scholarly journals Comparison of below knee cast and elasticated support bandage treatment foe an isolated fracture of the lateral malleolus

2017 ◽  
Vol 17 (2) ◽  
pp. 12-17
Author(s):  
Rajram Maharjan
Keyword(s):  
Ankle Fracture ◽  
External Rotation ◽  
Lateral Malleolus ◽  
Stage Ii ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Rotation Stage ◽  
Supination External Rotation

Introduction: Ankle fractures are the most common type of fractures treated in orthopaedics with isolated malleolar fractures, accounting for two-thirds of fractures. The most common injury mechanism is supination external rotation, which accounts for the majority of all ankle fracture patterns. Supination external rotation stage II is the classic short oblique fracture of the distal fibula without a medial side injury, which responds well to non-operative treatment as it is a stable fracture. The purpose of this study is to compare efficacy of elasticated support bandage versus plaster cast in the patient with isolated lateral malleolus fracture (Lauge-Hansen supination- eversion external stage II.)Method: A prospective comparative study was carried out in the Department of Orthopaedics in Bir Hospital from February 2007 to January 2009. Patients with ankle fracture were initially treated by below knee posterior slab for seven days to allow the swelling to subside and on seventh day follow-up they were grouped in two groups. Group A were patients with below knee cast and Group B were elasticated support bandage. Both groups were followed-up in the 5th week for cast or elasticated bandage removal and were evaluated after a week, thereafter, every monthly for 3 months and finally at 6 month.Result: Of the 48 cases enrolled, the mean age of the patients was 38.85 years. The common mode of injury was fall from height followed by road traffic accident. The modified subjective ankle score of Olerud and Molander (1984) was found more in group B in comparison to group A in all follow ups. In initial three successive follow ups at 6 week, 12 week and at 3 month subjective score was found statistically significant (p> 0.05) however, it was not significant at 6 month follow up. The range of motion was significantly improved in group B in all follow ups but the difference between the two groups at 6 weeks and 10 weeks follow ups was statistically significant. Immobilized group required less analgesic but the difference was not significant statistically.Conclusion: Both below knee cast and elasticated support bandage treatment methods are safe, satisfactory and equally effective with a better early result in elasticated support bandage. Supination External Rotation stage II type fracture can be treated conservatively, if there is no medial tenderness.Journal of Society of Surgeons of NepalVol. 17, No. 2, 2014, Page: 7-11

Osseous Talofibular Impingement after Supination–External Rotation Stage II Ankle Fracture: Case Report

2012 ◽  
Vol 33 (11) ◽  
pp. 1006-1010
Author(s):  
Michael Q. Potter ◽  
Brad D. Blankenhorn ◽  
Frank R. Avilucea ◽  
Timothy C. Beals ◽  
Florian Nickisch
Keyword(s):  
Case Report ◽  
Ankle Fracture ◽  
External Rotation ◽  
Stage Ii ◽  
Rotation Stage ◽  
Supination External Rotation

scholarly journals Which Surgical Method is More Effective in the Fifth Metatarsal Base Fracture?

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Jun-Beom Kim ◽  
Chi Ahn ◽  
Byeong-Seop Park
Keyword(s):  
Clinical Results ◽  
Plate Group ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Clinical And Radiological Results ◽  
Mean Time ◽  
Screw Group

Category: Trauma Introduction/Purpose: The aim of this study was to evaluate and compare the clinical and radiological results of internal fixation with headless cannulated screw and locking compression distal ulna hook plate for the fracture at the base of fifth metatarsal bone, Zone 1. Methods: From April 2012 to April 2015, thirty cases (29 patients) were evaluated retrospectively. The mean follow up periods was 13 months. There were divided two groups based on use of the screw (group A, n=15) or the plate (group B, n=15).We measured the displacement to diastasis of the fracture on the foot oblique radiographs taken pre- and post-operatively in each group, checked the time to bone union and the difference of the reduction distance in each group. Clinical results were evaluated using American Orthopedic Foot and Ankle Society (AOFAS) midfoot score at 12 months postoperative. Results: In group A, the mean time to union was 54.2±9.3 days, the mean displacement to diastasis improved to 0.3±0.4 mm postoperatively (p<0.001), and the mean reduction distance was 2.9±1.0 mm. In group B, the mean time to union was 41.5±7.0 days, the mean displacement to diastasis improved to 0.06±0.2 mm postoperatively (p<0.001), and the mean reduction distance was 4.1±1.6 mm. AOFAS score was verified 97.7±3.4 in group A and 98.2±3.2 in group B. The time to union was significantly different between groups A and B (p=0.01).There were no complications. Conclusion: We suggest that the plate is more effective method for the shorter union time in surgical treatment of fifth metatarsal base fractures.

scholarly journals Less is more: does the addition of barrel staves improve results in endoscopic strip craniectomy for sagittal craniosynostosis?

