scholarly journals Preoperative Determination of Tibia Length Using Contralateral Tibial Tubercle-Medial Malleolar Distance (TMD) in Western Part of Nepal

2021 ◽  
Vol 9 (01) ◽  
pp. 9-12
Author(s):  
Kishor Man Shrestha ◽  
Prakriti Raj Kandel ◽  
Bipan Shrestha ◽  
Shreshal Shrestha
Keyword(s):  
Shaft Fracture ◽  
Tibial Tubercle ◽  
Tibial Shaft Fracture ◽  
Medical Sciences ◽  
Anthropometric Parameter ◽  
Institutional Review ◽  
Tibial Nail ◽  
The Mean ◽  
Im Nailing ◽  
The Ideal

INTRODUCTION Intramedullary (IM) nailing is most commonly preferred for adult tibial shaft fracture. The objective of this study was to find the accuracy of predicting the tibial nail length pre-operatively from contra-lateral tibial tubeorsity to medial malleolar distance (TMD) length. MATERIAL AND METHODS After ethical clearance (UCMS/IRC/239/19) from the Institutional Review Board (IRB) of Universal College of Medical Sciences, all patients with recent fracture of tibia, who fulfilled the inclusion criteria were enrolled in the study and the informed written consent was obtained. The study was conducted on 45 patients of aged more than 15 years who attended Universal College of Medical Sciences Teaching Hospital (UCMS-TH) over a period of one year (Nov 2019 to Oct 2020). The TMD length of contra-lateral leg were measured preoperatively using a measuring tape and the ideal length of IM nail were measured intra-operatively using IM tibial nail under fluoroscopic guidance. RESULTS Analysis showed that majority of patients were males (77.78%) out of total 45 patients. The mean length of TMD length of contra-lateral leg and the ideal length of IM nail were 33.067 ±1.60 and 33.11 ±1.68 respectively. The mean difference between these two measurements was 0.04 (95% CI, -0.64 to 0.72). The significant correlation was found between these two measurements i.e r=0.88 by Pearson’s correlation (95% CI, 0.79 to 0.93), (p<0.001). Most of the TMD length were equal (37.78%) to ideal length of IM nail. CONCLUSION We recommended TMD length measurement of contralateral leg as an excellent anthropometric parameter for preoperative planning.  

TO ASSESS THE IDEAL TIME OF LAPAROSCOPIC CHOLECYSTECTOMY AFTER ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN CASES OF CHOLELITHIASIS WITH CHOLEDOCHOLITHIASIS

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Dhirendra Godara ◽  
Vineet Choudhary ◽  
Nitish Soni
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Sciences ◽  
Early Recovery ◽  
Endoscopic Retrograde ◽  
The Mean ◽  
Group 2 ◽  
Late Group ◽  
Group 1 ◽  
The Ideal

Background: Aims of this study was assess the ideal time of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography in cases of cholelithiasis with Choledocholthiasis Methods: The present study was carried out on 150 patients admitted in Department of General surgery National Institute of Medical Sciences and Research, Jaipur, diagnosed with cholelithiasis along with choledocholithiasis  from 1stJanuary 2019 to 30thJune, 2020. Results: In group 1 out of 75 patients 7 patients developed complications in post operative period compared to 35 patients out of 75 patients developed complications in group 2. The The mean hospital stay (in day) in group 1 patients was 2.26, median 2 and the mean of group 2 was 5.26, median 5. Conclusion: To conclude in our study there has been found significant advantage of early laparoscopic cholecystecomy following ERCP over the late group to minimize complications and promote early recovery of the patients. Keywords: ERCP, Cholecystectomy, Endoscopic retrograde cholangiopancreatography

scholarly journals Pattern of Tibial Shaft Fractures in Universal College of Medical Sciences, Bhairahawa: A Review of Sixty Cases

2013 ◽  
Vol 1 (3) ◽  
pp. 11-14 ◽  
Author(s):  
R Baral ◽  
JA Khan ◽  
GP Singh
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Medical Science ◽  
Shaft Fracture ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Medical Sciences ◽  
Epidemiological Characteristics ◽  
Type Of Fracture

