A Comparative Study of Pediatric Fracture Shaft Femur Fixating by Plate and Screws Using Lateral Approach Between Subvastus Lateralis and Transvastus Lateralis Outcome

BACKGROUND: Femoral shaft fracture is a common fracture in pediatric age group reaching 62% of all fracture shaft femur in children in spite of rapid union rate and successful conservative treatment but some cases need surgical intervention and one of the methods using plate and screw by the lateral approach. AIM: This study aims to compare functional outcome fixation of mid-shaft femur fracture in children by plate and screws between (subvastus lateralis and transvastus lateralis) regarding infection, union, and limitation of knee movement. PATIENT AND METHOD: The study was done on 30 children who had diaphyseal fracture femur in Al-Kindy Teaching Hospital in period (April 2018–April 2020) with 6 months follow-up, and the patient was divided into two groups: Group A first treated by subvastus lateral approach 15 patients and the second group, Group B by transvastus lateral approach 15 patients and follow-up done for them after 2 weeks, 4 weeks, 6 weeks, 3 months, and 6 months. RESULTS: At week 16 of follow-up all patients in Group A had union, while in Group B, 14 of 50 patients had union and one patient had no union and one patient in Group B had an infection when compared to Group A. From 15 patients of Group A, two patients had limitation of knee movement in the 1st month of follow-up then in the 3rd month of follow-up, no patient had limitation of knee joint movement, while five patients had limitation of knee joint movement in Group B in the 1st month of follow-up and one patient had limitation knee joint movement in the 3rd month of follow-up. CONCLUSIONS: The subvastus lateralis approach results better than transvastus lateralis in union.

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Superficial and Deep Infections Rate in Primary Total Ankle Replacement through Anterior Approach versus Lateral Transfibular Approach

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000394 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0003 ◽

Cited By ~ 1

Author(s):

Federico Giuseppe Usuelli ◽

Cristian Indino ◽

Luigi Manzi ◽

Camilla Maccario ◽

Ettore Vulcano

Keyword(s):

Anterior Approach ◽

Operative Time ◽

Deep Infection ◽

Lateral Approach ◽

Trabecular Metal ◽

Ankle Replacement ◽

Group A ◽

Group B ◽

Approach Group

Category: Ankle, Ankle Arthritis, Periprosthetic Infections Introduction/Purpose: Periprosthetic joint infections represent a relatively infrequent complication following total ankle replacement (TAR), with reported incidence ranging from 2% to 8,6%. Early treatment of any wound infection is the key to prevent disastrous outcomes. One of the most recent TARs (Zimmer Trabecular Metal Total Ankle, Zimmer Biomet, Warsaw, IN) requires implantation through a lateral transfibular approach. Potential advantages of this approach include the supposed decreased risk of wound complications, thanks to a preservation of the distal leg angiosomes. The purpose of this study is to retrospectively compare the rate of superficial and deep infections between TARs performed through an anterior approach and TARs performed through a lateral transfibular approach at 12-months follow-up. Methods: This study included 150 consecutive primary TARs performed between May 2011 and July 2015 with at least 1-year follow up. The 3-component uncemented Hintegra implant (Newdeal SA, Lyon, France) was used in 81 TARs (54.0%) through an anterior approach (group A). The 2-component uncemented Zimmer Trabecular Metal Total Ankle prosthesis, was implanted in 69 TARs (46.0%) through a lateral transfibular approach (Group B). Operative time, tourniquet time and superficial and deep infections were recorded up to 1-year follow-up. All patients were clinically and radiologically evaluated postoperatively at two, six and twelve months. Superficial wound infections were classified as dehiscence, eschar, or wound drainage according to criteria of the Centers for Disease Control and Prevention for surgical wound infection. Deep infections were classified according to Fitzgerald’s classification: acute postoperative, deep late infections, late hematogenous infections. We compared the incidence of superficial and deep infections as well as the operative time. Results: In group A there were 4 (4.9%) superficial infections. Two of these patients developed a deep infection. Overall, there were 3 (3.7%) deep infections in group A that required: intravenous antibiotics and vacuum assisted closure; replacement of the tibial component and polyethylene liner; polyethylene exchange and VAC treatment. In group B, there were 2 (2.9%) superficial infections. One of these patients developed the only deep infection (1.4%) that was treated with antibiotic-impregnated cement spacer. There was no statistically significant difference in terms of superficial (P= 0.687) and deep infections (P= 0.625). The mean operative time in group A was 115.2 minutes (65-150) and 179.5 minutes (105-333) in group B. Operative time was statistically different between group A and group B (P <0.001). Conclusion: This study demonstrates a lower superficial and deep infection rate in the lateral transfibular approach group compared to the anterior approach group. Nonetheless, this difference was not statistically significant. The significantly longer operative time in the lateral approach group did not seem to affect the infection rates. In conclusion, TARs performed through a lateral approach appear to be as safe as TARs done through an anterior approach in terms of the infection rate within the first postoperative year. Further studies on larger cohorts and longer follow-up are essential to validate the findings from this study.

