scholarly journals Outcome Assessment of Open Foot Injuries in A Teaching Hospital in Ghana

2019 ◽  
Vol 2 (4) ◽  
pp. 14-22
Author(s):  
Dominic Konadu-Yeboah ◽  
Peter Konadu ◽  
Ampem Darkwa ◽  
Virtue Fiawokome De-gaulle ◽  
Holdbrook Smith ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Weight Bearing ◽  
Open Fractures ◽  
Time Interval ◽  
Foot Injuries ◽  
Concomitant Injuries ◽  
Adequate Treatment ◽  
Foot Injury ◽  
Chi Square Analysis ◽  
Open Injuries

Purpose Foot injuries are common in low- and middle-income countries and continue to increase in incidence due to the surge in the use of motorcycles as means of transport.Yet, there is scanty data on the incidence and outcomes of treatment of open injuries to the foot in the developing world.We aimed to determine the incidence and functional outcomes of open foot injuries that are treated in a teaching hospital in Ghana. Methods We used a structured questionnaire to record the type of open foot injury, the mechanism of injury, any concomitant injuries, the time interval between injury and arrival at the hospital for treatment as well as the type of treatment instituted. Recruited patients were followed up for six months, complications resulting from the injury or its treatment were recorded for each patient. The function of the foot after healing of the injury was measured using a questionnaire-based visual analogue outcome scale of the American Foot and Ankle Society. Regression and chi-square analysis were used to evaluate potential associations. Results Over a four-month period, a total of 81 cases of open injuries to the foot were recorded. Out of this figure, 55 patients (67.9%) were males and 26 (32.1%) were females. It was found, that 66.7% aged between 19 and 49 years, 76.5% of the injuries occurred on the road and 29.7% was motor cycle related. Pedestrians are the most afflicted (61.7%). The treatment outcomes of traumatic amputations, open phalangeal fractures, dorsal skin degloving and lacerations were good. Gustillo-Anderson grade IIIB open fractures with associated plantar skin degloving had the worst outcomes with residual pain on weight bearing, bigger foot, inability to wear previous shoes and inability to tiptoe on the affected foot. Conclusions Open injuries to the foot are common in Ghana and exert a significant health burden, particularly on active young males. Long term disability may occur, even after adequate treatment of open fractures involving the foot.

scholarly journals Epidemiological Pattern of Foot Injuries in India: Preliminary Assessment of Data from a Tertiary Hospital

2012 ◽  
Vol 46 (3) ◽  
pp. 144-147 ◽  
Author(s):  
Manuj Jain ◽  
Sarvdeep Dhatt
Keyword(s):  
Tertiary Hospital ◽  
Road Accident ◽  
Preliminary Assessment ◽  
Foot Injuries ◽  
Surgical Delay ◽  
Foot Injury ◽  
High Incidence ◽  
Epidemiological Pattern ◽  
High Index Of Suspicion ◽  
Open Injuries

ABSTRACT Foot injuries are an often disabling, especially when the diagnosis is delayed and treatment is inappropriate; this becomes significant in polytrauma where diagnosis maybe missed, and in young adults who are injured in the prime of life. No data on foot injury is available from India or any other developing country; we undertook a prospective 1 year study to evaluate incidence and epidemiology of foot injuries seen at our center. One hundred and thirty-four feet were injured in 1,765 patients, with 82% being males, and the average age being 30.8 years. Road accident was predominant cause (73.8%) in contrast to the published literature, with two-third being open injuries; 47% were polytrauma victims. The surgical delay averaged 3.14 days, reasons for which were multifactorial. This high incidence of foot injury (7.59%) in men in their most productive years assumes significance when residual disability occurs due to mismanagement. A high index of suspicion needs to be maintained in road accident victims and polytrauma cases, so that foot injury is not missed and treatment is not inordinately delayed. How to cite this article Dhillon MS, Aggarwal S, Dhatt S, Jain M. Epidemiological Pattern of Foot Injuries in India: Preliminary Assessment of Data from a Tertiary Hospital. J Postgrad Med Edu Res 2012;46(3):144-147.

