.17511/ijoso.2019.i03.12","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.12","url":null,"abstract":"Background: The aim of the study was to evaluate the clinical presentation and to investigate the effectiveness of percutaneous catheter drainage in comparison to needle aspiration in the treatment of liver abscesses of size more than 5 cm in diameter. Material and Methods: This was a prospective randomized comparative study of 60 patients, presented in outpatient and admitted at the hospital, randomized equally into two groups, percutaneous needle aspiration and percutaneous catheter drainage. The effectiveness of either treatment was measured in terms of duration of hospital stay, days to achieve clinical improvement and total/near total resolution of abscess cavity. Independent ttest was used to analyze these parameters. Results: Percutaneous catheter drainage was successful in all the 30 cases. On the other hand, USG guided percutaneous needle aspiration was successful only in 24 of 30 patients (P=0.005). Out of these 24 patients successfully treated, 6 patients required only one aspiration, 12 required two aspirations, and 6 required three aspirations. The 6 patients who did not show clinical improvement and / or decrease in cavity size despite 3 aspirations were taken as failures. In the PNA group, on comparing the cavity volumes the mean cavity volume in those who were successfully treated was 200 ml which was significantly less than those failing treatment; the mean volume being 400 ml. The patients in PCD group showed earlier clinical improvement (P=0.043) and decrease in abscess cavity volume (P=0.001) as compared to those who underwent PNA. In the present study, the success rate was significantly better in percutaneous catheter drainage group (P=0.005) than needle aspiration. The patients in percuaneous catheter drainage group showed earlier clinical improvement (P=0.043) as compared to those who underwent percutaneous needle aspiration. Conclusion: In the present study, percutaneous catheter drainage is found to be more effective than percutaneous needle aspiration for large liver abscesses of size 5 cm or more in diameter. The clinical improvement is also faster in PCD group than PNA group of the present study.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"209 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":"134457344","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":"Outcome of minimally invasive percutaneous plate osteosynthesis (MIPPO) for closed comminuted fractures of upper metaphysis of Tibia","authors":"Shafeed T.P, Abdulla Sameer Jeeju","doi":"10.17511/ijoso.2019.i03.04","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.04","url":null,"abstract":"Background: Management of complex metaphyseal fractures is usually complicated by articular extension, characterized by the difficulty of achieving accurate joint reconstruction and the sufficient stabilization without jeopardizing the usually severely traumatized soft tissue envelope. Minimally invasive percutaneous plate osteosynthesis (MIPPO) method of fracture fixation proposes the advantages of indirect fracture reduction and percutaneous submuscular implant placement. Methods: 20 patients with AO/ASIF 41A-B-C fractures of proximal tibia were followed up from December 2016 to June 2018. All the patients underwent Minimally invasive percutaneous plate osteosynthesis (MIPPO) with medial proximal tibial LCP. Clinical and radiological follow-up were recorded for 18 months. Results: Mean surgical time in minutes was 59.2. The average time for appearance of callus was 4 to 5 weeks and full weight bearing duration 20 to 38 weeks. Average range of movements for flexion 121.7 degree and extension 1.8 degree. Conclusion: MIPPO plating of proximal tibial fractures permits stable fixation, mobilization and avoid soft tissue related complications.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"45 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":"127132252","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":"Outcomes and analysis of total knee arthroplasty with non-patella resurfacing techniques for patients with osteoarthritis of the knee in a subpopulation of Western India","authors":"Umang R Barot, Milan M. Chaudhari, K. Bhan","doi":"10.17511/ijoso.2019.i03.14","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.14","url":null,"abstract":"Introduction: The decision to resurface the patella during total knee arthroplasty remains controversial. Even though some surgeons routinely resurface the patella to avoid the increased rates of postoperative anterior knee pain and reoperation for secondary resurfacing, others selectively resurface based on the presence of anterior knee pain, notably damaged articular cartilage, inflammatory arthritis, isolated patellofemoral arthritis, and patellar subluxation and maltracking. It is often said that there is no difference in clinical and functional outcome of Total Knee Arthroplasty (TKA) for knee osteoarthritis using patellar resurfacing and non-resurfacing techniques. Thus, this study was performed to evaluate the outcome of non-patella resurfacing total knee arthroplasty. Materials and Methods: A total of 50 patients in series who came to Ruby Hall Clinic, Pune with clinical signs and symptoms of osteoarthritis confirmed radiologically, were operated. The functional and clinical outcomes with Knee society score and VAS score were measured. Results: There was significant difference in outcome of non-resurfaced patella pre-operatively and postoperatively. There was significant improvement in mean range of motion (ROM). It was 87.2 Pre-op vs 104.4 Post-op. The Knee Society Score (KSS) had a mean Pre-op 39.66 v/s Post-op 83.26. The improvement in functional score was from a Pre-op 52.5 to post-op of 83.36. The mean Visual Analogue Score (VAS) score decreased from 7.98 to 2. Conclusion: The results showed significant difference in both the main indicators of Knee Society Score (KSS) and Visual Analogue Score (VAS), both pre-operatively and post-operatively.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"11 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":"128436480","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}