2017 ◽  
Vol 20 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Benjamin C. Wood ◽  
Edward S. Ahn ◽  
Joanna Y. Wang ◽  
Albert K. Oh ◽  
Robert F. Keating ◽  
...  
Keyword(s):  
Consecutive Series ◽  
Less Is More ◽  
Sagittal Craniosynostosis ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Scan Data ◽  
Group B ◽  
Strip Craniectomy

OBJECTIVEEndoscopic strip craniectomy (ESC) with postoperative helmet orthosis is a well-established treatment option for sagittal craniosynostosis. There are many technical variations to the surgery ranging from simple strip craniectomy to methods that employ multiple cranial osteotomies. The purpose of this study was to determine whether the addition of lateral barrel-stave osteotomies during ESC improved morphological outcomes.METHODSAn IRB-approved retrospective review was conducted on a consecutive series of cases involving ESC for sagittal craniosynostosis at 2 different institutions from March 2008 to August 2014. The patients in Group A underwent ESC and those in Group B had ESC with lateral barrel-stave osteotomies. Demographic and perioperative data were recorded; postoperative morphological outcomes were analyzed using 3D laser scan data acquired from a single orthotic manufacturer who managed patients from both institutions.RESULTSA total of 73 patients were included (34 in Group A and 39 in Group B). Compared with Group B patients, Group A patients had a shorter mean anesthetic time (161.7 vs 195 minutes; p < 0.01) and operative time (71.6 vs 111 minutes; p < 0.01). The mean hospital stay was similar for the 2 groups (1.2 days for Group A vs 1.4 days for Group B; p = 0.1). Adequate postoperative data on morphological outcomes were reported by the orthotic manufacturer for 65 patients (29 in Group A and 36 in Group B). The 2 groups had similar improvement in the cephalic index (CI): Group A, mean change 10.5% (mean preoperative CI 72.6, final 80.4) at a mean follow-up of 13.2 months; Group B, mean change 12.2% (mean preoperative CI 71.0, final 79.6) at a mean follow-up of 19.4 months. The difference was not statistically significant (p = 0.15).CONCLUSIONSBoth ESC alone and ESC with barrel staving produced excellent outcomes. However, the addition of barrel staves did not improve the results and, therefore, may not be warranted in the endoscopic treatment of sagittal craniosynostosis.

scholarly journals Therapeutic effects of internal fixation with support plates and cannulated screws via the posterolateral approach on supination external rotation stage IV ankle fracture

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Zhongbing Liu ◽  
Genling Tang ◽  
Shuguang Guo ◽  
Bin Cai ◽  
Qingsong Li
Keyword(s):  
Ankle Fracture ◽  
External Rotation ◽  
Stage Iv ◽  
Cannulated Screw ◽  
Posterolateral Approach ◽  
Therapeutic Effects ◽  
Cannulated Screws ◽  
Support Plate ◽  
Rotation Stage ◽  
Supination External Rotation