scholarly journals Outcome of Ilizarov assisted ankle arthrodesis

2018 ◽  
Vol 5 (2) ◽  
pp. 433
Author(s):  
Priyajit Chattopadhyay ◽  
Paras Kumar Banka ◽  
Anindya Debnath ◽  
Sanjay Kumar
Keyword(s):  
Dynamic Compression ◽  
Weight Bearing ◽  
Major Complication ◽  
Ankle Arthrodesis ◽  
Time Interval ◽  
Early Weight Bearing ◽  
Ilizarov Fixator ◽  
American Orthopaedic ◽  
Second Procedure

Background: Among the various techniques used for ankle arthrodesis, Ilizarov technique has various advantages along with the potential for treating complex and failed cases.Methods: Eleven cases were undertaken for ankle arthrodesis using the Ilizarov fixator. Two rings were applied along the tibia and one at the talus/calcaneum. The articular cartilage was denuded, and dynamic compression applied. The clinical, functional and radiological outcome were evaluated. The goal was a stable fusion with a well aligned foot.Results: The mean follow-up period was 95 weeks. Fusion was achieved in all cases with no major complication. Only one case had a residual deformity. The average time interval for the ankle fusion was 140.8±25.7 days. The postoperative modified American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot score was 67.5±9.6 points.Conclusions: Ilizarov assisted ankle arthrodesis aids in early weight bearing, better alignment, and has good functional outcomes even in cases with previously failed procedures. It has the advantage of postoperative readjustment of the arthrodesis without the need of any second procedure with no major complications.

Epoxy-Pin External Skeletal Fixation for Management of Open Bone Fractures in Calves and Foals: A Review of 32 Cases

2019 ◽  
Vol 32 (03) ◽  
pp. 257-268
Author(s):  
Hari Aithal ◽  
Prakash Kinjavdekar ◽  
Abhijit Pawde ◽  
Prasoon Dubey ◽  
Rohit Kumar ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Weight Bearing ◽  
Fracture Site ◽  
Open Fractures ◽  
Adhesive Tape ◽  
Stable Fixation ◽  
Early Weight Bearing ◽  
Pin Fixation ◽  
Bone Fragments ◽  
The Subject

Objective The aim of this study was to evaluate epoxy-pin external skeletal fixation technique for the treatment of open fractures in calves and foals. Study Design Twenty-eight calves and four foals (weighing 45–105 kg) with fractures distal to the stifle or elbow made the subject for the retrospective study. The pins (2.0–3.0-mm Kirschner wires, crossed at 60–90°) were fixed at least at two locations in both proximal and distal bone fragments as per the case situation. The pins in the same plane were bent (∼2 cm from the skin) towards the fracture site or joint and were joined using an adhesive tape (additional pins used when required) to make a temporary scaffold of connecting bars or rings. Thoroughly mixed epoxy putty was applied along the pin scaffold (the epoxy columns were 20–25 mm diameter) and allowed to set for 45 to 60 minutes. All animals were evaluated based on various clinical and radiographic observations made at regular intervals. Results The epoxy-pin fixation was easy to apply and provided stable fixation of bone as indicated by early weight bearing, and fracture healing within 45 to 60 days (17/32 cases). The functional recovery was good to very good in 14 animals and satisfactory in nine cases by 12 months after removal of the fixator. Conclusions The multiplanar epoxy-pin external skeletal fixation provides stable fixation of unstable open fractures distal to the stifle or elbow joint; hence, it can be used to treat a variety of fractures in calves and foals weighing up to approximately 100 kg, especially open infected fractures of lower limb, which are difficult to treat by conventional techniques.

scholarly journals Epidemiology of Operative Foot injuries in College Level Athletes

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0013
Author(s):  
Jimmy J. Chan ◽  
Kevin K. Chen ◽  
Javier Z. Guzman ◽  
Ettore Vulcano
Keyword(s):  
Female Athletes ◽  
Injury Rate ◽  
College Level ◽  
Time Loss ◽  
Foot Injuries ◽  
Injury Rates ◽  
Foot Injury ◽  
Ncaa Athletes ◽  
Multiple Variables ◽  
Lisfranc Injuries

