scholarly journals Penetrating Scrotal Injuries: A War Time Experience in a Civilian Setup

2021 ◽  
Vol 9 (B) ◽  
pp. 1198-1202
Author(s):  
Ammar Fadil Abid ◽  
Naimet Naoum
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Surgical Intervention ◽  
Demographic Data ◽  
Conservative Approach ◽  
Associated Injuries ◽  
Explosive Devices ◽  
Non Surgical Treatment ◽  
Salvage Rate

AIM: To present our experience in managing testicular involvement in penetrating scrotal injuries, trying to highlight a possible role for conservative management of selected cases. METHODS: We reviewed retrospectively all-penetrating scrotal injuries presented to Alyarmook teaching hospital for the period between January 2009 and November 2015, including only those injured victims who reached the hospital alive. Patients’ charts reviewed regarding their demographic data including age, status being civilian or military, and married or single. We documented as well the cause of injury (bullets vs. explosive devices), laterality, associated injured organs, and type of management performed whether operative or non-operative conservative approach. Postoperative complications were recorded while in-patient and after a follow-up period of at least 1 month. RESULTS: Thirty-one penetrating scrotal injuries were identified, resulted in 34 injured testicles. The patients’ mean age was 34.35 years (±12.89standard deviation [SD]) (18–70 years). Most of the victims 24 (77.4%) were civilians. Explosive devices were the cause of injury in 23 patients (74.2%), while bullets were the cause in the remaining 8 patients (25.8%). Orchidectomy needed to be done in 17 (50%) testicles, while 11 (32.4%) injured testes were repaired by suturing. Six cases (17.6%) were treated conservatively without any surgical intervention. The overall testicular salvage rate was (50%). Twenty-one patients (68%) had associated injuries, mostly fractures. Complications occurred in 10 (32.2%) patients, including two mortalities. CONCLUSIONS: Management of genitourinary injuries continues to be a challenging task. In our penetrating testicular injured series, we succeeded to salvage 50% of the injured testes. Non -surgical treatment is feasible in selected patients, an approach that needs further study and longer follow-up.

Interdigital Hyperkeratosis of the Foot: Orthopaedic Approach to Surgical Treatment

2013 ◽  
Vol 20 (3) ◽  
pp. 42-45
Author(s):  
S. Yu Berezhnoy ◽  
A. I Protsenko ◽  
V. V Kostyukov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Surgical Intervention ◽  
Roentgenologic Examination ◽  
Treatment Results ◽  
Minimum Risk ◽  
Development Data ◽  
Reproducible Method ◽  
Positive Results

Surgical treatment results for 27 patients with interdigital keratosis of the foot were analyzed. To determine the predisposing factors for keratosis development data of clinical and roentgenologic examination were used. In all cases transcutaneous technique that enabled to avoid surgical intervention directly on a pathologic focus was applied. Mean follow up period made up 6 months. It was shown that transcutaneous surgical intervention was an effective and reproducible method for interdigital keratosis treatment. That technique provided positive results with minimum risk of postoperative complications in the majority of cases and could be used at outpatient department.

scholarly journals MEAN 6 YEAR CLINICAL OUTCOMES, SURVIVORSHIP, AND RETURN TO SPORTS AFTER ARTHROSCOPIC CAPSULAR REPAIR WITH SUTURE ANCHORS FOR ADOLESCENT MULTIDIRECTIONAL SHOULDER INSTABILITY

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0002
Author(s):  
Brendon C. Mitchell ◽  
Matthew Y. Siow ◽  
Alyssa Carrol ◽  
Andrew T. Pennock ◽  
Eric W. Edmonds
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Shoulder Instability ◽  
Surgical Intervention ◽  
Operation Time ◽  
Demographic Variables ◽  
Return To Sports ◽  
Suture Anchors ◽  
Surgical Failure

