scholarly journals Femoral malalignment after gamma nail insertion in the lateral decubitus position

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 34
Author(s):  
Hossam M.A. Abubeih ◽  
Osama Farouk ◽  
Mohammad Kamal Abdelnasser ◽  
Amr Atef Eisa ◽  
Galal Zaki Said ◽  
...  
Keyword(s):  
Case Series ◽  
Gamma Nail ◽  
Lateral Decubitus Position ◽  
Entry Point ◽  
Age Group ◽  
Rotational Malalignment ◽  
Implant Positioning ◽  
High Incidence ◽  
Nail Insertion ◽  
Lateral Decubitus

Introduction: Insertion of gamma nail with the patient in lateral decubitus position have the advantages of easier access to the entry point, easier fracture reduction and easier implant positioning. Our study described the incidence of femoral angular and rotational deformity following gamma nail insertion in lateral decubitus position. Methods: In a prospective clinical case series, 31 patients (26 males and 5 females; the average age of 42.6 years) with 31 proximal femoral shaft fractures that were treated with gamma IMN were included in our study. Postoperatively, computerized tomography scans of the pelvis and both knees (injured and uninjured sides) were examined to measure anteversion angles on both sides. A scout film of the pelvis and upper both femurs was taken to compare the neck shaft angles on both sides. Results: No angular malalignment was detected in our series; the mean angular malalignment angle was 1.6 ± 1.5°. There was a high incidence of true rotational malalignment of ≥10° in 16 out of 31 patients (51.6%); most of them were external rotational malalignment. Younger age group (≤40 years) had significantly more incidence of rotational malalignment (≥10°) than older age group (>40 years) (P-value 0.019). Discussion: Gamma nail fixation in lateral decubitus position without the fracture table gives an accurate and easier access to the entry point, good implant positioning with no or minimal angular malalignment (varus −valgus) but poses high incidence of true rotational malalignment. Great care and awareness of rotation should be exercised during fixing proximal femoral fractures in lateral decubitus position.

scholarly journals Lateral decubitus position to facilitate pelvic examination of the patient with severe obesity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel M. Breitkopf
Keyword(s):  
Severe Obesity ◽  
Case Series ◽  
Outpatient Setting ◽  
Lateral Decubitus Position ◽  
Lithotomy Position ◽  
Pelvic Examination ◽  
Institutional Review ◽  
Lateral Decubitus ◽  
Dorsal Lithotomy Position ◽  
Dorsal Lithotomy

Abstract Background Patients with elevated BMI pose a number of challenges for the gynecologist. Pelvic examination may be more difficult due to adiposity in the perineum and labia, increasing the distance between the vulva and cervix. The objective of the current work was to describe use of the lateral decubitus position to improve visualization of the cervix in women with severe obesity. Methods A case series was collected. From 7/1/2010 until 1/31/2020, all records of patients with obesity and unsuccessful cervical visualization during pelvic exam in the dorsal lithotomy position in the author’s clinical practice were reviewed after obtaining Mayo Clinic Institutional Review Board approval. For the lateral decubitus position, the patient was asked to lie on her side on the exam table, facing away from the examiner with knees bent. An assistant elevated the upper bent leg 45 degrees from horizontal, exposing the perineum. A vaginal speculum was then placed in the vagina with the posterior blade toward the anus. The speculum was opened gently as would be done with examination in dorsal lithotomy position until the cervix was visualized. Results Eleven patients with severe obesity in the gynecologic practice of the author with prior unsuccessful cervical visualization in dorsal lithotomy position were examined in the lateral decubitus position. In all but one case the cervix was successfully visualized in the lateral decubitus position and all intended intrauterine procedures were successfully performed. Conclusions In this case series, the use of the lateral decubitus position appears to improve visualization of the cervix in the outpatient setting among women with severe obesity. Consideration should be given to use of the lateral decubitus position when the cervix cannot be visualized in the dorsal lithotomy position.

