Background: Covering soft tissue defect of the foot is important with respect to function and aesthetic means. It is a challenging task and requires a clear cut planning so as to use the right flap for the right size and site in the foot. Materials & methods: A total of fifty three patients with soft tissue defects in the foot admitted between August 2014 to April 2015 under Hand & Microsurgery, Department of Orthopaedics, were included in this study. Post-operatively they were monitored for any flap related complications. Results: The most common defects were trauma related followed by trophic ulcers and infective causes. Various coverage options which include fasciocutaneous flaps, muscle flaps, free flaps and split thickness skin grafts (STSG) were used. All the flaps were satisfactorily taken up at the end of follow-up period (three months). Conclusion: Planning of the defect based on site and size is very important so as to obtain satisfactory result.
Plantar fasciitis is the one of the most common causes of painful heel in adults. It is assumed to be caused by inflammation and is typically precipitated by biomechanical stress. Conservative management is the mainstream treatment option for plantar fasciitis like non steroidal anti-inflammatory drugs (NSAIDs), steroid injections, PRP injection, stretching exercises. There is no consensus on the efficacy of any particular conservative treatment regimen. This study was taken with objective to compare the efficacy of NSAID and local steroid injection in treating plantar fasciitis. Method: Sixty patients were randomized into 2 groups, group I patients were treat with oral NSAIDs and group II patients were treated with local steroid injection. Patients of both groups are given common supportive measures such as soft heel and advised same stretching exercises. The patients were evaluated using VAS score for pain assessment at pre-treatment stage, 1 week, 2 weeks, 4 weeks, 2 months and 3 months. Results: 60 patients were randomized into 2 groups, both groups had similar demographics. The VAS scores at pre treatment level in group I was 6.60±1.14 and in group II was 6.46±1.05. The VAS score reduced to 3.10±1.18 in group II after injection and in group I reduced to 4.9±1.33 after a starting oral NSAIDs. The VAS scores consistently reduced in both the groups till 4 weeks of follow up but group II VAS scores were always lower than group I (p-value < 0.001). After 4 weeks, a trend towards increase in VAS scores was noted in both groups, patients had complaints of relapse of pain or increase in intensity of it. Conclusion : With this study we concluded that as compared to NSAIDs the use of local injection of steroid gives better and more sustained pain relief with fewer complications and lesser recurrences of heel pain in cases of plantar fasciitis.
Introduction: Pain in the cervical region is one of the major orthopaedic problem. It causes unhappiness to surgeon and patient both. This study is to analyse the different non-operative treatment modalities for the cervical pain. Purpose of the study: To compare the clinical outcome of cervical spondylosis treated with different non-operative methods. Methods: The study conducted between October 2018 to April 2019 involve patients with cervical pain visiting orthopaedic OPD. Patients were divided into 3 groups involving a) Neck muscle strengthening exercises (NMS) b) Pharmacological regime c) Combined muscle strengthening and drug regime (CMD).Results: On analysis of results with 90 patients each in group a, b, and c, the patient relief was higher in group c planned for CMD regime followed by group b and group a in decreasing order of response rate. Conclusion: Neck pain being one of the very common disease and its nonresponse to treatment is the reason not to trust the doctor by the patient. We concluded that among the different methods, combined muscle strength and drug regime given best results in majority of cases. And also this CMD regime is easy to follow and cheap compared to other nonoperative treatment modalities.
Introduction: Osteoarthritis (OA) is a painful chronic degenerative joint. As of now, there are less options available for patients with mild to moderate arthritis. Most of the approaches are palliative and address the symptoms rather than influencing the biochemical environment of the joint or the disease process.PRP is a newer treatment option emerging in the recent times and its efficacy needs to be examined in our population and hence the study. Materials and Methods: It is a prospective, observational, time bound, hospital-based study conducted from November 2017 to May 2019, after obtaining institutional Ethical committee approval. 60 primary OA knee joints, included in this study, selected from R L Jalappa Hospital and Research centre, Department of Orthopaedics, Kolar. Autologous PRP prepared and infiltration was done under strict aseptic conditions. Patients assessed with WOMAC scoring &VAS for pain, before giving the PRP injection & after giving the injection at periods of 1 month, 3 & 6 months. The decrease in WOMAC & VAS scores was suggestive of improvement in patient's condition. Results: Significant difference was observed in mean VAS and WOMAC total scores. No local or systemic complications noted during the study period. The mean VAS score at baseline was 7.08 ± 0.79 and the decrease in mean VAS score continued up to six months follow-up that is 2.78 ±1.22 (P value <0.001). The mean WOMAC Total at baseline was 66.20 ±7.63 and the decrease in mean WOMAC Total continued up to six months follow-up that is 19.95 ±11.69 (P value <0.001).
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