14 research outputs found
PW 0410 Adressing the burden of orthopedic trauma and categorically identifying the pattren of injuries presenting at trauma center civilhospital karachi-pakistan
No full textGiant Lipoma of Unusual Regions: A Case Series of Two Unfortunate Adults
No full textLipomas are prevalent, benign, asymptomatic mesenchymal tumors that can develop in various areas where adipose tissue is present. However, when lipomas reach sizes larger than 10 cm in width or exceed 1 kilogram in weight, they are classified as giant lipomas [1-3]. These oversized lipomas can lead to functional restrictions, aesthetic concerns, and compression-related injuries, all of which can negatively impact an individual’s quality of life. They are usually surgically removed to avoid injury to major neurovascular structures; however, they have a predisposition for recurrence and the risk of malignancy following surgery. This case series discusses the clinical findings and surgical treatment of two patients who had enormous, deformable, fatty tumors of buttocks and thigh, respectively
Outcome of Intraarticular Communicated Fractures Distal Radius Treatment with Orthofix External Fixators
No full textObjective:
Assess the outcome of intraticular comminuted fracture distal radius treated with orthofix external fixator.
Methods:
Prospective study with inclusion criteria of Comminuted intraarticular fractures distal radius , 20 to 60 years age, close and open fractures and exclusion criteria of patient above 60 years , extraarticular fracture , volar and dorsal barton fractures , more then 10 days old fracture.
Results:
From Januarry 2012 to sept 2014 , 63 patient with intraarticular comminuted fracture distal radius treated with orthofix external fixator included in this study. Functional outcome was assessed on Gartland and Wesley scoring system. 40 (63%)male and 23(37%) female patients, 35(56%) road traffic accident and 28(44%) have fall. AO C1, were 32(51%), C2 ,19(30%), C3, 12(19%) patients. Additional kwire fixation applied in 54 patients.Fixator removed at 6 weeks. Functional result were excellent in 26 patient(41%) , good 32(51%) , satisfactory in 4 patient(6%) , poor in 1(2%). Complication observed were , minor and major pin track infection 30(65%), tethering of external indicis tendon 3(7%) patient, k wire loosening 10(22%) and sudecks atrophy 3(7%) patients.
Conclusion:
Orthofix external fixator application in intraarticular comminuted fracture distal radius is recommended because it is minimal invasive technique ,have excellent to good outcome . Most of the times needs additional kwire fixation for the fragment stabilization.
Key Words:
Intraarticular , Comminuted , Distal Radius , Orthofix External Fixator, K Wire
Proximal Fibular Osteotomy – Simplest and Most Effective Mean to Delay Total Knee Arthroplasty
No full textBackground: Osteoarthritis involves degeneration of articular cartilage seen with increasing age. The knee joint, the most common joint that falls prey to attacks of osteoarthritis, has 30% incidence in population above 60 years. Total knee arthroplasty (TKA) is the main surgical option for orthopaedics. Though it corrects the deformity and relieves pain, yet it is not the treatment of choice in younger population. This study aimed to validate the effects of proximal fibular osteotomy (PFO) as a newer technique in managing medial compartment knee osteoarthritis.
Methods: The diagnosed patients for medial compartment knee joint osteoarthritis were selected for study from Dr. Ziauddin University hospital of Karachi. Excluded were aged less than 40 years, or with BMI more than 30, and patients with tri-compartmental arthritis. Medial and lateral joint spaces along with Oxford knee score were measured and recorded pre- and post-operatively. Patients underwent PFO after giving written and informed consent.
Results: Total number of patients selected was 30 for this study; 21 (70%) females, and 9 (30%) males (mean age 58.8 years). Mean pre-operative measured medial joint space on standard antero-posterior (AP) radiograph was 0.442± 0.04 cm. Mean recorded pre-operative Oxford knee score was 23.87±3.74 mm. Improvement was observed in mean postoperative medial joint space to 0.572± 0 .066 cm and mean post-operative Oxford knee score to 40.2±5.8mm.
Conclusion: This study concludes that PFO significantly improves joint function in patients with medial compartment osteoarthritis knee and may delay the need for total knee arthroplasty, if carried out at an appropriate stage.