Surgical Techniques for Thoracoscopic Esophagectomy at the Left Lateral Decubitus Position

2019 ◽  
Vol 70 (2) ◽  
pp. 197-197
Author(s):  
H. Sato ◽  
Y. Miyawaki ◽  
N. Fujiwara ◽  
H. Sugita ◽  
M. Aikawa ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
Lateral Decubitus Position ◽  
Thoracoscopic Esophagectomy ◽  
Left Lateral Decubitus Position ◽  
Lateral Decubitus

scholarly journals Changes in the Bronchial Cuff Pressure of Left-Sided Double-Lumen Endotracheal Tube by Lateral Positioning: A Prospective Observational Study

2021 ◽  
Vol 10 (8) ◽  
pp. 1590
Author(s):  
Jong-Hae Kim ◽  
Eugene Kim ◽  
In-Young Kim ◽  
Eun-Joo Choi ◽  
Sung-Hye Byun
Keyword(s):  
Thoracic Surgery ◽  
Endotracheal Tube ◽  
Primary Outcome ◽  
Cuff Pressure ◽  
Lateral Decubitus Position ◽  
Double Lumen ◽  
Double Lumen Endotracheal Tube ◽  
Bronchial Cuff ◽  
Lateral Decubitus ◽  
Lateral Positioning

Proper bronchial cuff pressure (BCP) is important when using a double-lumen endotracheal tube (DLT), especially in thoracic surgery. As positional change during endotracheal tube placement could alter cuff pressure, we aim to evaluate the change in BCP of DLT from the supine to the lateral decubitus position during thoracic surgery. A total of 69 patients aged 18–70 years who underwent elective lung surgery were recruited. BCP was measured at a series of time points in the supine and lateral decubitus positions after confirming the DLT placement. The primary outcome was change in the initial established BCP (BCPi), which is the maximum pressure at which the BCP did not exceed 40 cmH2O without air leak in the supine position, after lateral decubitus positioning. As the primary outcome, the BCPi increased from 25.4 ± 9.0 cmH2O in the supine position to 29.1 ± 12.2 cmH2O in the lateral decubitus position (p < 0.001). Out of the 69 participants, 43 and 26 patients underwent surgery in the left-lateral decubitus position (LLD group) and the right-lateral decubitus position (RLD group) respectively. In the LLD group, the BCPi increased significantly (p < 0.001) after lateral positioning and the beginning of surgery and the difference value, ∆BCPi, from supine to lateral position was significantly higher in the LLD group than in the RLD group (p = 0.034). Positional change from supine to lateral decubitus could increase the BCPi of DLT and the increase was significantly greater in LLD that in RLD.

scholarly journals BRONCHOSPIROMETRY IN THE LATERAL DECUBITUS POSITION

1950 ◽  
Vol 19 (6) ◽  
pp. 821-829
Author(s):  
Emil Rothstein ◽  
Francis B. Landis ◽  
Benjamin G. Narodick
Keyword(s):  
Lateral Decubitus Position ◽  
Lateral Decubitus

scholarly journals The Cardiac Sympathetic Nerve Activity in the Elderly Is Attenuated in the Right Lateral Decubitus Position

2017 ◽  
Vol 3 ◽  
pp. 233372141770807 ◽  
Author(s):  
Konosuke Sasaki ◽  
Mayu Haga ◽  
Sarina Bao ◽  
Haruka Sato ◽  
Yoshikatsu Saiki ◽  
...  
Keyword(s):  
Heart Rate ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Lateral Decubitus Position ◽  
The Other ◽  
Elderly Adults ◽  
Nerve Activity ◽  
Left Lateral Decubitus Position ◽  
Lateral Decubitus ◽  
The Right

Objectives: The aim of this study was to evaluate the effect of the supine, left lateral decubitus, and right lateral decubitus positions on autonomic nervous activity in elderly adults by using spectral analysis of heart rate variability (HRV). Method: Forty-five adults aged 73.6 ± 5.7 years were enrolled. After lying in the supine position, all participants moved to the lateral decubitus positions in a random order and maintained the positions for 10 min, while electrocardiographic data were recorded to measure HRV. Results: The lowest heart rate continued for 10 min when participants were in the left lateral decubitus position compared with the other two positions ( p < .001), while the HRV indexes remained unchanged. The low-frequency HRV to high-frequency HRV ratio (LF/HF) for the right lateral decubitus position was significantly lower than that for the other positions. Discussion: The right lateral decubitus position may attenuate sympathetic nerve activity in elderly adults.

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