AIMThis study carried out in Department of Orthopaedics, S.S. Medical College and Sanjay Gandhi Memorial Hospital, Rewa, MP to study the orthopaedic injury caused by road traffic accidents and factors responsible for these injuries. BACKGROUNDRoad traffic accidents are one of the major causes of death in developed as well as developing countries. India accounts for about 10% of road accident fatalities worldwide and more deaths are recorded due to traffic crashes than due to cardiovascular diseases or neoplasms.
<p><strong>Background:</strong> Comparison of the efficacy of short term (up to 48 hours) versus long term (five days) antibiotic therapy in preventing deep wound infections in elective orthopaedic surgeries.</p><p><strong>Methods: </strong>Two hundred patients of all ages and both sexes were divided into two groups of 100 patients. One group received long term antibiotic treatment consisting of 2 days intra-venous cefoperazone sulbactam 1.5 gm twice daily and intra-venous amikacin 500 mg twice daily followed by 3 days of oral amoxicillin clavulunate 625 mg thrice daily. Other group received short term antibiotic of 2 days intra-venous cefoperazone sulbactam 1.5 gm twice daily and intra-venous amikacin 500 mg twice daily. Comparison of SSI was done with age, sex, BMI, pre-operative haemoglobin, TLC, duration of surgery in both the groups.</p><p><strong>Results: </strong>In group I and group II respectively, average duration of surgery in procedures involving implants was 65.02±27.41 and 59.47±20.27 minutes and non implant related procedures was 53.66±23.97 and 53.74±22.40 minutes. Overall incidence of SSI in Group I and Group II was 14% and 10% respectively. Mean infection in the present study was 12%.</p><p><strong>Conclusions: </strong>It was concluded that in clean orthopaedic elective surgeries short term antibiotics regimen is as effective as long term antibiotics regimen. Continuing antibiotics for more than two days is associated with drug related complications like allergic reactions and gastrointestinal upset, adverse interactions in other drugs, development of resistant organisms and it adds to overall cost of treatment.</p>
BACKGROUND Management of proximal tibial fractures has always been controversial. The main aim in management of such fractures is to achieve articular congruity, proper limb alignment and proper joint mobility besides achieving union. ORIF using either single or dual plates has been in vogue for long time with good outcomes. But these are associated with problems, especially overlying skin conditions, delayed recovery and rehabilitation with limited functional outcome. To overcome these problems, MIPPO technique has been devised which is based on principle of indirect reduction without opening the fracture site. It involves lesser incision, lesser soft tissue dissection with lesser complications and better functional outcomes. MATERIALS AND METHODS The present study was carried out on the patients admitted in orthopaedic ward of Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (M.P.) during the 2-year period from October 2013 to September 2015. The fractures were assessed for soft tissue injuries and followed by radiological assessment of fracture with Schatzker's classification. All patients included in the study group were given an "inverted hockey stick incision" followed by MIPPO. All patients were followed up regularly at an average of 6-8 weeks till fracture union was complete. A clinical and radiological evaluation was carried out using the modified Rasmussen clinical and radiological criteria. RESULTS Out of the 40 patients treated, most of them were males and belonged to the age group of 20-40 years (75%). Unilateral fractures were more common than bilateral fractures and were of the type 3 and type 4 of Schatzker's classification associated with high velocity RTA. Infection, implant failure and non-union were reported in 3 patients one in each; 23 fractures gave excellent result; 12 fractures healed with good results. Only 3 of the patients showed fair results and 2 had poor result. CONCLUSION All the fractures treated with MIPPO technique were found to be rapidly healing by secondary fracture union and hence achieving strong bone union across the fracture site due to inherent benefits of less tissue damage and minimal disturbance of fracture site biology.
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