Physiotherapy Rehabilitation in Operated Case of Patellar Fracture and Medial Malleolus Fracture- A Case Report

Introduction: Road traffic accidents (RTA) are responsible for a considerable amount of global death and morbidity, particularly in developing nations. 'Hidden pandemics,' such as mortality from RTA, often go unnoticed over the world.(1) These days traffic road accidents lead to many fractures included patellar fracture. Patellar fractures account for about 1% of all skeletal fractures and are most common in people between the ages of 20 and 50. 1–3 Men have nearly twice as many cases as women. Clinical Findings: On physical examination respiratory system, cardiovascular system and central nervous system are normal and on local examination of left lower limb demonstrate attitude of limb in hip and knee in extension and foot in external rotation and multiple abrasions are present over the knee and there were abrasion of 10*2cm present over medial aspect of great toe and abrasion of 5*2cm present over the postero-medial aspect of distal 3rd leg, lacerated wound on medial malleolus.In this case patient was on 8 week protocol for physiotherapy management. Discussion: In this case report we are discussing a case of 36 year old male with fracture of patella and medial malleolus managed with tension band wiring and nailing respectively. The primary goal of physiotherapy management was to prevent secondary complications and make the patient independent for which rehabilitation protocol was planned which included isometric exercises, dynamic quadriceps bed mobility exercises and ambulation. Conclusion: Physiotherapy plays an important role in rehabilitation of patient with medial malleolus and patella fracture.

Authenticity of Aloe vera and Acacia Honey on Wound and their Comparative Wound Healing Efficiency on Lacerated Wound in Rabbit

Reseаrсh study wаs соnduсted tо аnаlyze the effeсts оf Асасiа hоney аnd Аlоe verа gel оn lасerаted wоund induсed in rаbbits. Fоr this рurроse, а tоtаl оf 30 heаlthy mаle аdult rаbbits were seleсted аnd divided intо 3 grоuрs (А, B аnd С). Surgiсаl wоunds were induсed in аll rаbbits with the helр оf shаrр blunt sсissоr аnd eасh rаbbit frоm аll grоuрs wаs рre-mediсаted by аdministering аtrорine sulрhаte @0.035mg/kg bоdy weight thrоugh s/с rоute hаlf аn hоur рriоr tо surgiсаl interventiоn. Аnimаls were аnesthetized by tоtаl раrenterаl (intrаmusсulаr) аnesthesiа using а mixture оf ketаmine (35mg/kg) аnd xylаzine (5mg/kg). Rаbbits оf grоuр А were treаted with Асасiа hоney, аррlied twiсe dаily, grоuр B rаbbits were treаted with Аlоe verа gel tорiсаlly twiсe dаily while grоuр С served аs соntrоl аnd treаted with stаndаrd treаtment рyоdine. Wоunds were рrорerly соvered with sterile bаndаges tо reduсed mаximum infeсtiоns аnd the effiсасy оf these treаtments wаs evаluаted in terms оf their effeсts оn heаling time, wоund соntrасtiоn, рeriоd оf eрithelizаtiоn, tensile strength, histораthоlоgy аnd wоund index. Wоund соntrасtiоn rаte wаs higher in bоth grоuрs (А аnd B) аs соmраred tо the grоuр С (Соntrоl grоuр) аnd inсreаsed wоund соntrасtiоn were оbserved оn dаy 10 аnd wаs соmрleted оn 20 dаys. In саse оf eрithelizаtiоn, deсreаsed рeriоd оf eрithelizаtiоn wаs оbserved in grоuр А аnd B аs соmраred tо the С grоuр (соntrоl grоuр). Heаling time wаs lоwer аnd stаtistiсаlly signifiсаnt аs соmраred tо the соntrоl grоuр (grоuр С). Grоuр B wаs signifiсаnt аs соmраred tо the grоuр С. Wоund index vаlues were reduсed in bоth grоuрs А аnd B аnd grоuр С wаs higher wоund index vаlues оn dаy 15 аnd vаlue wаs 1.78 аs соmраred tо the оther treаtments grоuрs. The vаlues оf grоuр А аnd B wаs nоn signifiсаnt аt dаys 20 аs соmраred tо the соntrоl grоuр. Grоuр С wаs higher рeriоd оf eрithelizаtiоn аs соmраred tо the оther twо grоuрs А аnd B.