Keywords: Osteotomy; Osteoarthritis; Total Knee Arthroplasty
Passage of moisture due to perspiration in fabrics
No full textCotton Incorporation;Epro Development Limited;et al;Graham C (Hong Kong) Limited;Institute of Textiles and Clothing;TAL Apparel Limited2011 Spring Conference of the Fiber Society --23 May 2011 through 25 May 2011 -- --The study has been done by the first author during his post graduation with the full help of his respected Prof. Dr. Zhang Weiyuan on 05-09-2000 in fabric testing lab at Dong Hua University, Shanghai, China. Moisture from perspiration collects in and passes through clothing as worn and the properties of clothing fabrics influence both the collection and passage of this moisture. The selection and measure of moisture properties that relate to comfort in wear has proved to be more difficult than first perceived. Surface wetness of fabrics has been found to correlate with skin contact comfort in wear for variety of fabric types, suggesting that mobility of thin films of condensed moisture is an important element of wearing comfort. This study discusses how surface wetness is measured, particularly in regards to moisture that condenses in clothing next to the skin
Aneurysmal bone cyst of ischiopubic ramus: A rare location with literature review
No full textAneurysmal bone cyst (ABC) is a locally destructive lesion of the bone rather than a true neoplasm. The pelvis is not an unusual site for an ABC; approximately 12% of cases occur in this location. We present a case of aneurysmal bone cyst (ABC) in ischiopubic ramus in a 22 years old male who presented with right inguinal swelling and pain. He was evaluated with X-ray and Magnetic Resonance Imaging (MRI) of pelvis. A review of literature regarding this rare site of ABC with radiological features is also described in this case report.ABC of ischiopubic ramus is an uncommon entity hence diagnosis of such a case requires proper clinical, radiological and histopathological evaluation to rule out other differential diagnoses of an expansile, osteolytic lesion. This will help in selecting a proper treatment plan
Evaluation of Complex Tibial Pilon Fractures Treated with Ilizarov External Fixator
No full textBACKGROUND: Ilizarov external fixator is now considered a suitable alternate treatment modalityfor treatment of complex tibial pilon fractures with questionable soft tissue integrity; it allows early weight bearing without jeopardizing the fracture stability and bone healing.
OBJECTIVE: The purpose of study was to evaluate clinico-radiological outcome and morbidity of the Ilizarov external fixator used for fixation of complex tibial pilon fractures.
METHODS: This retrospective analytic cross-sectional study was conducted at Orthopaedic Surgery department, Dow Medical College / Dr Ruth Pfau Civil Hospital Karachi, from June 2014 to May 2017. A total of 17 consecutive patients with complex tibial pilon fracture (AO type 43C) operated with Ilizarov external fixator technique were evaluated functionally by using the American Orthopaedic Foot and Ankle Society scoring system (AOFAS) and radio-logically for fracture union (delayed, nonunion) after a mean followup of 6 months. Post-surgical complications were noted. Polytrauma patients with additional fracture in pelvis and spine, pathological fracture, delayed presentation (> 2 weeks) and AO type 43A & B were excluded from the study.
RESULTS: Total 17 patients (29.4% female and 70.6% male) with mean age 28 years (range, 17 - 48 years) were analyzed in this study. 11 (64.7%) fractures had left ankle while 6 (35.2%) fractures had right ankle involvement. The minimum follow-up was 3 months after complete frame removal. According to AO classification, C1 in 9 cases, C2 in 3 cases and C3 in 5 cases. All fractures were united in average 14.6 weeks (range 10-28 weeks). According to AOFAS scoring system, the final functional results were excellent in 5 (29.4%), good in 10 (58.8%) and fair in 2 (11.7%). There were 82.3% pin tract infections in this series. Ankle joint arthritis was noted in five patients. We had no instance of postoperative deep infection and neurovascular complications due to Ilizarov fixation.