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Comparative study of day 01 spica cast versus skin traction followed by spica cast for treatment of closed femoral shaft fracture in children

Z H Sikder Women’s Medical College Journal ◽

10.47648/zhswmcj.2020.v0201.04 ◽

2020 ◽

Vol 2 (Number 1) ◽

pp. 16-19

Author(s):

Ripon Kumar Das

Keyword(s):

Femoral Shaft ◽

Shaft Fracture ◽

Spica Cast ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Fractures In Children ◽

Group A ◽

Group 2 ◽

Group B ◽

Skin Traction

Femoral shaft fractures are among the commonest fracture of lower extremity in children and commonly require hospital admission. There are various modalities of treatments both operative and non-operative. The aim of treatment is to secure union, in good alignment with length restored and early rehabilitation. objective of this study was to compare the results of day 1 spica cast and skin traction followed by spica cast in the treatment of femoral shaft fractures in children (6 months to 10 years). A total of 64 patients with fracture shaft femur of either sex aged 6 months – 10 years with closed , isolated diaphyseal femur fracture were included in this study. Case with clinical evidence of infection, pathological fractures and multiple injuries including neurovascular injuries were excluded from the study. The patients were randomly assigned into two groups, Group -1 ( n-32) patients who underwent early spica application while Group -2 ( n-32) patients underwent skin traction in followed by spica cast. Mean age in group A was 5.06 years and 5.12 years in group B (range 6 month – 10 years). Ratio of males and female in Group A and Group B was 19:13 and 20:12 respectively. Average duration of hospital stay was 1.65 days and 11.65 days in group A and group B respectively. Average total time of spica cast application was 45.13 days 49.41 days in group A and group B patients respectively. There were no significant differences between early and delayed spica regarding the complications of treatment and functional outcome. But immediate spica decreased the hospitalization time and the cost of treatment significantly with increased availability of beds while having similar result as achieved by delayed spica application.

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A comparative clinical study of the effect of Upanaha Sweda by using Kottamchukkadi Churna and Grihadhumadi Churna in Janusandhigata Vata w.s.r. to Osteoarthritis of Knee Joint

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.5.4.19 ◽

2020 ◽

Vol 5 (04) ◽

pp. 112-117

Author(s):

Reshmi PK ◽

Sudarshan A ◽

Jeejo Chandran

Keyword(s):

Clinical Study ◽

Knee Joint ◽

Modern Medicine ◽

Osteoarthritis Of Knee ◽

Womac Index ◽

Comparative Clinical Study ◽

Group A ◽

Group B ◽

Single Blind

As per Ayurveda, Janusandhigata Vata is one among Vatavyadhi and can be compared with Osteoarthritis of Knee Joint in Modern Medicine with respect to the similarity of symptoms. Aims and Objectives: To evaluate and compare the effect of Grihadhumadi and Kottamchukkadi Upanaha in Janusandhigata Vata. Methods: Single blind randomized comparative clinical study allocated into 2 equal groups as A and B. Procedure: In Group A, Grihadhumadi Upanaha Sweda done for 7 days and in Group B, Kottamchukkadi Upanaha Sweda done for 7 days. Patients were examined as per the assessment criteria on 1st day before treatment, 8th day after completion of the treatment and 15th day as part of follow up. Observations and Results: Group A showed statistically highly significant effect in most of the criteria’s like Swelling, Stiffness, Tenderness, Visual Analogue Scale (VAS), Range Of Movements (ROM) and WOMAC INDEX. Group B showed statistically highly significant effect in Pain and Crepitation.