Management of Horn Gore Injury of Vagina in a Buffalo: A Case Report

A 6 year old murrah buffalo weighing around 350 kg was presented with the complaint of lacerated wound in the vagina resulted after horn gore injury since eight hours. The area around the injury was debrided and wound was flushed properly with normal saline followed by washing with povidone iodine (5%). After stabilizing the animal, lacerated wound was closed in routine manner. The buffalo had an uneventful recovery.

Surgical Management of Lacerated Wound in a Buffalo

A 4 year old Graded Murrah Buffalo was presented with extensive lacerated wound on right external ear that occurred due to horn gore injury by a bull. The animal was examined thoroughly and prepared for surgery and the wound was sutured in routine manner. Good surgical technique and effective post operative management made the case successful recovery.

A fracture of OS trigonum: a rare case report

<p class="abstract">Fractures of os trigonum is an extremely rare event. It is one of the accessory ossicles of the foot found in about 7 % of the population. Very few cases have been reported in the literature about a fracture of the ostrigonum. We present a case of fracture of ostrigonum with associated fracture of the fibula and a large lacerated wound in the leg, in a young man sustained due to road traffic accident. The initial radiological examination with Xray ankle showed a doubtful fracture of posterior process of talus but was not clear. The diagnosis was clinched by CT scan of the ankle with 2mm cuts, which showed clearly a fracture of the os trigonum. It was treated by flap cover for the wound and plaster immobilisation for the fracture. So, any doubtful fracture near the posterior process of talus should be fully assessed radiologically with a CT scan to guide in the treatment.</p>

Orthopedic Case Burden at Nunukan Hospital: Focus On Trauma Case

Incidence of orthopedic case is quite high in Nunukan Hospital, most of them need both non-operative and surgical intervention due to congenital, debridement, fracture, rupture of tendon and blood vessel, even amputation. Until now, data orthopedic case profile especially trauma case in Nunukan Hospital is not available. Also, the urgency of having an orthopedic surgeon is unbearable which unavailable in Nunukan, this made the management can’t be done comprehensively and as soon as possible. The aim of this research was to describe the incidence of orthopedic case at Nunukan hospital as basic data for further research. This Retrospective Study was conducted at Nunukan Hospital, North Kalimantan – Indonesia. The data is collected by using logbook and medical records during January 2016 - April 2017. Total of 231 cases were obtained. Male patients accounted for 73.6% (170 patients) and Female was 26.4% (61). The age ranged from 1 day to 82 years old. There are 8-21 cases happened per month (average: 14 cases). Based on case category, trauma occurred for 88.7%% (205). Five top diagnoses are; Close Fracture happened for 44.6% (103 cases), followed by Open Fracture 17.7% (41 cases), Lacerated wound 11.3% (26 cases), Traumatic Amputation 7.4% (17 cases) and CTEV 7.4% (17 cases). Most pathology within the period located in Foot for 29.9% (69). The multiple fracture, vascular, and soft tissue injury were observed. Orthopedic fractures were the most common injuries among patients with 88.7% in Nunukan Hospital from January 2016 to April 2017. There are 14 cases happened for each month with most of the patient were adult. Most of injuries happened at foot region.Abstract: Incidence of orthopedic case is quite high in Nunukan Hospital, most of them need both non-operative and surgical intervention due to congenital, debridement, fracture, rupture of tendon and blood vessel, even amputation. Until now, data orthopedic case profile especially trauma case in Nunukan Hospital is not available. Also, the urgency of having an orthopedic surgeon is unbearable which unavailable in Nunukan, this made the management can’t be done comprehensively and as soon as possible. The aim of this research was to describe the incidence of orthopedic case at Nunukan hospital as basic data for further research. This Retrospective Study was conducted at Nunukan Hospital, North Kalimantan – Indonesia. The data is collected by using logbook and medical records during January 2016 - April 2017. Total of 231 cases were obtained. Male patients accounted for 73.6% (170 patients) and Female was 26.4% (61). The age ranged from 1 day to 82 years old. There are 8-21 cases happened per month (average: 14 cases). Based on case category, trauma occurred for 88.7%% (205). Five top diagnoses are; Close Fracture happened for 44.6% (103 cases), followed by Open Fracture 17.7% (41 cases), Lacerated wound 11.3% (26 cases), Traumatic Amputation 7.4% (17 cases) and CTEV 7.4% (17 cases). Most pathology within the period located in Foot for 29.9% (69). The multiple fracture, vascular, and soft tissue injury were observed. Orthopedic fractures were the most common injuries among patients with 88.7% in Nunukan Hospital from January 2016 to April 2017. There are 14 cases happened for each month with most of the patient were adult. Most of injuries happened at foot region.

