scholarly journals Management and Treatment of Wounds by Projectile from a Firearm in Hand in the Plastic and Reconstructive Surgery Service of the Central Military Hospital in Two Years

2021 ◽  
Vol 2 (3) ◽  
pp. 01-07
Author(s):  
Brenda Arcos Vera ◽  
Felipe Alejandro López Silva ◽  
Héctor Adolfo Morales Yépez
Keyword(s):  
Bone Graft ◽  
External Fixator ◽  
Gunshot Wounds ◽  
Military Hospital ◽  
Metacarpal Fractures ◽  
Skin Cell ◽  
Cell Tissue ◽  
Study Results ◽  
Treatment Of Wounds ◽  
Phalangeal Fractures

Introduction: Gunshot wounds are a major cause of morbidity and lead to serious socioeconomic problems. Wounds often causing severe functional sequelae. Therefore, it is vitally important to provide proper management of these wounds. OBJECTIVES: Define the treatment of gunshot wounds at the Central Military Hospital in the period from March 2019 to March 2021. Material and Methods: It is a descriptive, retrospective, observational study, RESULTS: Patients who fulfilled the diagnosis presented 3 metacarpal fractures (27.27%), 2 metacarpal and phalangeal fractures (18.18%), 2 fractures of phalanges (18.18%), 1 carpal + metacarpal fractures (9.09%), 3 with injury only to skin cell tissue without evidence of fractures (27.27%). Therapeutic management: 3 patients received external fixator, 2 ORIF, 1 external fixator + ORIF + inguinal flap + bone graft, 1 external fixator + bone graft + ORIF, 0 wound closure, 4 management with wet therapy, CONCLUSIONS: The wounds By firearm in hand are frequent injuries, which merit immediate treatment. This depends on the complexity of the injury for a speedy recovery and integration into the workplace.

Fetomaternal Outcome of Pregnancy with COVID-19: An Observational Study in Tertiary Care Hospitals of Pakistan

2021 ◽  
Vol 15 (6) ◽  
pp. 1903-1906
Author(s):  
Nabila Khan ◽  
Zahra Wasim ◽  
Aesha Sadaf Rizwan ◽  
Afshan Ahmad ◽  
Muhammad Tahir ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Negative Impact ◽  
Heart Defects ◽  
Tertiary Care ◽  
World Health ◽  
Observational Research ◽  
Military Hospital ◽  
Corona Virus ◽  
Study Results ◽  
The World

Background: The new corona virus first appeared in Wuhan, China in December 2019 and has since spread around the world to other countries. The World Health Organization believes that this new CoV-19 epidemic is a public health emergency of international concern (PHEIC) on January 30, 2020Worldwide.The mortality rate of this viral infection ranges from 2% in Pakistan to 14.4% in Italy. Lympopenia, elevated transminase, proteinuria, increased LDH, and C-reactive protein levels are all common laboratory findings in the early stages of the disease. Covid patients have experienced a variety of complications, including extreme pneumonia, ARDS, heart defects, sepsis and septic shock, and respiratory tract super infection. Methodology: This retrospective observational research study was carried out at the Gynecology Unit of MardanMedical Complex, Mardan and Combined Military Hospital, Risalpur for 06 months duration from April 2020 to September 2020. In a pre-constructed data collection form, biochemical and radiological parameters of medical history, test results, symptoms, pregnancy, and neonatal outcomes were noted. Patients treated in an outpatient setting were not included in the study. Results: There were 121 patients in total, with mean age of 27 having standard deviation ± 5, having range 19-40 years. 48.3% pregnant women reported their first pregnancy(primigravida). 51.3% of SARS-Cov-2 were in their 3rd trimester while 34.7% were in their 35-40 weeks of gestational age. Common complications are gestational hypertension (PIH) (16 cases), hypothyroidism (14 cases) and gestational diabetes (GDM) 9 cases. More than half (53%) of patients are asymptomatic. Common symptoms are cough (22%) and fever (11%). The incidence of multiple organ failure was 2% as shown in table 01. Lymphopenia was common (84%). A CT scan of 24 patients showed bilateral invasion. Conclusion: COVID-19 has a negative impact on the foetus, according to our results. Although pregnant women do not seem to be more vulnerable to COVID-19 complications than non-pregnant adults, previous research has suggested that pregnant women could be at higher risk for negative pregnancy outcomes such as preterm birth, foetal pain and respiration, symptoms, and LBW in a newborn baby. Keywords: Corona virus, COVID-19, Pregnancy, Outcome.

Current methods, outcomes and challenges for the treatment of hand fractures

2020 ◽  
Vol 45 (6) ◽  
pp. 547-559
Author(s):  
Michel E. H. Boeckstyns
Keyword(s):  
Conservative Treatment ◽  
Outcome Measures ◽  
Surgical Intervention ◽  
Metacarpal Fractures ◽  
Complex Fractures ◽  
Hand Fractures ◽  
Surgical Methods ◽  
Technical Advances ◽  
Phalangeal Fractures

In treating hand fractures, we have to make a proper decision about conservative treatment versus surgical intervention and decide on individual surgical methods. This article reviews recent publications, technical advances, and outcome measures in treating metacarpal fractures, phalangeal fractures, complex fractures of the proximal interphalangeal joints, bony mallet fingers, and fractures of the thumb. My personal preferences and considerations are presented. At the end, the current challenges that hand surgeons are facing in treating frequent phalangeal and metacarpal fractures are discussed.