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Post-exercise Stretching Protects Strain of Knee Joint Movement System by Relieving Knee Pain and Iliotibial Band Tension

10.21203/rs.3.rs-954348/v1 ◽

2021 ◽

Author(s):

Le Yin ◽

Li-ming Zhu ◽

Ye-qi Zhou ◽

Hai-tao Ma

Keyword(s):

Knee Joint ◽

Knee Pain ◽

Joint Pain ◽

Exercise Group ◽

Iliotibial Band ◽

Joint Movement ◽

Post Exercise ◽

Group A ◽

Movement System ◽

Group B

Abstract Background Studies have reported that exercise stretching therapy has a certain effect on improving knee joint pain and knee joint function.However, few studies have compared the effects of post-exercise stretching and non-stretching on strain of knee joint movement system. The purpose of this study is to observe the influence of whether people have stretched after exercise on knee joint pain and iliotibial band tension,and to compare the difference between the stretched group and the unstretched group after exercise for further discussion.Methods Collecting data analysis of 71 people who love sports in the First People's Hospital of Xiaoshan District from December 2019 to October 2020, including the non-stretching group after exercise (group A, n=40) and post-exercise stretching Group (Group B, n=31), compare the differences in knee pain and iliotibial band tension between the two groups and analyze the relationship between this difference and stretching.Results The incidence of knee pain and iliotibial band tension in group A was significantly higher than that in group B (P<0.05). The risk of knee pain in group A was 2.940 times greater than that in group B. The incidence of iliotibial band tension in group A was 4.190 times higher than that in group B. Conclusions 1. People who do not stretch after exercise are at higher risk of knee pain than those who stretch. 2. People who do not stretch are more likely to develop iliotibial band tension than those who stretch. 3. Stretching after exercise helps to relieve the stiffness of the iliotibial band, maintain the stability of the knee joint, and reduce the occurrence of knee pain.

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Comparative study of day 01 spica cast versus skin traction followed by spica cast for treatment of closed femoral shaft fracture in children

Z H Sikder Women’s Medical College Journal ◽

10.47648/article/zhswmcj.2020.v0201.04 ◽

2020 ◽

Vol 2 (Number 1) ◽

pp. 16-19

Author(s):

Ripon Kumar Das ◽

Md Johurul Hoque ◽

Md Emam Zamman ◽

Fakhrul Islam

Keyword(s):

Femoral Shaft ◽

Shaft Fracture ◽

Spica Cast ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Fractures In Children ◽

Group A ◽

Group 2 ◽

Group B ◽

Skin Traction

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Absorbable suture material in carotid surgery

VASA ◽

10.1024/0301-1526/a000468 ◽

2015 ◽

Vol 44 (6) ◽

pp. 451-457 ◽

Cited By ~ 4

Author(s):

Vincenzo Gasbarro ◽

Luca Traina ◽

Francesco Mascoli ◽

Vincenzo Coscia ◽

Gianluca Buffone ◽

...

Keyword(s):

Suture Material ◽

Absorbable Suture ◽

Paediatric Surgery ◽

Carotid Surgery ◽

Suture Materials ◽

Absorbable Suture Material ◽

Absorbable Sutures ◽

Group A ◽

Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

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Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

Reviews on Recent Clinical Trials ◽

10.2174/1574887114666190201111332 ◽

2019 ◽

Vol 14 (2) ◽

pp. 141-146

Author(s):

Simone Zanella ◽

Enrico Lauro ◽

Francesco Franceschi ◽

Francesco Buccelletti ◽

Annalisa Potenza ◽

...

