Background: The majority of studies show positive results when treating lumbar disc herniations with open discectomy, which is the method of choice according to many writers. Even if traditional discectomy produces results that are equivalent, microdiscectomy is currently considered as the gold standard. Aim of work:This study aimed to investigate the endoscopic lumbar discectomy's efficacy, safety, and outcomes for patients with a herniated lumbar disc. Subjects and Methods: From April 2020 to May 2021, 18 patients with a herniated lumbar disc underwent endoscopic lumbar discectomy in the Department of Orthopedics at Zagazig University Hospitals. Thorough history and precise clinical examination were done for all the participating. All patients underwent the preoperative imaging tests as Lumbosacral spine plain x-ray, Lumbo-sacral spine CT scan and Lumbar-sacral spine MRI. Then, patients with lumbar disc herniation who had symptoms that persist after six weeks of conservative treatment or who had neurological deficits are frequently considered for surgical treatment (Endoscopic Discectomy). Three to twelve months was the follow-up period. Results: Postoperatively, VAS score was significantly lower than it was before the procedure. Postoperatively, ODI score was significantly lower than it was before the procedure. 11.1% experienced an unintentional durotomy, 5.6% experienced a superficial infection, and 83.3% experienced no postoperative complications with a statistically significant difference. Conclusion: Endoscopic lumbar discectomy is a minimally invasive procedure that starts with a small incision in the skin for better cosmetic results and avoidance of tissue dissection to reduce intra-operative blood loss, iatrogenic devascularization, and denervation of the paraspinous muscles.
Background: Total hip replacement in patients of younger age with higher levels of activity increases the risk of loosening and mechanical failure.
Background: Osteoarthritis of the knee is a prevalent form of joint disease that can result in debilitating pain and limited movement. Objectives: This study aimed to know the better management of medial compartment osteoarthritis with varus deformity. Patients and Methods: This clinical trial was conducted at Orthopedic Surgery Department, Zagazig University through the period from January 2019 to June 2022. Twenty-four cases of medial compartment knee osteoarthritis were included in this study, all of which had proximal fibular osteotomy (PFO). The mean age of the included cases was 56.6 years. Results: In this study, American Knee Society (AKS) scores showed a significant increase (p < 0.001) from 41.6 ± 5.4 preoperatively up to 80.6 ± 2.6 at 12th month postoperatively. There was significant decrease in visual analogue scale from 8.4 ± 1.6 pre-operation to 1.5 ± 0.8 at 12th month post-operation. Conclusion: Patients with medial compartment knee osteoarthritis often find relief from their symptoms and an increase in their quality of life following a proximal fibular osteotomy.
Background: Physeal fractures of long bones are common injuries treated by orthopedists. Distal tibial physeal fractures account for 11% of all physeal injuries. Objectives: The aim of the work is evaluation of the clinical and radiological outcome of lower tibial epiphyseal injury managed by percutaneous pinning. Patients and Methods: This was a prospective randomized study carried out on 12 cases with distal tibial epiphyseal injuries admitted to Zagazig University with follow up period up to six months. The youngest patient was 8 years old, while the oldest was 16 years old, with an average of 12 years; the high incidence was in the age group 10-15 years. Results: Overall results obtained from 12 cases were satisfactory in 11 cases (91.66%) and unsatisfactory in 1 cases (8.37%). More satisfactory results in this work were in the age group 10-15 years. However, age did not affect the results significantly. Cases with closed injury showed more satisfactory results (100%) than those with open injury, the difference was statistically highly significant. All cases in this study were presented within the first 48 hours from onset of trauma. 8 cases were immobilized for 8 weeks and 4 cases for 6 weeks. The difference was statistically insignificant. 2 cases were managed by open reduction and internal fixation and the difference was statistically insignificant. Conclusion:The percutaneous pinning for lower tibial epiphyseal injury showed good reduction of fracture, satisfactory functional outcome and less complications. The technique provided speed recovery, secure fixation and avoiding prolonged cast immobilization and conservative treatment.
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