Penetrating Eyelid and Ocular Fishhook-Related Injury

Purpose: To report removal techniques and outcomes for a patient with penetrating eyelid and cornea complicating localized retinal detachment from a fishhook. Methods: This is a case report of a 35-year-old man who presented with a fishhook embedded in his right upper eyelid and globe while participating in a fishing competition. On initial examination, his right eyelid was opened with difficulty and limited evaluation could be performed. Results: In an operating room, a shank was transected and removed from a lacerated eyelid by a back-out technique. Then, a barbed hook was noticed to penetrate through temporal peripheral cornea, iris, and entrapped within ciliary body behind the lens. A successful surgical removal of a fishhook was performed within a primary operation. After that, additional operations to repair injured ocular tissues including a localized retinal detachment were performed. The patient achieved a best-corrected visual acuity of 20/20 at 10-month follow-up. Conclusions: The visual prognosis for a fishhook-related ocular injury is associated with various variables including size and location of lacerated wound and technique to remove a fishhook. In this case, a patient could achieve a favorable final visual and anatomical outcome. This removal technique could be taken into consideration when encountering a fishhook-related eye injury patient.

Study on the efficacy of Palandu Ghrita in the Management of Sutured Clean Lacerated Wound w.s.r. To Hypertrophic scar

Ayurveda is a science of life and is believed to exist as long as the origin of life on this nature as it mentioned in Charak Samhita. Ever since, the life originated, human being has been susceptible to injury which is made him to think about healing. Hypertrophic scar is a type of scar characterized by hypertrophy or proliferation of mature fibroblast or fibrous tissue without proliferation of blood vessels. It is caused due to tissue formation during healing process. Acharya Sushruta has mentioned Palandu (Allium Cepa) as Sthirdhatukarta and Krumighna. Palandu is one of the oldest cultivated vegetables in indian history. Palandu contains vitamin A, C and proteins which are essential factors for wound healing ,with keeping these factors in mind,present study was planned as a local application of Palandu Ghrita to prevent hypertrophic scar because prevention is better than cure. For this research study we designed 2 groups viz. experimental group (Group A) i.e. application of Palandu Ghrita and control group (Group B) i.e. application of plain gauze piece. In this, we observed 30 patients from each group according to age, occupation, family history, sharir prakruti etc. and made result on the basis of assessment criteria like pain, scar colour, pliability, tenderness etc. By taking all observations into consideration we made result by using Wilcoxon signed rank test and Mann Whitney’s U test and came on the conclusion that Palandu Ghrita application prevents hypertrophic scar with economical and easy acceptability.

Fracture of Proximal Humerus & Shaft Managed With Closed Reduction & External Fixation by Joshi External Stabilisation System (Jess) – A Case Report

We are presenting a case of proximal humerus& shaft fracture in a 50 year old female. She sustained injury on her left upper limb in a road traffic accident. It was managed with closed reduction & external fixation by Joshi External Stabilisation System (JESS). Lacerated wound over her left shoulder & arm region was managed with skin grafting. The post-operative period was uneventful. Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, Page: 54-58

Epidemiological profile and pattern of injuries in road traffic accidents in Moradabad: A prospective study

Background: In many countries, motor vehicle accidents rank first among all fatal accidents. RTAs have got multi-factorial causation. It is a part of the price we pay for our technological progress. Regional differences exist in the pattern of injury sustained by different types of road users that can have significant implications in the development of prevention policies. The objective of the Study: To understand the profile and pattern of injuries sustained and circumstances leading to RTAs in and around Moradabad, U.P. Materials and Methods: After ethical clearance for the study, all RTA victims presenting to the Casualty of TMU Moradabad, U.P. were taken for this study. All relevant details of RTIs were recorded and data collected, entered on a predesigned proforma and then tabulated, analyzed and interpreted statistically. Results: Out of 730 patients included in this study, most common victims were pedestrians (33.01%), most common site of injury was head (86.71%), most common external injury was lacerated wound (46.75%), and intoxication was seen in 24.11%, protective/safety measures used by 10.23%. Conclusion: RTAs continue to be a speedily rising problem, causing heavy loss of manpower and resources. Road users should be properly trained by authorized centers; driving licenses should be issued after strict testing of driving skills. Trauma centers with integrated facility of surgical, orthopedic, neurosurgical, anesthetic experts with modern investigative procedures like USG, CT-Scan and facility of blood-bank is the best solution for RTA victims who are severely injured.