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

The Elderly ◽

Long Term Follow Up ◽

Group A ◽

Group B ◽

Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

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A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v1i1.3631 ◽

2016 ◽

Vol 1 (1) ◽

Author(s):

Praveenkumar H. Bagali ◽

A. S. Prashanth

Keyword(s):

Medical Science ◽

Frozen Shoulder ◽

Signs And Symptoms ◽

Treatment Modalities ◽

Animal Kingdom ◽

Shoulder Joints ◽

Group A ◽

Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

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A Comparative Study of Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana in the Management of Shweta Pradara

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i4.9322 ◽

2017 ◽

Vol 2 (4) ◽

Author(s):

Renuka M. Tenahalli

Keyword(s):

Vitamin C ◽

Early Stage ◽

Pathological Condition ◽

Before And After ◽

Group A ◽

Phosphorus Iron ◽

Group B ◽

Busy Schedule ◽

Iron And Calcium

Shweta Pradara (Leucorrhoea) is the disease which is characterized by vaginal white discharge. Vaginal white discharge this symptom is present in both physiological and pathological condition, when it becomes pathological it disturbs routine life style of the woman. Most of the women in the early stage will not express the symptoms because of hesitation and their busy schedule. If it is not treated it may leads to chronic diseases like PID (Garbhashaya Shotha etc.) Charaka mentioned Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana. This treatment is used in Shweta Pradara shown positive results, hence a study was under taken to assess its clinical efficacy. 30 diagnosed patients of Shweta Pradara were randomly selected, allocated in three groups. Group A and Group B received Amalaki Choorna with Madhu and Vata Twak Kashaya Yoni Pichu Dharana respectively and Group C received Amalaki Choorna with Madhu followed by Vata Twak Kashaya Yoni Pichu Dharana for 15 days. The patients were assessed for the severity of the symptoms subjectively and objectively before and after the treatment and at the end of the follow up. Data from each group were statistically analyzed and were compared. No side effects were noted and it may be considered as an effective alternative medicine in Shweta Pradara (leucorrhea). Amalaki is rich in natural source of vitamin C and contains phosphorus, iron and calcium. Honey contains carbohydrate, vitamin C, phosphorus iron and calcium. All together these help to increase Hb% and immunity. Vata Twak Kashaya contains tannin which helps to maintain normal pH of the vagina.

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Oral Tranexamic Acid for the Treatment of Melasma

Kathmandu University Medical Journal ◽

10.3126/kumj.v10i4.10993 ◽

2014 ◽

Vol 10 (4) ◽

pp. 40-43 ◽

Cited By ~ 26

Author(s):

D Karn ◽

S KC ◽

A Amatya ◽

EA Razouria ◽

M Timalsina

Keyword(s):

Tranexamic Acid ◽

Controlled Trial ◽

Severity Index ◽

Sustained Improvement ◽

Treatment Measures ◽

Group A ◽

Group B ◽

Novel Concept ◽

High Treatment

Background Melasma poses a great challenge as its treatment is unsatisfactory and recurrence is high. Treatment of melasma using tranexamic acid (oral, topical or intralesional) is a novel concept. Objective To compare the efficacy of oral tranexamic acid with routine topical therapies for the treatment of melasma. Methods It is a prospective, interventional, randomized controlled trial conducted among 260 melasma patients. Patients were divided into two groups consisting of 130 patients each. First group (Group A) was given routine treatment measures and oral Tranexamic Acid while second group (Group B) was treated only with routine topical measures. Capsule Tranexamic Acid was prescribed at a dose of 250 mg twice a day for three months and cases were followed for three months. Response was evaluated on the basis of Melasma Assessment Severity Index (MASI). Mean scores between the two groups were then compared. Results Statistically significant decrease in the mean Melasma Assessment Severity Index from baseline to 8 and 12 weeks was observed among group A patients (11.08±2.91 vs 8.95±2.08 at week 8 and vs. 7.84±2.44 at week 12; p<0.05 for both). While among group B patients the decrease in mean score was significant at 8 weeks and insignificant at 12 weeks follow up (11.60±3.40 vs 9.9±2.61 at 8 weeks and vs. 9.26±3 at 12 weeks; p<0.05 for former but p>0.05 for later). Conclusion Addition of oral tranexamic acid provides rapid and sustained improvement in the treatment of melasma. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10993 Kathmandu Univ Med J 2012;10(4):40-43

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