Objective: To evaluate the therapeutic effects of internal fixation with support plates and cannulated screws via the posterolateral approach on supination external rotation stage IV ankle fracture. Methods: Eighty-five patients with SER-IV°ankle fracture and large posterior malleolar fracture treated from June 2016 to June 2018 in our hospital, were randomly divided into a support plate group (n=47) and a cannulated screw group (n=38). The treatment outcomes were compared regarding surgical time, amount of bleeding, time of fracture healing, postoperative complications, as well as the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score and excellent rate one year later. Results: The surgical time and intraoperative blood loss of cannulated screw group were significantly lower than those of support plate group (P<0.05). There were four cases of posterior lateral incision redness complicated with obvious bloody exudation in support plate group on the postoperative 2nd day. One case developed into superficial incision infection subsequently, and one case suffered from deep infection. After dressing and treatment with sensitive antibiotics, stitch removal was delayed, and primary healing was obtained. In cannulated screw group, there were two cases of posterior lateral incision redness complicated with obvious bloody exudation on the postoperative 3rd day, without skin incision infection. One case had cannulated screw loosening two months after surgery, and the posterior malleolar fracture block was slightly displaced. The incidence of surgical complications in support plate and cannulated screw groups were 8.51% and 7.89%, respectively (P>0.05). The AOFAS scores of cannulated screw ((81.71 ± 12.39) points) and support plate groups ((86.62 ± 10.12) points) were significantly different (P<0.05). Conclusion: For patients with posterior malleolar fracture or osteoporosis, fixation using support plate is recommended. Cannulated screw fixation is suitable for for patients with poor conditions of skin soft tissues or basic diseases such as diabetes intolerant to long surgery. doi: https://doi.org/10.12669/pjms.36.3.1671 How to cite this:Liu Z, Tang G, Guo S, Cai B, Li Q. Therapeutic effects of internal fixation with support plates and cannulated screws via the posterolateral approach on supination external rotation stage IV ankle fracture. Pak J Med Sci. 2020;36(3):---------.  doi: https://doi.org/10.12669/pjms.36.3.1671 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Influence of Modic Changes on Cervical Fusion After Single-level Anterior Cervical Discectomy and Fusion.

2021 ◽  
Author(s):  
Mengxin Zhang ◽  
Shangpu Zhang ◽  
Yong Shen ◽  
Zhanyong Wu
Keyword(s):  
Bone Marrow ◽  
Fusion Rate ◽  
Modic Changes ◽  
Anterior Cervical Discectomy ◽  
Cervical Fusion ◽  
Single Level ◽  
Group A ◽  
The Difference ◽  
Group B

Abstract Objective: The purpose of this study was to investigate the relationship between cervical Modic changes and cervical fusion. Methods: This study enrolled 222 patients who underwent single-level anterior cervical discectomy and fusion(ACDF) surgical treatment between April 2014 and July 2019 at our institution, xingtai mining group general. All patients were followed up for more than 1 year after surgery. According to the presence or absence of Modic changes, 66 cases were divided into group A with Modic changes and 156 cases in group B without Modic changes. The pathological changes of cervical spine Modic were divided into 3 stages: Type 1 (inflammation or edema), manifested as endplate and subendplate The tissue is replaced by fibrovascular tissue, accompanied by granulation tissue ingrowth, bone marrow and trabecular edema; type 2 (fatty stage or yellow bone marrow stage), showing the corresponding histopathological changes as red bone marrow transition between trabecular bone It is yellow bone marrow with a large amount of adipose tissue deposition; Type 3 (osteosclerosis stage), which manifests as the endplate and the sub-endplate tissue hyperplasia and hardening into bone tissue. The bone healing process is roughly divided into the organizing period of hematoma formation; the original callus formation period; and the plastic period of callus transformation. According to Modic I, II, and III classifications, sub-groups are carried out in sequence: A1, A2, A3, and the differences in fusion between the groups during follow-up are compared. Results: There was a statistically significant difference between the two groups at the 3 months (p=0.004) and 6 months (p=0.044) follow-up of group A and group B, and there was no statistical difference between the two groups at the last follow-up (p=0.43) Significance; the three groups of A1, A2, and A3 were followed up for 3 months (p=0.007) and 6 months (p=0.002). The difference between the three groups was statistically significant, and the difference between the three groups at the last follow-up (p=0.092) No statistical significance. Conclusion: The fusion rate of patients with cervical Modic changes in the early and middle postoperative period is lower than that of normal cervical patients, and the fusion effect of Modic type I patients is better than that of Moidc II and III. However, the last follow-up showed that all patients have achieved fusion, that is, cervical Modic changes have a positive effect. The patient's fusion rate has no effect.

scholarly journals INGUINAL HERNIOPLASTY

2009 ◽  
Vol 16 (04) ◽  
pp. 475-480
Author(s):  
MUHAMMAD SUHAIL AMER ◽  
MUHAMMAD ASHRAF
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Sampling Technique ◽  
Clinical Problem ◽  
Preoperative Pain ◽  
Group A ◽  
The Difference ◽  
Group B