BACKGROUND: Tibia is one of the commonest long bone fracture seen in emergency. Road traffic accidents are the major causes of fracture shaft of tibia. However, studies on these fracture have not been conducted in this part of the world so we conducted this study to identify epidemiological characteristics (age, sex, mechanism of injury, season, source of injury, type of fracture. any associated injury, location, method of treatment and complication) in patients with fracture shaft of tibia admitted in the emergency of Medical College hospital, Bhairahawa. METHODS: This is hospital based prospective observational study conducted at Universal College of Medical Science Teaching Hospital, Bhairahawa (Lumbini zone) among 60 tibial shaft fracture patients in hospital emergency. The study period was from December 2010 to November 2011. RESULTS: All total of 60 tibial shaft fracture in 60 patients with a mean age of 28.35 yrs(3-75yrs) were reviewed. The cause of injury were mostly road traffic accident of which Bike (26.6%,), Bus (6.7%), Car (6.7%), Cycle (10%), Rickshaw (6%), Tractor (6.7%), Truck (1.7%), and Vehicle collision (3.3%) were more prevalent. Other injuries were Bomb blast (1.7%), Fall injury (16.7%), Logroll (3.3%), Sports/football (5.5%) and Stone injury (1.7%) . Distal one third of tibial shaft (49.2%) was the commonest site of fracture. Most of the patients presented between 1st  hour to even 10 days of injury. Sixty five percent of the fracture were closed and 35% were open. Most were managed operatively (51.7%). Mean time for union of close type of fracture was 13.78(SD ±2.99) weeks and for open was 16.2 weeks (SD±3.34). Complication included infection in one patient and delayed union in two patients. CONCLUSION: In our present study, most tibial shaft fracture were due to road traffic accident. So, efforts should be made by concerned authorities for improving the roadways system of Nepal as well as provision of standard but affordable health care for victims of road traffic crashes.DOI: http://dx.doi.org/10.3126/jucms.v1i3.8773 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 11-14

Tibial shaft fracture following tibial tubercle osteotomy

1996 ◽  
Vol 11 (1) ◽  
pp. 117-119 ◽  
Author(s):  
Merrill A. Ritter ◽  
Kimberly Carr ◽  
E. Michael Keating ◽  
Philip M. Faris ◽  
John B. Meding
Keyword(s):  
Shaft Fracture ◽  
Tibial Tubercle ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Tibial Tubercle Osteotomy

Tibial Shaft Fracture after Removal of an ACE Tibial Nail

2011 ◽  
Vol 21 (3) ◽  
pp. 193-196 ◽  
Author(s):  
loannis Sourlas ◽  
Michalis Papadakis ◽  
Stergios N. Lallos ◽  
Emmanuel Brilakis ◽  
Nikolaos E. Efstathopoulos
Keyword(s):  
Shaft Fracture ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Tibial Nail

Nonunion after a tibial shaft fracture complicating tibial tubercle osteotomy

1998 ◽  
Vol 13 (8) ◽  
pp. 958-960 ◽  
Author(s):  
Jorge Arredondo ◽  
Richard L. Worland ◽  
Douglas E. Jessup
Keyword(s):  
Shaft Fracture ◽  
Tibial Tubercle ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Tibial Tubercle Osteotomy

scholarly journals Evaluation and Comparison of Clinical Rounds from the Perspective of Professors and Students of Shahrekord University of Medical Sciences

2021 ◽  
Author(s):  
A Malekpour-Tehrani ◽  
M Moezzi ◽  
SS Hosseini ◽  
SM Hosseini
Keyword(s):  
Clinical Education ◽  
Medical Training ◽  
Cross Sectional Study ◽  
Demographic Information ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Status ◽  
The Mean ◽  
The Ideal

Introduction: Evaluating different fields of clinical education is necessary to improve the medical course. Among these, clinical rounds are an important part of clinical education. Therefore, achieving maximum realization in any clinical field is the goal of every medical training center. Methods: Present descriptive cross-sectional study was conducted at Shahrekord University of Medical Sciences by census method on more than 67% of clinical medical professors and 79% of medical students who are on internship. The research instrument included a questionnaire of demographic information and a clinical round, which was prepared based on clinical standards approved by the Ministry of Health. 30 out of 44 clinical professors and 30 out of 38 interns succeeded in completing the questionnaires. The obtained data were analyzed by SPSS-16 software and tests (T-test and ANOVA). Result: The mean scores of clinical rounds of professors were 65± 13.16 and interns were 52.47± 35.19 and in general, the situation in this field was described as higher than the average (42) for both groups. Comparison of the two groups also showed a significant difference (P = 0.00). Thus, the mean scores of clinical round scores in the professors’ group were higher than the average scores of the interns’ group. Conclusion: The current clinical rounds situation in Shahrkord University of Medical Sciences was described as more favorable than average. Therefore, in order to further promote medical education, it is recommended that universities continuously evaluate and monitor the status of various areas of clinical education in order to reach the ideal level as soon as possible.