Category: Hindfoot, Lesser Toes, Midfoot/Forefoot, Sports, Trauma Introduction/Purpose: Foot injuries represent a broad category of injuries that may have profound implications in National Collegiate Athletic Association (NCAA) athletes. Accordingly, a more thorough characterization of these injuries and what predisposes NCAA athletes to them is crucial to their prevention. This study examines the incidence and effect of foot injuries on NCAA athletes and their athletic season. Methods: Foot injuries across 16 sports among men and women during the 2004-05 to 2013-14 academic years were analyzed from the NCAA Injury Surveillance Program (NCAA-ISP). Three common orthopaedic foot injuries were sub-analyzed, including fifth metatarsal injuries (5MT), Lisfranc injuries, and turf toes. Multiple variables were reported including injury rates per 100,000 athlete-exposures (IR), operative rate, annual injury rate trends, re-injury rates, in-season status (pre/in/post-season) at time of injury, and time loss distributions were compiled and calculated. Results: A total of 3718 foot injuries were identified over 10-year period. 4.4% of all injuries were operative. Overall foot injury rate was comparable between male (IR=31.1) and female athletes (IR=32.4); however, the operative injury rate was greater in male compared to female (IR=2.0 vs. 0.6) athletes. The top three operative injuries were 5MT (45.1%), stress fractures (12.2%), and Lisfranc injuries (7.9%). 10.8% of turf toes are re-injury, and average time loss was 7.0 days. 43% of 5MT injuries were operative, and 19.2% were re-injuries. 40.6% of 5MT injuries were season-ending with an average time loss of 36.5 days. 33% of Lisfranc injuries were operative, and 7.5% were re-injuries. 45.9% of Lisfranc injuries were season-ending with an average time loss of 25.9 days. Conclusion: Foot injuries are among the most common form of injuries that occur in NCAA athletics. In addition, these injuries can sometimes lead to significant loss of playing time and may even result in the end of the athlete’s season or career. Certain NCAA sports such as men’s football and basketball may more likely predispose patients to season ending injuries and require operative fixation. Close examination of the kinds of foot injuries and their respective mechanisms may help elucidate trends useful in the development of various prevention strategies.

The Violated Neck: Cervical Node Biopsy Prior to Definitive Treatment

1986 ◽  
Vol 94 (6) ◽  
pp. 605-610 ◽  
Author(s):  
K. Thomas Robbins ◽  
Randolph Cole ◽  
Jeffrey Marvel ◽  
Robert Fields ◽  
Patricia Wolf ◽  
...  
Keyword(s):  
Distant Metastases ◽  
Subsequent Treatment ◽  
Response To Treatment ◽  
Definitive Treatment ◽  
Wound Complications ◽  
Control Group ◽  
Time Interval ◽  
Adequate Treatment ◽  
Node Biopsy ◽  
Significant Difference

The intent of this study was to determine whether open neck biopsy for patients with squamous cell carcinoma metastatic to the neck influenced the biologic course of the disease or the response to treatment. One hundred ninety-two patients, treated over a 10-year period at M.D. Anderson Hospital and Tumor Institute, were reviewed; 102 of the 139 patients, whose primary site of disease was identified prior to definitive treatment, were matched with a control group of 204 patients. The results showed no significant difference in wound complications, neck recurrence, distant metastases, and 5-year survival. Also, time interval from the biopsy to subsequent treatment and the type of node biopsy did not appear to have any significant detrimental effect. On the basis of these findings, we conclude that, although it is important to refrain from proceeding with an open biopsy until a complete head and neck evaluation has been done, violation of the neck does not signify a poorer prognosis—provided adequate treatment is subsequently given.

scholarly journals Hand hygiene compliance by health care workers at a teaching hospital, Kingston, Jamaica

2016 ◽  
Vol 10 (10) ◽  
pp. 1088-1092 ◽  
Author(s):  
Alison M Nicholson ◽  
Ingrid A Tennant ◽  
Allie C Martin ◽  
Kelvin Ehikhametalor ◽  
Glendee Reynolds ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Teaching Hospital ◽  
Compliance Rate ◽  
Physical Contact ◽  
University Hospital ◽  
Chi Square ◽  
Factors Affecting ◽  
Outpatient Departments ◽  
Hygiene Compliance ◽  
Chi Square Analysis

