Aim: To assess the prevalence of osteomyelitis of the foot in patients with non-healing diabetic foot ulcers, the diagnostic accuracy of tests and the results of conservative treatment. Methods: Prospective data from 180 diabetic patients (selected by consecutive sampling) who presented to the Surgical and Orthopaedic department with non-healing diabetic foot ulcers were assessed and selected for the study. All subjects had plain x-rays, physical and general examination, and complete blood count done. The results were analyzed using SPSS v. 21.0. Results: Of 180 patients with non-healing diabetic foot ulcers assessed and treated in the out-patient department, 105 (58.3%) had osteomyelitis based on positive clinical picture, laboratory data, and imaging tests. 105 patients whom tested positive for osteomyelitis initially received conservative treatment. Twenty-five patients (13.8%) faced the tragic fate of amputation, which was not prevented by conservative treatment, the rest were positive and did not require amputation. Conclusions: We conclude that conservative treatment gives positive results in most cases. It is recommended that patients at risk of osteomyelitis be assessed on an outpatient basis so that the disease can be diagnosed at an early stage and thus help reduce the frequency of amputations. Keywords: diabetic foot ulceration, osteomyelitis, frequency of amputations.
Introduction: The increasing use of minimally invasive orthopedic procedures has led to a greater reliance on fluoroscopy, resulting in elevated radiation exposure for surgeons. This study aimed to evaluate the knowledge, awareness, and daily practices of orthopedic surgeons regarding radiation safety in an academic hospital. Understanding radiation safety is crucial to minimize patient exposure and prevent adverse effects on surgeons. Methods: This cross-sectional study was conducted at the Department of Orthopedics of different tertiary care hospitals in Rawalpindi, Pakistan. Data were collected prospectively for two years, and a total of 505 participants, including residents, consultants, and operation theatre assistants, completed a questionnaire. The questionnaire was validated by experts and covered information on fluoroscopy usage, frequency of surgeries, awareness of radiation safety, and protective measures. Ethical approval was obtained, and data were analyzed using SPSS version 26.0. Results: The majority of participants were male (74.1%), and the sample included various ranks of orthopedic surgeons. Only 56.2% of participants were aware of the usage of fluoroscopy, and 40.2% had read some research on the topic. While 44.6% used lead aprons for radiation protection, the usage of other protective measures and dosimeters was limited. The mediation analysis showed an insignificant indirect association between the rank of orthopedic surgeons, number of surgeries performed, and fluoroscopy usage as a mediator. Awareness and reading research on fluoroscopy were significantly associated with radiation protection. Conclusion: The knowledge, awareness, and daily practices of orthopedic surgeons regarding radiation safety in fluoroscopy use need improvement. The findings emphasize the importance of implementing training programs, providing radiation protection devices, and ensuring compliance with safety guidelines.
Background: The 1 in every 1000 infants are affected by the idiopathic club-foot. It is most commonly observed among the people living in the low middle income countries. Objective: The study was carried out to evaluate the surgical treatment algorithm in case of neglected clubfoot among patients admitted at tertiary care unit. Study design: It is a cohort based retrospective study conducted for the duration of six months from January 2022 to June 2022. Material and Methods: The study was conducted on the 40 patients presented with clubfoot at the tertiary health unit, Khyber Teaching Hospital, Peshawar, were included. The patients mean age was 11 years. The range of patient’s age was from 3 to 25 years. 13 patients went through bilateral intervention. And among these 40 patients there were 15 had received unilateral intervention for each foot. The basic features of the patients were recorded. There were 3 groups made containing operated clubfeet patients, first group included 15 patients, second and third group included 12 patients each. Results: There were 29 patients that received only one follow-up visit. The patients visited their doctors for the first year after surgery but then the visiting attendance became irregular afterwards. The altered ICFSG data was compared for only those patients that completed at least three follow-up visits. The variation between the score of participants between group 1 and 2 was not significant statitically. Conclusion: In case of neglected club-foot condition, PMR has shown excellent to fair results in patients especially children. Therefore, it can be proposed that PMR can be used to lessen the burden of neglected club-foot in the LMICs as it also has no side effects. There is a strong link between age and the surgical outcomes so the treatment must be done as soon as possible. Keywords: Club-foot, PMR, ICFSG data, surgical outcomes.
Background: The supracondylar humeral fractures were the most common fracture of the paediatric elbow with a high incidence between the ages 5 to 14 years. The aim of this study was that to compare the functional and radiological outcome between Gartland type II and III by percutaneous spinning surgery treating method in children. Study design: The study was cross sectional being conducted at the orthopedic department of Watim Medical College Rawat, Rawalpindi for the duration of six months, from June 2022 to December 2022. Methodology: The age range was >5 and <13 years. The children age, gender, affected area, post-operative loss of reduction and complications were recorder. The functional and radiological outcomes were follow up at least 7-8 weeks. Flynn’s criteria and Baumann angle were used to assess elbow movement after surgery. Results: A total number of patients was 110 operated for supracondylar humeral fracture which divide into 55 patients in each type of Gartland fractures. The maximum children 82%, p=0.01* were belong to age group 6-12 years which show significant. The left side 55%, p=0.009 was more injured as compared to right side. According to Flynn’s rating, Gartland 2 and 3 show significant improvement; p=0.001** of fractures after treatment. All patients had show satisfactory results in terms of loss of carrying angle, and elbow flexion. The data was analyzed by SPSS21. Conclusions: The percutaneous spinning show better clinical outcome of radiological and functional between two types of fracture Gartland 2 and 3 suprcondylar humeral fracture after treatment in children. Keywords: Humerus, Range of motion, injury, Fracture.
Background: Plantar fasciitis is an orthopedic ailment that affects athletes and non-athletes equally. The 10% of the general population attend the orthopedic surgeons with heel pain in their lifetime. The degenerative changes in plantar fasciitis worsen the conditions of patients. Objective: The study aimed to evaluate the treatment efficacy of corticosteroid injection in reducing the pain intensity in the patients clinically diagnosed with the plantar fasciitis. Study design: This descriptive study was conducted on 40 patients who attended the orthopedics department of Lady Reading Hospital Peshawar. The duration of study was one year from April 2021 to March 2022. Material and Methods: The patients who were clinically diagnosed with the plantar fasciitis and met the inclusion criteria were selected for the study. The study was approved by the ethical and review board committee of the hospital. The selected patients were administrated with the Triamcinolone injection in the heel. The visual analog scale was used to assess the outcomes. The data was collected and SPSS was used for the statistical analysis. Results: The total 40 patients were selected for the study. The mean calculated age was 42.83± 7.07. Out of 40 patients the (22) 55% were male and remaining (18) 45% were female. The mean pre injection VAS improved from 6.30±2.1 to 1.5±6 post injection. The p-value was 0.03. Conclusion: It was concluded that the single injection of corticosteroid significantly reduce the pain intensity associated with plantar fasciitis. Keywords: Triamcinolone injection and visual analog scale.
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