Introduction: Chronic pain following inguinal hernia repair is becoming a significant clinical problem, involving increased numberof patients and surgeons. Much controversy exists regarding treatment. Elective division of the nerves has been proposed to reduce the riskof chronic post operative pain. O b j e c t i v e s : To evaluate the effectiveness of elective neurectomy during open hernia mesh repair, in reducingpostoperativ pain. Materials a n d m e t h o d s : Settings: All patients admitted in SUN department of surgery, Allied Hospital Faisalabad wereincluded in study. Study was started after the approval of synopsis on with inguinal hernia 2n d Feb, 2007 to Aug, 2007.100 patients of inguinalhernias were divided into 2 groups, 50 in each group i.e. group A & group B. The last patient was registered in the first week of July,convenience nonprobability sampling was used for location of patients in two groups. Results: On day one the pain was assessed in the twogroups i.e. Group A and group B (convenience non probability sampling technique used for patient grouping).It was found to be absent in 24/50(48 %) and 18/50 (36 %), mild in 10/50 (20 %) and 12/50 (24 %), it was moderate in10/50 (20 %) and 10/50 (20 %) and was severe in 6/50(12%) and 10/50 (20%) in the two groups respectively. One week after operation, in groups A and B, respectively, pain assessed with the useof the 4-point verbal scale was absent in 45 patients (90%) and 37 patients (74%), mild in 3/50 (6%) and 4/50 (8%), moderate in 2/50 (4%) and6/50 (12%), and severe in none and 3/50 (6%). Postoperative pain was not correlated with the presence of preoperative pain, and no correlationwas evidenced in the 2 subgroups. One month after operation, follow-up visits were performed in group A patients and group B patients. Inparticular, pain was absent in 46/50 (92%) patients in group A and 41/50 (82%) patients in group B. It was mild in 2 (6%) and 6/50 (12 %),moderate in 2/50 (4%) and 2/50 (4 %) none of the patients with elective neurectomy had pain at follow up of one month and 1 (2 %)one patientwithout elective neurectomy had pain. The numbness was assessed by checking sense of touch around the operated area. The difference foundbetween the 2 groups with respect to the presence of numbness was 15/50 (30 %) and 7/50 (14%) in the two groups i.e. group A and groupB respectively at day 1 and 12/50 (24%) and 7/50 (14%) at follow up of one week and it was 5/50 (10%) and 2/50(4%) at one month in the twogroups. C o n c l u s i o n s : When performing lichtenstein inguinal hernia repair, routine ilioinguinal, iliohypogastric and genital branch ofgenitofemoral nerves neurectomy is a reasonable option.

scholarly journals A study to evaluate and compare the outcomes of endoscope versus microscope assisted myringoplasty

2021 ◽  
Vol 7 (6) ◽  
pp. 988
Author(s):  
K. Sharath Babu ◽  
R. Shankar
Keyword(s):  
Sinus Tympani ◽  
Graft Take ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Group A ◽  
Prospective Comparative Study ◽  
The Difference ◽  
One Year ◽  
Group B

<p class="abstract"><strong>Background:</strong> In microscope assisted middle ear procedures surgeons can only observe the parts of the tympanic cavity, the hidden areas, such as the facial recess and sinus tympani, would not be visualised which needs to be exposed for performing tympanoplasty. The aim of the study was to compare the outcomes of microscope versus endoscope assisted myringoplasties in terms of duration of the procedure, graft take up, improvement in hearing and incidence of any complications.</p><p class="abstract"><strong>Methods:</strong> A prospective comparative study was conducted for a period of one year. A total of 72 patients with CSOM were randomised into two groups of 36 each. Group A patients (n=36) underwent traditional myringoplasty under a microscope and group B patients (n=36) endoscopic assisted myringoplasty was performed. Post-operatively all the patients were followed up for a period of one year. During the follow-up period patients were assessed for the graft take up, hearing improvement, incidence of complications and recurrence rate between the two groups.</p><p class="abstract"><strong>Results:</strong> Successful graft uptake was observed in 88.8% among patients underwent microscope assisted myringoplasty and it was 94.4% in endoscopic assisted myringoplasty. The mean duration of surgery was 123 mins in microscopic assisted group compared to 92 mins in endoscopic assisted group and the difference was found to be statistically significant. Similarly, the cosmetic results and the post-operative pain were more favorable for endoscopic assisted group than microscopic assisted group and the difference was found to be statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> Enoscopic assisted procedure could be considered as a better alternative for microscopic assisted myringoplasty.</p>