Introduction: Consistent practice of hand hygiene (HH) has been shown to reduce the incidence and spread of hospital acquired infections. The objectives of this study were to determine the level of compliance and possible factors affecting compliance with HH practices among HCWs at a teaching hospital in Kingston, Jamaica. Methodology: A prospective observational study was undertaken at the University Hospital of the West Indies (UHWI) over a two weeks period. Trained, validated observers identified opportunities for hand hygiene as defined by the WHO “Five Hand Hygiene Moments” and recorded whether appropriate hand hygiene actions were taken or missed. Observations were covert to prevent the observer’s presence influencing the behaviour of the healthcare workers (HCWs) and targeted areas included the intensive care units (ICUs), surgical wards and surgical outpatient departments. A ward infrastructure survey was also done. Data were entered and analysed using SPSS version 16 for Windows. Chi-square analysis using Pearson’s formula was used to test associations between ‘exposure’ factors and the outcome ‘compliance’. Results: A total of 270 hand hygiene opportunities were observed and the overall compliance rate was 38.9%. No differences were observed between the various types of HCWs or seniority. HCWs were more likely to perform hand hygiene if the indication was ‘after’ rather than ‘before’ patient contact (p = 0.001). Conclusion: This study underscores the need for improvement in HH practices among HCWs in a teaching hospital. Health education with particular attention to the need for HH prior to physical contact with patients is indicated.

scholarly journals Acute correction of proximal tibial coronal plane deformity in small children using a small monolateral external fixator with or without cross-pinning

2021 ◽  
pp. 1-6
Author(s):  
Chaemoon Lim ◽  
Chang Ho Shin ◽  
Won Joon Yoo ◽  
Tae-Joon Cho
Keyword(s):  
External Fixator ◽  
Proximal Tibia ◽  
Weight Bearing ◽  
Coronal Plane ◽  
Time Interval ◽  
Angular Deformity ◽  
Small Children ◽  
Monolateral External Fixator ◽  
Tibia Osteotomy

PurposeSurgical correction of proximal tibia deformity in small children can be challenging. We present the surgical technique and outcome of proximal tibia osteotomy fixed with small monolateral external fixator in this patient group.MethodsA total of 17 cases in eight patients younger than nine years of age were study subjects. A proximal tibia osteotomy was fixed with a small monolateral external fixator with or without cross-pinning. Outcome was evaluated by changes of radiographic parameters such as medial proximal tibia angle (MPTA), metaphyseal diaphyseal angle (MDA) and clinical findings of complications, time interval until weight bearing and fixator removal time.ResultsMPTA improved from a preoperative mean of 73° (sd 4°; 66° to 78°) to an immediate postoperative mean of 90° (sd 3°; 85° to 96°) in varus tibiae, and from 104° (sd 1°; 103° to 105°) to 89° (sd 1°; 88° to 89°) in valgus tibiae. In all, 15 of the 17 cases (88.3 %) achieved postoperative MPTA within the normal range (85° to 90°). MDA improved from a preoperative mean of 19° (sd 5°; 11° to 24°) to an immediate postoperative mean of 0° (sd 4°; -6° to 7°) in varus tibiae, and from -25° (sd 2°; -22° to -24°) to 2° (SD 1°; 1° to 3°) in valgus tibiae. Full weight bearing was possible at mean 1.7 months (0.5 to 3.0). Mean follow-up period was 6.5 years (sd 5.4; 1.0 to 16.0). No complications developed during the follow-up.ConclusionProximal tibia osteotomy fixed with small monolateral external fixator provides accurate, safe and efficient correction in the management of coronal plane angular deformity in small children.Level of EvidenceLevel IV

169 BEHAVIORAL ASPECTS OF ESTRUS IN THE COMMON ELAND ANTELOPE, TAUROTRAGUS ORYX

2009 ◽  
Vol 21 (1) ◽  
pp. 183
Author(s):  
G. Wirtu ◽  
P. M. Pennington ◽  
C. E. Pope ◽  
R. A. MacLean ◽  
J. Mercado ◽  
...  
Keyword(s):  
Estrous Cycle ◽  
Captive Breeding ◽  
Detection System ◽  
Courtship Behavior ◽  
Animal Health ◽  
Reproductive Technologies ◽  
Time Of Day ◽  
Time Interval ◽  
Early Afternoon ◽  
Chi Square Analysis