A Comparison of Unlearned IM-nailing with Reamed IM-nailing in Tibial Shaft Fracture

1997 ◽  
Vol 10 (2) ◽  
pp. 295
Author(s):  
Su Chan Lee ◽  
Bum Gu Lee ◽  
Do Hyun Moon ◽  
Jin Hong Ko ◽  
Hong Ki Park ◽  
...  
Keyword(s):  
Shaft Fracture ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Im Nailing

A Clinical Comparison between DCP Fixation and Brooker-Wills IM Nailing in the Treatment of Tibial Shaft Fracture

1994 ◽  
Vol 7 (2) ◽  
pp. 284
Author(s):  
Hyung Seok Kim ◽  
Ki Do Hong ◽  
Sung Sik Ha ◽  
Young Ki Ko ◽  
Dong Seok Kang ◽  
...  
Keyword(s):  
Shaft Fracture ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Clinical Comparison ◽  
Im Nailing

scholarly journals Medial Malleolus Fracture Fixation in the Setting of Concomitant Tibial Shaft Fractures

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Stephen Barchick ◽  
Samuel Adams ◽  
Andrew Matson
Keyword(s):  
Shaft Fracture ◽  
Medial Malleolus ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Shaft Fractures ◽  
Tibial Nail ◽  
Fixation Techniques ◽  
Medial Malleolus Fracture ◽  
Buttress Plate ◽  
Tibial Shaft Fractures

Category: Ankle, Trauma Introduction/Purpose: The association between tibial shaft fractures and concomitant posterior malleolus fractures has been well-studied; however less is known about tibial shaft fractures and concomitant medial malleolus fractures. Treatment of tibial shaft fractures with a plate or intramedullary nail in the setting of concomitant medial malleolus fracture may pose obstacles to standard medial malleolus fractures fixation due to hardware that impedes optimal screw placement. The purpose of this study is to report the presentation and management strategies used to treat medial malleolus fractures in the setting of concomitant tibial shaft fractures. Methods: From 2011 to 2015, seven (1.4%) patients were identified with concomitant tibial shaft fractures and isolated medial malleolus fractures. Data was collected through review of patient charts, radiographs, and operative reports including the following variables: demographics, injury patterns, fixation techniques, and outcomes. Five male patients and two female patients with a mean age of 39.1 years (range, 13.9-67.9 years) were included. Three patients reported tobacco use. Mechanisms of injury included motor vehicle accident (n=4), fall from standing (n=2), and pedestrian versus vehicle (n=1). Average medial malleolus fracture fragment length was 19.1 mm (range, 14.3-29.4 mm). Tibial shaft fractures were open in four cases, and included five transverse patterns, one spiral pattern, and one segmental fracture. All patients were treated surgically for tibial shaft and medial malleolus fractures simultaneously. All medial malleolus reductions were anatomic. The average time to union for medial malleolus fractures was 3.12 months (range 1.53 to 5.93 months). Results: Fixation techniques included screw (n=5) or buttress plate (n=2) fixation for the medial malleolus, and intramedullary nailing (6) or blade plate fixation (n=1, prior TKA) for the tibial shaft. Of the five medial malleolus fractures treated with screw fixation, screws were positioned anteriorly (n=2) or medially (n=2) to tibial shaft fixation implant in four cases; in one case the distal extent of the tibial nail was proximal to the medial malleolar screws. One buttress plate was placed with screws distal to the tibial nail, another was placed angling one proximal screw anterior and one posterior to the tibial nail. Two patients reported complications following surgery: one with chronic pain and one with wound dehiscence and delayed union at the open tibial shaft fracture site. Conclusion: Seven patients were treated operatively for concomitant tibial shaft and medial malleolus fractures, requiring careful attention to placement of medial malleolar screws or buttress plate due to the presence of implant used to treat the tibial shaft fracture. Medial malleolar screws can safely be redirected anteriorly or medially to accommodate the tibial shaft fracture implant, with acceptable fracture union outcomes in this small case series. Further biomechanical and long-term data may help to validate these adjustments to standard techniques.

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