Study of incidence and cause of delay for treatment of long bone fractures of the lower limb in tertiary care hospital

Background: Musculoskeletal trauma represents a considerable global health burden. Lower limb long bone fractures are seen as a serious concern at the individual and population level. So the purpose of the study was to find incidence and cause of delay for treatment of long bone fractures of the lower limb in tertiary care hospital.Methods: All adult patients (more than 18 years) reporting to Emergency Medicine Department of a tertiary care hospital with long bone fractures of lower limb were included in the study. Effects on the final outcome on the lifestyle of the patients were evaluated against the interventions and management at all stages of the course of the illness. Delay of surgery: in our study delay of surgery means if surgery occurs after one day (24 hours) of admission. The entire data is statistically analysed using SPSS software. P values less than 0.05 are considered to be statistically significant.Results: 74 operated cases. 60 cases (81.10%) had delayed surgery, 14 cases (18.9.0%) did not have delayed surgery. 33 cases (55%) had medical reason for delay, 19 cases (31.7%) had financial reason for delay, 5 cases (14.3%) had infrastructure issues (unit system/non availability of implant), 3 cases (5.0%) had plan of surgery as causes of delay.Conclusions: These factors have an effect in the final outcome of the cases. The final outcome is dependent on multiple factors. Adequate attention to each and every one of them was long way to get the patient to the pre-incident stage.

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Assessment of complications for long bone fractures treatment in tertiary care hospital

MedPulse International Journal of Anesthesology ◽

10.26611/10151212 ◽

2019 ◽

Vol 12 (1) ◽

pp. 05-08

Author(s):

Elizabeth C Sada ◽

◽

Firdaus Bhot ◽

Rohit Kanishetty ◽

◽

...

Keyword(s):

Tertiary Care Hospital ◽

Bone Fractures ◽

Tertiary Care ◽

Long Bone ◽

Care Hospital ◽

Long Bone Fractures

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Assessment of pain management intervention for treatment of long bone fractures in tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20194209 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1544

Author(s):

Elizabeth C. Sada ◽

Firdaus Bhot ◽

Rohit Kanishetty

Keyword(s):

Pain Management ◽

Lower Limb ◽

Initial Treatment ◽

Personal Experience ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Long Bone ◽

Study Patient ◽

Care Hospital ◽

Management Intervention

Background: Musculoskeletal trauma represents a considerable global health burden. Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. So the purpose of the study was to do assessment of pain management intervention, post-op analgesics for treatment of long bone fractures.Methods: All adult patients (more than IS years) reporting to Emergency Medicine Department of a tertiary care hospital with long hone fractures of lower limb were included in the study. Patient pain management was assessed by visual analogue score (VAS). Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. The entire data is statistically analyzed using SPSS software. p-values less than 0.05 are considered to be statistically significant.Results: 74 cases got operated, 64 cases (86.5.0%) did not have any intra-op complications and 10 cases (13.50%) had intra-op complications .Postoperative analgesia the 74 cases operated was as follows: 17 cases (23.0%) epidural anaesthesia 41 Cases (55.4%) had epidural + intravenous analgesics. Recent was managed with 1.V, analgesics alone; 12 cases (16.20%) had tramadol, 2 cases (2.7%) received paracetamol and 2 cases (2.7%) had dynaper for post-operative analgesia.Conclusion: Adequate pain management on arrival in the Emergency Department is an important aspect in patient care and is not at all difficult to achieve. Femoral nerve block in Proximal lower limb fractures is very effective and easy to perform.

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ICD-10 Diagnostic Coding for Identifying Hospitalizations Related to a Diabetic Foot Ulcer

Clinical & Investigative Medicine ◽

10.25011/cim.v44i4.37592 ◽

2021 ◽

Vol 44 (4) ◽

pp. E11-16

Author(s):

Muzammil H. Syed ◽

Mohammed Al-Omran ◽

Jean Jacob-Brassard ◽

Joel G. Ray ◽

Mohamad A. Hussain ◽

...

Keyword(s):

Lower Limb ◽

Diabetic Foot ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Care Hospital ◽

Reference Standard ◽

Diagnostic Coding ◽

Icd 10

Purpose: To estimate the positive predictive value (PPV) of Canadian ICD-10 diagnostic coding for the identification of hospitalization related to a diabetic foot ulcer (DFU). Methods: Hospitalizations related to a neuropathic and/or ischemic DFU were identified from the Discharge Abstract Database (DAD) records of a single Canadian tertiary care hospital between April 1, 2002 and March 31, 2019. The first coding approach required a most responsible diagnosis (MRDx) code for diabetes-specific foot ulceration or gangrene (DSFUG group). Three alternative coding approaches were also considered: MRDx code for lower-limb osteomyelitis (osteomyelitis group); lower-limb ulceration (LLU group); or lower-limb atherosclerotic gangrene (atherosclerosis group)—each in conjunction with a non-MRDx DSFUG code on the same DAD record. From all eligible DAD records, random samples were drawn for each coding group. DAD records were independently compared by a masked reviewer who manually abstracted data from the entire hospital record (reference standard). The PPV and 95% CI were generated. Results: Out of 1,460 hospitalizations, a total of 300, 50, 33 and seven records were included from the DSFUG, osteomyelitis, LLU and atherosclerosis samples, respectively. Compared to the reference standard, the PPV for all 390 records was 88.5% (95% CI 84.9 to 91.5). The DSFUG group had the highest PPV (90.0%, 95% CI 86.0 to 93.2), followed by the atherosclerosis (85.7%, 95% CI 42.1 to 99.6), LLU (84.9%, 95% CI 68.1 to 94.9) and osteomyelitis (82.0%, 95% CI 68.6 to 91.4) groups. Conclusion: Based on data from a Canadian tertiary care hospital, the specified coding algorithms can be used to identify and study the management and outcomes of people hospitalized with a DFU in Ontario.