Background: Multidirectional shoulder instability (MDI) refractory to rehabilitation can be treated with arthroscopic capsulolabral reconstruction with suture anchors. No studies have reported on outcomes or examined the risk factors that may contribute to poor outcomes in adolescent athletes. Hypothesis/Purpose: To identify risk factors for surgical failure by comparing anatomic, clinical, and demographic variables in adolescents who underwent surgical intervention for MDI. Methods: All patients undergoing arthroscopic shoulder surgery at one institution between January 2009 and April 2017 were reviewed. Patients >20 years old at presentation were excluded. Multidirectional instability was defined by positive drive-through sign on arthroscopy plus positive sulcus sign and/or multidirectional laxity on anterior and posterior drawer testing while under anesthesia. Two-year minimum follow-up was required, but those whose treatment failed earlier were included for reporting purposes. Demographics and intraoperative findings were recorded, as were Single Assessment Numeric Evaluation (SANE) scoring, Pediatric and Adolescent Shoulder Survey (PASS), and the short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) results. Results: Eighty adolescents (88 shoulders) were identified for having undergone surgical treatment of MDI. Of these 80 patients, 42 (50 shoulders; 31 female, 19 male) were available at a minimum of 2-year follow-up. Mean follow-up was 6.3 years (range, 2.8-10.2 years). Thirteen (26.0%) shoulders experienced surgical failure defined by recurrence of subluxation and instability, all of which underwent re-operation. Time to re-operation occurred at a mean of 1.9 years (range, 0.8-3.2). Our cohort had an overall survivorship of 96% at 1 year after surgery and 76% at 3 years. None of the anatomic, clinical, or demographic variables tested, or the presence of generalized ligamentous laxity, were correlated with subjective outcomes or re-operation. Number of anchors used was not different between those that failed and those that did not fail. Patients reported a mean SANE score of 83.3, PASS score of 85.0, and QuickDASH score of 6.8. Return to prior level of sport (RTS) occurred in 56% of patients. Conclusion: Multidirectional shoulder instability is a complex disorder that can be challenging to treat. Adolescent MDI that is refractory to non-surgical management appears to have long-term outcomes after surgical intervention that are comparable to adolescent patients with unidirectional instability. In patients who do experience failure of capsulorraphy, we show that failure will most likely occur within 3 years of the index surgical treatment. [Table: see text][Figure: see text]

scholarly journals Charlson Comorbidity Index Predicts 5-Year Survivorship of Surgically Treated Hip Fracture Patients

2018 ◽  
Vol 9 ◽  
pp. 215145931880644 ◽  
Author(s):  
Lei Jiang ◽  
Andrew Chia Chen Chou ◽  
Nivedita Nadkarni ◽  
Caris En Qi Ng ◽  
Yun San Chong ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hip Fracture ◽  
Charlson Comorbidity Index ◽  
Demographic Data ◽  
Survival Rates ◽  
Predictive Ability ◽  
Fracture Pattern ◽  
Mortality Data ◽  
Comorbidity Index

Introduction: This study aims to assess the correlation of the age-adjusted Charlson comorbidity index (ACCI) with 5-year mortality in a surgically treated hip fracture population. Materials and Methods: A retrospective analysis was performed on 1057 patients aged 60 years and above who underwent surgery for hip fracture with a minimum of 5-year follow-up (92.2% 5-year follow-up rate) in a tertiary hospital. Manual review of patients’ electronic hospital records was performed to record demographic data, comorbidities, and length of stay. Mortality data were extracted from the hospital’s electronic medical records and corroborated with the National Electronic Health Record. Results: Of the 1057 patients, 283 (26.8%) were male. The majority of patients were 80 years of age and above (42.5%), with the oldest patient operated on age 102 with a mean age of 77.8 (8.6) years. Four hundred eighteen (39.5%) patients sustained extracapsular intertrochanteric fractures. The mean follow-up duration was 8 years and 3 days with an overall survivorship of 37.2%. A multiple regression model constructed with ACCI, age, gender, and fracture pattern demonstrated satisfactory predictive ability with a concordance statistic of 0.68. Patients with a higher ACCI category (≥6) had an increased 5-year mortality rate (41.8%) with an odds ratio of 13.6 (6.7-31.8, P < .001) compared to those with an ACCI category of 3 and below (89.3%). Discussion: The study demonstrates that ACCI correlated with 5-year mortality after surgical treatment of hip fracture. This information is pertinent in the counseling of patients with regard to their midterm survival following hip fracture surgery and may inform policy makers of the varied midterm survival rates in patients with differing ACCI scores and educate the allocation of health-care resources. Conclusion: The ACCI correlates with 5-year mortality after surgical treatment of hip fracture.

scholarly journals Congenital Talipes Equinovarus (CTEV)

e-CliniC ◽  
2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Richardo J. Laloan ◽  
Andreissanto C. Lengkong
Keyword(s):  
Surgical Treatment ◽  
Quantitative Measurement ◽  
Foot Deformities ◽  
Congenital Talipes Equinovarus ◽  
Talipes Equinovarus ◽  
Long Term Follow Up ◽  
Congenital Talipes ◽  
Non Surgical Treatment