scholarly journals CLIPPED OR CLIPLESS CHOLECYSTECTOMY

2018 ◽  
Vol 25 (06) ◽  
pp. 805-809
Author(s):  
H. Sabiha Akhtar ◽  
Zia Farooq ◽  
Hassan Rathore ◽  
Muhammad Umar Farooq ◽  
Arooj Ahmad
Keyword(s):  
Treatment Options ◽  
P Value ◽  
Surgical Removal ◽  
Biliary Leakage ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Trial Setting ◽  
Selection Of

Background: Cholecystectomy is the surgical removal of the inflamedgallbladder. Advancement in technology has led to many treatment options and methods ofcholecystectomy but the selection of right method depends upon severity of disease alongwith available resources and expertise. Objective: To compare the frequency of biliary leakagewith clipless versus clipped laparoscopic cholecystectomy for management of cholecystitis.Material & Methods: Study design: Randomized control trial. Setting: Unit 1, Departmentof Surgery, Jinnah hospital, Lahore. Duration: It was conducted for a period of six monthsfrom July 2016 to January 2017. Data collection: A total of 130 patients were included in thestudy using nonprobability consecutive sampling and were randomly divided in two groups byusing lottery method. In group A, clip-less Harmonic scalpel was used along with Ultrasonicshear. In group B, the conventional instruments were used with the application of clips. Patientswere called for follow-up in OPD after 1 week to assess biliary leakage through MRCP. All thedata was collected through a pre-designed proforma. The data was entered and analyzed inSPSS version 20. Results: The mean age of patients was 42.97±10.77 years with 68 (52.31%)patients were male and 62 (47.69%) patients were females. The biliary leakage was noted in29 cases i.e. 9 from clipless group and 20 were from clipped group and the difference wasstatistically significant (p-value=0.020) Conclusion: It can be concluded from this study thatthe frequency of biliary leakage is significantly higher in the clipped LC for management ofCholecystitis. Thus it is encouraging to use clipless method to avoid such complication andimprove surgical outcomes.

scholarly journals Parsplana vitrectomy alone versus parsplana vitrectomy combined with phacoemulsification for the treatment of rhegmatogenous retinal detachment: a randomized study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paolo Mora ◽  
Stefania Favilla ◽  
Giacomo Calzetti ◽  
Giulia Berselli ◽  
Lucia Benatti ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Randomized Study ◽  
Retinal Breaks ◽  
Retinal Tears ◽  
Retinal Reattachment ◽  
Group A ◽  
The Difference ◽  
Group B

Abstract Background To compare parsplana vitrectomy (PPV) with and without phacoemulsification to treat rhegmatogenous retinal detachment (RRD). Methods Subjects aged 48–65 years with RRD in a phakic eye due to superior retinal tears with an overall extension of retinal breaks < 90° underwent to PPV alone (group A); or PPV plus phacoemulsification (phacovitrectomy, PCV, group B). Post-operative follow-up visits occurred at 1 week, 1 month (m1), 3 months (m3), and 6 months (m6) after surgery. The main outcome was the rate of retinal reattachment. Secondary outcomes included best-corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT), and cataract progression (in the lens-sparing [PPV-alone] group). Results In this initial phase of the study a total of 59 patients (mean age: 55 years, 59 eyes) were enrolled: 29 eyes in group A and 30 eyes in group B. Both groups had similar gas tamponade. During the follow-up there were three cases of RRD recurrence in group A and one in group B. The relative risk of recurrence in group A was 3.22 times higher but the difference was not significant (p = 0.3). The two groups were also similar in terms of BCVA and IOP variation. At m3, CMT was significantly higher in group B (p = 0.014). In group A, cataract progression was significant at m6 (p = 0.003). Conclusions In a cohort of RRD patients selected according to their preoperative clinical characteristics, PPV was comparable to PCV in terms of the rate of retinal reattachment after 6 months. Trial registration ISRCTN15940019. Date registered: 15/01/2021 (retrospectively registered).

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