This study compared the treatment of total contact casting (TCC) with traditional dressing treatment (TD) in the management of neuropathic diabetic plantar ulcers. Thirty-one patients with plantar ulcers without any gross infection, osteomyelitis or gangrene were randomly assigned to the TCC group (n ¼ 15) or TD group (n ¼ 16). In the experimental group, TCC was applied on the initial visit and subjects were instructed to limit ambulation to one-third of their usual activity. Subjects in the control group (TD) were prescribed dressing changes and were advised against bearing weight on the involved extremity. Ulcers were considered healed if they showed complete skin closure with no drainage. Ulcers were considered not healed if they showed no decrease in size by 6 weeks or if infection developed requiring hospitalization. In the TCC group, 12 of 15 ulcers healed in 48 + 7 days; in the TD group, 10 of 16 ulcers healed in 58 + 9 days. Comparatively higher rate of ulcer healing with fewer infections was seen in the TCC group. We conclude TCC is a more effective method than dressing for treating diabetic plantar ulcers reducing the risks of amputation.
Background: Bilateral total knee arthroplasty (TKA) is one of the most common surgeries performed in patients with Osteoarthritis knee. The functional assessment in between two knees have not been in literature which is an important evaluation to help provide patients with evidence based outcome. We evaluated the functional outcomes on operated Bilateral TKA patients and compared them between the two knees. Methodology: Patients who underwent primary Bilateral sequential and staggered TKA between 1 st January 2019 and 31 st Dec 2019, were included and their functional outcomes were assessed at 6 weeks, 3 month, 6 months and 1 year intervals were evaluated in our study. Results: With a mean age of 66.95 years (50-82), 142 primary bilateral total knee replacements were included. In the 142 patients observed a total of 17 patients had a difference in the left and right knees where 13 patients had right knee better than left and the other 4 had left better than right based on the KSS score. In conclusion, the differences between knees were not significant over 1 year period followup based on the KSS scores Conclusion: In our study, we found that functional outcomes of knees based on KSS scores were different in the early follow ups at 6 weeks and 3months interval but at a long term follow up of 1 year the differences were not significant.
Soft tissue loss with multiple sinuses, osteomyelitis, osteoporosis, complex deformities with limb length inequality, stiffness of the adjacent joints and multi drug resistant infection all complicate treatment and recovery. Aim of the study is to observe the role of Orthofix limb reconstruction system as a treatment in non-union with bone loss and major soft tissue defect due to fresh fractures. The method of treatment of infected non-union by the Limb Reconstruction System with a predictable healing of nonunion and control of infection is well shown in this study.
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