Abstract: Congenital talipes equinovarus (CTEV) is a type of foot deformities characterized with hindfoot varus, adducted metatarsus, wide arched of the foot (cavus), and equinus. Its incidence is 1.2% per 1000 births annually. Around 80% of cases occur as idiopathic type and the remaining 20% is associated with other anomaly conditions. Genetic component is considered to play a role in the occurrence of CTEV. However, up to this day, there is no exact underlying etiology that defines the exact pathogenesis of CTEV. The evolving etiology nowadays is still multifactorial. Management of CTEV varies from non-surgical treatment to surgical treatment. A number of scoring and grading using qualitative and quantitative measurement are being used nowadays to assess the severity of CTEV because this deformity needs long-term follow-up due to its tendency to relapse.Keywords: congenital talipes equinovarus, clubfoot Abstrak: Congenital talipes equinovarus (CTEV), dikenal juga dengan true clubfoot, merupakan deformitas pada kaki yang ditandai oleh adanya bentuk varus kaki belakang, adduksi metatarsus, dan adanya bentuk lengkungan kaki yang lebar (cavus) serta equinus. CTEV merupakan salah satu dari deformitas kaki pada saat lahir dengan insidensi 1,2% per 1000 kelahiran hidup per tahunnya. Pada 80% kasus terjadi secara idiopatik dan 20% dikaitkan dengan kondisi-kondisi lain. Komponen genetik diduga berperan pada CTEV, namun, sampai saat ini, belum ada etiologi pasti yang menjelaskan patogenesis CTEV. Etiologi yang berkembang sampai saat ini bersifat multifaktorial. Tatalaksana pasien CTEV bervariasi mulai dari non-operatif maupun operatif. Sejumlah pengukuran kualitatif maupun kuantitatif telah dikembangkan untuk menilai keparahan CTEV berhubung kondisi deformitas ini membutuhkan follow-up jangka panjang karena mempunyai kecenderungan untuk relaps.Kata kunci: congenital talipes equinovarus, clubfoot

scholarly journals Prevention of pain syndrome and immediate postoperative complications in the surgical treatment of chronic hemorrhoids

2020 ◽  
pp. 68-71
Author(s):  
V. N. Ishchenko ◽  
A. E. Krasnobaev ◽  
A. A. Grigoryuk
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Surgical Intervention ◽  
Pain Syndrome ◽  
Modified Technique ◽  
Postoperative Urinary Retention ◽  
Clinical Comparison ◽  
Suggested Technique

Objective: To assess the efficacy of hemorrhoidectomy with Milligan-Morgan technique in the author’s modification.Methods: Results of surgical treatment of 558 patients aged 21–72 years with complicated hemorrhoids of III–IV stage were analyzed. The group of clinical comparison (207 patients) was operated according to standard scheme, the main group (351 patients) – according to author’s technology with modified technique for treating the hemorrhoid bolus using betamethasone.Results: When using the author’s technique, a more significant decrease in postoperative pain syndrome severity was achieved: injection analgesics were not required already in a day, and after 6 days the pain syndrome was stopped in all cases. Only three patients (0.9%) demonstrated an acute urinary retention up to two days. The group of clinical comparison maintained a longterm (up to three months) pain syndrome; postoperative urinary retention was registered in 38 cases (18.4%); 9 patients (4.3%) developed blood loss in the area of surgical intervention.Conclusions: Suggested technique of surgical treatment for hemorrhoids is quite effective, simple and can be implemented in any surgical inpatient facility. 

scholarly journals The treatment of chronic periodontitis by non-surgical periodontal therapy in association with diode laser compared to conventional non-surgical therapy

2020 ◽  
Author(s):  
Bellia Loredana ◽  
Ruggiero Roberta ◽  
Nicolò Michele
Keyword(s):  
Surgical Treatment ◽  
Diode Laser ◽  
Surgical Therapy ◽  
Test Group ◽  
Control Group ◽  
Probing Depth ◽  
Baseline Test ◽  
Mechanical Therapy ◽  
Non Surgical Treatment