A Novel Handmade External Fixator for Phalangeal and Metacarpal Fractures

2016 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Davod Jafari ◽  
Ali Ajvadi
Keyword(s):  
External Fixator ◽  
Metacarpal Fractures

Treatment of phalangeal fractures in the hand with the mini-Hoffman external fixator

2003 ◽  
Vol 13 (3) ◽  
pp. 142-144 ◽  
Author(s):  
B. Lenehan ◽  
P. Fleming ◽  
A. Laing ◽  
M. O'Sullivan
Keyword(s):  
External Fixator ◽  
Phalangeal Fractures

scholarly journals One-stage correction of multiple brachymetatarsia and hallux valgus with calcaneal autograft

2018 ◽  
Vol 12 (4) ◽  
pp. 342-46
Author(s):  
Felipe Almeida Rocha ◽  
Henrique Mansur ◽  
Rubens Theodoro Meira ◽  
Lucio Gusmão ◽  
Cesar Barbosa Gonçalves ◽  
...  
Keyword(s):  
Bone Graft ◽  
Hallux Valgus ◽  
Expert Opinion ◽  
External Fixator ◽  
Single Procedure ◽  
One Stage ◽  
Premature Closure ◽  
The Right ◽  
Bone Elongation ◽  
Gradual Distraction

Brachymetatarsia is the shortening of the metatarsus caused by congenital premature closure of the metatarsal physis. In general, the patient presents a shortened and dorsally situated toe causing metatarsalgia in addition to aesthetic effects. The aim of surgery is to improve the symptoms andaesthetics through bone elongation and rebalancing of the metatarsal formula. This elongation may be performed through gradual distraction with an external fixator or a single procedure with a bone graft. We report a case of bilateral brachymetatarsia of the 3rd and 4th metatarsals associated with hallux valgus and deformities in the 2nd toe, in which surgery was performed on the right foot with a calcaneal autograft.Level of Evidence V; Therapeutic Studies; Expert Opinion. 

scholarly journals The Use of the S-Quattro Dynamic External Fixator for the Treatment of Intra-Articular Phalangeal Fractures: A Review of the Literature

2012 ◽  
Vol 6 (1) ◽  
pp. 54-59 ◽  
Author(s):  
J.S Bhamra ◽  
W.S Khan ◽  
P Pastides
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Current Literature ◽  
External Fixator ◽  
Operative Time ◽  
Rigid Fixation ◽  
Review Of The Literature ◽  
Poor Functional Outcome ◽  
Younger Patients ◽  
Phalangeal Fractures

Intra-articular phalangeal fractures are a common injury. If left untreated, these injuries can lead to poor functional outcome with severe dehabilitating consequences, especially in younger patients.The S-Quattro external fixator device (Surgicraft®, UK) can be used to treat such injuries. Its use has been widely documented and has shown many advantages in comparison to other conventional treatments. Advantages include reduced operative time, rigid fixation and early range of motion.We present a review of the current literature and use of the S-Quattro serpentine system in the management of intraarticular phalangeal fractures.

scholarly journals First ray reconstruction with distraction osteogenesis

2008 ◽  
Vol 32 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Mahmut Kömürcü ◽  
Mustafa Kürklü ◽  
Bahtiyar Demiralp ◽  
Ali Sabri Atesalp ◽  
Serap Alsancak ◽  
...  
Keyword(s):  
External Fixator ◽  
Gunshot Wounds ◽  
Metacarpophalangeal Joint ◽  
Healing Time ◽  
Callus Distraction ◽  
External Fixators ◽  
Reconstruction Method ◽  
Dash Score ◽  
Amputation Level ◽  
Additional Surgery

Disarticulation of the thumb at the metacarpophalangeal joint level is not beneficial either aesthetically or functionally without additional surgery because it requires a bulky and an unacceptable prosthesis to be made for this amputation level. In this study, the authors have presented our experience of 12 metacarpal distractions in thumb amputated patients. Twelve male patients who had thumb amputation due to gunshot wounds were included in the study. Before the operation, aesthetic hand prostheses were made for 5 of the12 patients. Callus distraction was performed with the use of a mini Ilizarov type external fixator in 7 cases and uniplanar dynamic mini external fixator in 5 cases too. External fixators were removed after the completion of the radiographic consolidation. Five patients whose prosthesis had been made before the operation wore their prosthesis for an average 6.8 months (5 – 14) due to poor appearance and poor construction. Union of the lengthened segment was observed in all cases. Average lengthening was 28.9 mm (range from 25 – 37). Average healing time was 2.1 months (range from 1.8 – 2.5). Average healing index was 0.73 month/cm (range from 0.65 – 0.88). Pin tract infection was seen in 7 cases (58.3%). Volar angulation developed after removing the external fixator in 1 case. Webplasty was performed in all cases. Patients were evaluated by means of Disability of the Arm, Shoulder and Hand (DASH) score and pick-up test. It was concluded that the metacarpus lengthening by callus distraction technique may be a functionally and cosmetically effective reconstruction method for traumatic thumb amputations. It is believed that the possibility for a functionally and aesthetically acceptable fabrication of a thumb prosthesis, by providing a suction suspension with distraction and/or webplasty procedures.

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