CONCLUSIONS: The Ilizarov ring fixator is a minimal invasive procedure that offers biological advantages and is a suitable alternate for treatment of complex tibial pilon fractures with questionable soft tissue integrity providing fracture healing, rapid functional recovery, and avoidance of major complications associated with extensive operative dissection needed with plate osteosynthesis
Outcomes of Extended Curettage with and without Bone Allograft for Grade II Giant Cell Tumors around the Knee. A Retrospective Comparative Study
No full textAbstract Objective This is the first study to establish the utility of extended curettage with or without bone allograft for Grade II giant cell tumors GCTs around the knee joint with the aim of exploring postoperative functional outcomes. Methods We retrospectively reviewed 25 cases of Campanacci grade II GCTs undergoing extended curettage between January 2014 and December 2019. The participants were divided into two groups: one group of 12 patients underwent extended curettage with bone allograft and bone cement, while the other group of 13 patients underwent extended curettage with bone cement only. Quality of life was assessed by the Revised Musculoskeletal Tumor Society Score and by the Knee score of the Knee Society; recurrence and complications were assessed for each cohort at the last follow-up. The Fisher test and two-sample t-tests were used to compare the categorical and continuous outcomes, respectively. Results The mean age was 28.09 (7.44) years old, with 10 (40%) males and 15 females (60%). The distal femur and the proximal tibia were involved in 13 (52%) and in 12 (48%) patients, respectively. There was no significant difference in the musculoskeletal tumor society score (25.75 versus 27.41; p= 0.178), in the knee society score (78.67 versus 81.46; p= 0.33), recurrence (0 versus 0%; p= 1), and complications (25 versus 7.69%; p= 0.21). Conclusions Extended curettage with or without bone allograft have similar functional outcomes for the knee without any major difference in the incidence of recurrence and of complications for Grade II GCTs. However, surgical convenience and cost-effectiveness might favor the bone cement only, while long-term osteoarthritis prevention needs to be investigated to favor bone allograft
Cord Compression from Bony Metastasis: An Important Quality of Life Issue which can be Resolved by a Spinal MDT Tumor Board
No full textCancer prevalence is increasing over the past few decades. Spinal osseous metastasis is one of the most common sites of secondary neoplastic disease among cancer patients [1]. Spinal malignancies can broadly be classified into primary spinal cancers and secondary spinal metastasis. Metastatic spinal cancers are more common than primary malignancy of the spine. Metastatic spinal cancers are further subdivided into two parts based on the involvement of the dura mater; metastasis external to dura mater can be termed as metastatic epidural spinal cancers (MESC); metastasis inside the dura mater is called metastatic intradural spinal cancers (MISC) [2]. Bony involvements of vertebrae are common at the presentation of MESC while the involvement of the spinal cord and meninges is a prominent feature of MISC. However, the clinical presentation is quite overlapping and timely-decision making is quite challenging in several cases. Several grading systems have been developed to assess the severity of spinal cancers [3-6]. Such ambiguities require a need for teamwork between different specialties to decide the management plan for better patient care. Multidisciplinary Tumor Boards (MDT) are the practical venue where different specialists are present for the discussion [7]
Experience from Cancer Registry of a Developing Country Regarding Quality of Care and Non-Compliance among Osteosarcoma Patients
No full textAbstract: In this study, we evaluated the level of care given by our institution and to assess the non-compliance along with predictor for
non-compliance among osteosarcoma patients.
Materials and Methods: The included participants were proven for osteosarcoma after biopsy between January 2014 to December 2020.
Records were searched from Departmental Cancer Registry for details regarding treatment plans and follow-ups. The data of outcomes were
compared with the standard guidelines. Patients who did not attend follow-ups, surgery or chemotherapy were termed as non-compliant. The
patients or their next of kins were inquired about the factors behind non-compliance.
Results: 46 participants with 34 (74.9%) males and 12 (26.1%) females and a mean age of 19.7± 9.7 years were included. The prescribed
treatment plan was followed by 11 (23.91%) patients. Neoadjuvant and adjuvant chemotherapy were taken by 18 (39.13%) and 10 (21.74%)
candidates, respectively. Surgery was performed in 22(44.9%). The patients who did not received chemotherapy was attributed to affordability
(P=0.008) and patients’ or next to kins’ choices (P=0.02) while age (P=0.039), patients’ consent not given (78.3%; P=0.05), and stage II
(52.2%; P=0.048) were predictors of surgical non-compliance.
Conclusion: We conclude that the care deferred significantly from the guidelines regarding surgery and chemotherapy. Age, affordability, late
stage, and personal choices are the significant predictors for non-compliance for chemotherapy and surgery