Mechanical surface treatment and removal of the above and subgingival biofilm (Tartar ablation; SRP) are considered the most suitable tools for the treatment of periodontal inflammatory diseases, with the aim of destroying bacterial bioflim, reducing bacteria, and slowing down recolonization by pathogenic microorganisms. Often, however, the only S&RP are not enough, as there are patients who are experiencing relapses. Recently, laser therapy has been suggested as a potential tool to improve the outcome of periodontal non-surgical treatment. The objective of the following study was to evaluate the clinical healing of periodontal pockets treated with mechanical therapy, scaling and root planing, and diode laser application, compared to that obtained with non-surgical mechanical therapy alone. The study was designed as a randomized controlled clinical trial. Patients in the control group (13 patients) underwent conventional non-surgical therapy only, while patients in the test group (17 patients) were associated with conventional non-surgical treatment, a laser irradiation session. At baseline and after 6 months, the parameters of probing depth (PD), bleeding on probing (BOP), gingival recession (REC) were assessed The main variable of this study was the PD (probing depth) FMPS and FMBS at follow-up improved in both groups. The FMPS baseline test group 32.59 ± 6.74 - follow up 12.00 ± 3.16. The baseline of the control group showed 33.00 ± 9.55, the follow up 13.15 ± 4.85 The FMBS baseline test group found 24.29 ± 5.01 while at follow 9.65 ± 2.69. The baseline control group 30.31 ± 7.74, Follow up 11.08 ± 2.33. There is a statistical significance. (P.VALUE 0.0001) There were no significant differences between the groups in terms of PD, CAL and BOP at baseline and at follow-up. PD Test group 4,89±1,58 3,95±0,85 0,0001 Control group 5,02±1,57 4,01±0,86 CAL (mm)Test group 0,89±2,29 0,77±1,91 Control group 0,28±1,38 0,24±1,14 REC Test group 0,19±0,49 0,19±0,51 Control group 0,06±0,29 0,57±029 BOP Test group 51,2% 23,5% Control group 54,0% 20,9% The results showed differences in both baseline and follow-up for REC. Test group 0,19±0,49 0,19±0,51-Control group0,06±0,29 0,57±029 In intra-group analyzes, there are differences between baseline and follow-up for all values, except for REC in the control group. The diode laser can be used as an appropriate device for periodontal treatments, but it can offer additional and significant benefits if used according to appropriate protocols and parameters, and especially if associated with non-surgical, manual and ultrasound periodontal instrumentation, always site-specific , as it is a tool that does not replace traditional methods.

scholarly journals Duplex scanning as an alternative to computer tomography with contrast enhancement for the control of complications after endovascular aneurysm repair

2018 ◽  
Vol 9 (1) ◽  
pp. 44-49
Author(s):  
D. I. Korshunov ◽  
R. I. Khabazov ◽  
N. V. Ustiantseva ◽  
A. V. Chupin ◽  
S. V. Deryabin
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Early Detection ◽  
Computer Tomography ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Endovascular Aneurysm Repair ◽  
Duplex Scanning ◽  
Non Invasive ◽  
Aneurysm Repair

EVAR (endovascular aneurism repair) is the preferred method for the surgical treatment of ananeurysm. The advantage of this type of surgical intervention is that a smaller number of postoperative complications will occur. The main diagnostic tasks for patients after EVAR are to determine the size of the aneurysmal sac, detection of an endoleak, detection of the endoprosthesis migration and the deformation of the stent graft itself. Conclusion: early detection of complications in the postoperative period remains the main problem for monitoring patients after EVAR. Duplex scanning is a safe, non-invasive and effective method of measuring the size of an aneurysmal sac and detecting possible complications after EVAR.

Resection and reconstruction of idiopathic scrotal elephantiasis: surgical approach and quality of life assessment

2021 ◽  
Vol 14 (10) ◽  
pp. e244018
Author(s):  
Hasan Gökcer Tekin ◽  
Karin Andersen ◽  
Vivi Bakholdt ◽  
Jens Ahm Sørensen
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Surgical Intervention ◽  
Life Assessment ◽  
Quality Of Life Assessment ◽  
Assess Patient Satisfaction ◽  
Industrialised Countries ◽  
Disease Specific

Scrotal elephantiasis (SE) is a condition considered rare in western industrialised countries but common in filaria prone regions. If no apparent causes are found for SE, it is called idiopathic SE. Medical and conservative therapies are ineffective against idiopathic SE, and surgical intervention is mandatory to treat this disabling condition. Nevertheless, it remains unclear whether surgical intervention improves quality of life among patients with idiopathic SE. Herein, we report a case of a 41-year-old man who underwent acute scrotal resection and reconstruction, secondary to haemorrhage from his idiopathic SE. The aim of this study was to describe the operative approach and assess patient satisfaction after surgical treatment. The patient had no recurrence of SE after surgical treatment at 6 months follow-up and had considerable improvements assessed by general and disease-specific quality of life questionnaires.

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