Knowledge of the estrous cycle and behavior is important in managing captive breeding programs. However, such information is negligible in spiral-horned antelopes, including the eland. In the present study, conducted between September 2007 and March 2008, we sought to characterize mounting activity and courtship behavior in a group of eight adult eland females. Estrus was induced in groups of four females by treatment with 25 mg PGF2 ∝ (IM, Lutalyse®, Pharmacia and Upjohn Company, Kalamazoo, MI, USA) administered after 7 days of daily oral progestin (5 mL of 2.2% altrenogest, DPT Laboratories, San Antonio, TX, USA) or 11 days after an initial treatment of PGF2 ∝ (25 mg). The eight females received each treatment in a crossover design. Females were induced and monitored during the induced and subsequent natural estrus for 34 to 38 days. Observations for estrus behavior were initially assisted by using Estrotect™ heat detector patches (Rockyway, Inc., www.estrotect.com). Since January 2008, the HeatWatch® electronic heat detection system (CowChips, Denver, CO, USA) and an androgenized eland female were used to assist with heat detection. For androgenization, 8 pellets of Synovex-H® (Fort Dodge Animal Health, Fort Dodge, IA) comprising a total dose of 1600 mg testosterone propionate and 160 mg estradiol benzoate were implanted (SC) on the convex side of the ear. To confirm mounting activity detected by Estrotect™ or HeatWatch®, eland behavior was recorded continuously using an 8-channel real time DVR. Chi-square analysis was used to test the association between time of day (day or night) and the frequency of standing to be mounted. The cycle length (n = 6 females) was the time interval (d) between the first mounts at the induced and natural estrus. The time of mounts was determined for a total of 52 mounts. More than half of the mounts (n = 32 or 61.5%) occurred between 6 pm and 6 am (night); however, there was no association between the number of mounts and time of the day (p = 0.886). Analysis of mounts by quarters of the day showed that mounts were evenly distributed between early afternoon (noon to 6 pm: 29%), late afternoon (6 pm to midnight: 33%) and early morning (midnight to 6 am: 29%) but were less frequent during late morning, between 6 am and noon (10%) possibly due to interference by human activities. The number of mounts observed per female ranged from 1 to 20. Mounts lasted for 2 seconds or less. The duration of estrus ranged from 2.1 to 29.0 hours. Typical courtship behaviors included prolonged head butting, flehmen response and following the female in estrus before mounting. The average length of the estrous cycle, based on mounting activities, was 19.3 d (range: 17–24). Although further studies are required in herds with eland males, the present results suggest that estrus detection for captive breeding or application of reproductive technologies in the eland should be spread around different times of the day and night. We have also demonstrated that an electronic mount detection system can be applied to assist with determination of estrus in the eland.

scholarly journals Out-of-Hospital Cardiac Arrest in a Teaching Hospital in Hong Kong: Descriptive Study Using the Utstein Style

2005 ◽  
Vol 12 (3) ◽  
pp. 148-155 ◽  
Author(s):  
AKC Wai ◽  
P Cameron ◽  
CK Cheung ◽  
P Mak ◽  
TH Rainer
Keyword(s):  
Cardiac Arrest ◽  
Hong Kong ◽  
Hospital Discharge ◽  
Teaching Hospital ◽  
Discharge Rate ◽  
Demographic Data ◽  
University Teaching ◽  
Time Interval ◽  
Utstein Style ◽  
Hospital Cardiac Arrest

Objective To describe, using the Utstein template, the characteristics of patients presenting with out-of-hospital cardiac arrest to a university teaching hospital in the New Territories of Hong Kong, and to evaluate survival. Design Prospective study. Setting The emergency department of a teaching hospital in the New Territories, Hong Kong. Participants Patients older than 12 years with non-traumatic out-of-hospital cardiac arrest who were transported to the hospital between 1 July 2002 and 31 December 2002. Main outcome measures Demographic data, characteristics of cardiac arrest and response time intervals of the emergency medical service presented according to the Utstein style, and also survival to hospital discharge rate. Results A total of 124 patients were included (49.2% male; mean age 71.9 years). The majority of cardiac arrests occurred in patients' home. The overall bystander cardiopulmonary resuscitation (CPR) rate was 15.3% (19/124). The most common electrocardiographic rhythm at scene was asystole, whilst pulseless ventricular tachycardia (VT)/ventricular fibrillation (VF) was found in 18.0%. The overall survival was 0.8% (1/124), and survival to hospital discharge was significantly higher for patients with VF or pulseless VT than those patients with other rhythms of cardiac arrest (11.1% versus 0%). The median witnessed/recognised collapse to defibrillation time was 14 minutes. The median prehospital time interval from collapse/recognition to arrival at hospital was 33 minutes. Conclusion The prognosis of out-of-hospital cardiac arrest in Hong Kong was poor. Major improvements in every component of the chain of survival are necessary.

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