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A comparative study of colour doppler findings in diabetic and non-diabetic lower limb deep vein thrombosis patients attending tertiary care hospital

International Journal of Radiology and Diagnostic Imaging ◽

10.33545/26644436.2020.v3.i1d.86 ◽

2020 ◽

Vol 3 (1) ◽

pp. 284-288

Author(s):

Dr. Priyanka Pawar ◽

Dr. Anil G Joshi

Keyword(s):

Deep Vein Thrombosis ◽

Comparative Study ◽

Lower Limb ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Colour Doppler ◽

Vein Thrombosis ◽

Deep Vein ◽

Limb Deep Vein Thrombosis

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Prevention of posttraumatic hypoxaemia in isolated lower limb long bone fractures with a minimal prophylactic dose of corticosteroids

Injury ◽

10.1016/s0020-1383(03)00056-1 ◽

2004 ◽

Vol 35 (3) ◽

pp. 309-317 ◽

Cited By ~ 13

Author(s):

George A Babalis ◽

Christos K Yiannakopoulos ◽

Konstantinos Karliaftis ◽

Emmanuel Antonogiannakis

Keyword(s):

Lower Limb ◽

Bone Fractures ◽

Long Bone ◽

Prophylactic Dose ◽

Long Bone Fractures

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Percutaneous plating of lower limb long bone fractures

Injury ◽

10.1016/j.injury.2006.01.020 ◽

2006 ◽

Vol 37 (6) ◽

pp. 543-553 ◽

Cited By ~ 3

Author(s):

Eve W.Y. Wong ◽

Edison W.K. Lee

Keyword(s):

Lower Limb ◽

Bone Fractures ◽

Long Bone ◽

Long Bone Fractures

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Outcomes of Lower Limb Ulcers in Diabetics vs Non Diabetics – Our Experience in a Tertiary Care Hospital

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v8i4.34 ◽

2020 ◽

Vol 08 (04) ◽

Author(s):

Pratha Anantha Ramani ◽

Keyword(s):

Lower Limb ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital

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Management of infected non-union of lower limb long bone fractures using ilizarov technique: a study of outcomes

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171901 ◽

2017 ◽

Vol 3 (3) ◽

pp. 557 ◽

Cited By ~ 1

Author(s):

Hrishikesh Pande ◽

Chander Mohan Singh ◽

Anjan Prabhakara ◽

Vivek Mathew Philip ◽

Mohd Shezan Iqbal ◽

...

Keyword(s):

Lower Limb ◽

Bone Fractures ◽

Lower Limbs ◽

Long Bone ◽

Long Bones ◽

Ilizarov Technique ◽

Infected Nonunion ◽

Ring Fixator ◽

Long Bone Fractures ◽

Ilizarov Ring Fixator

Background: Nonunion of long bone fractures is a common condition treated by an orthopaedic surgeon. Many nonunions can be treated effectively by internal fixation with or without bone grafting but, an infected nonunion can prove to be a tough challenge. The Ilizarov method is effective in managing infected nonunion of long bones. This study aims to assess the outcome of management of infected nonunions of long bones of lower limb with Ilizarov Ring fixator using bone and functional results as per Association for the Study and Application of Methods of Ilizarov (ASAMI) Scoring System.Methods: We retrospectively analysed 18 patients (16 Male: 2 Female; Mean age 43.2 years) managed with Ilizarov technique for an infected tibial or femoral nonunion between 01 January 2013 and 31 December 2014. They were followed up for an average of 25.4 months after removal of fixator. They were assessed for functional and Bone (radiological) outcomes using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria.Results: 17 limbs were salvaged and union could be achieved. One limb required amputation due to severe persistent intractable infection. None required any additional skeletal stabilisation after removal of fixator frame except casting in a few patients for a period of 6 weeks. Mean time to union was 211.83 days (range 136 - 320days/median 184) or 7.01 months. As per the ASAMI score, Bone results were excellent in 10, good in 5, fair in 2 and poor in 1. Functionally 7 were graded as excellent, 6 as good, 3 as fair and 1 as poor and 1 patient underwent amputation.Conclusions: The Ilizarov’s method remains one of the most versatile and successful means of achieving bone healing in infected nonunions of long bones of lower limbs with additional benefits of correcting bone defects, deformities and limb length inequalities.

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