Small bowel obstruction is common complication after abdominal surgery, and can occur due to many reasons. Although obstruction leading to perforation of small bowel is less likely but can occur in some circumstances in which treatment was not taken or misdiagnosed. Case report: We report here 25 year old male with small bowel obstruction caused by adhesions between right side undescended testis and terminal ileum leading to perforation of small bowel proximal to obstruction. Conclusion: Cryptorchidism can cause Small bowel obstruction and perforation in patients with no history of abdominal surgery.
Need for the study: Treatment of proximal tibia fracture is difficult especially when intraarticular and metaphyseal comminution present. The tibial plateau involves weight bearing so restoration of joint congruity is important to preserve normal function of knee. Subchondral raft construction is one popular method under investigation for this purpose where subchondral screws support the bone pieces along with cartilage and prevent it to depress again. Aim: to evaluate clinical and radiological results of Schatzker type II, III, VI fractures treated using open reduction and internal fixation with subchondral RAFT system combined with lateral plateau locking compression plates. Methods: 30 patients of proximal tibial plateau split fracture and depression, including men and women aged >18 years who came to department of orthopaedics GMCH between 2017 to 2019 were enrolled in the study. Diagnosis made by x-rays and computerized tomography. In all patients, the depressed joint line was elevated and fixed with subchondral RAFT screws through the locking compression plate. At the last follow up, clinical and radiological data were recorded. Results: The mean ROM was 110.5 0 (range 90 0 -125 0 ), Mean KSS was 90.2 (range 65-100), Mean Rasmussen radio score was 15.6(range 10-18). All 30 patients showed signs of fracture healing on follow up x-rays and on final follow up complete bone union. Two patients developed superficial infection and one patient had screw backout on 2 nd follow up. none encountered major intra or post-operative complications. Conclusion: Subchondral RAFT combined with locking compression plate helps surgeon to maintain the anatomical reduction of depressed intraarticular fragment with satisfactory functional and radiological outcome.
Introduction: Tibial fractures are most common long bone fractures, while distal fractures are even more complicated due to its proximity to ankle, and with close relationship with thin soft tissue envelope and severe comminution. Distal tibial extraarticular fractures are a common consequence due to road traffic accidents or other high energy injuries. AIM: To compare functional and radiological outcomes in extra articular distal third tibia fractures, treated with intramedullary nailing or plating. Material and Method: Study comprised of 40 patients of distal tibia fracture without articular involvement, admitted in Geetanjali Medical College and Hospital, Udaipur, Rajasthan. After primary management of fracture stabilisation. patients were randomly selected for surgical fixation either with IMN or MIPPO plating. 20 patients were included from each study group. Result: All the patients treated with either surgical modality were compared for time of fracture union, ROM at ankle joint, early weight bearing, non-union and malunion. ROM at ankle joint was assessed with AOFAS ankle score. The mean fracture union time for IMN was 4.5 month, whereas in plating group it was 6.5 month. Immediate weight bearing was advised for IMN group, while weight bearing was delayed for at least 6 weeks in plating group. AOFAS ankle score for the nailing group was 92.05 (EXCELLENT) while for plating group was 89.10 (GOOD). The difference between two score was found to be significant (p value =0.05).
Conclusion:Both the treatment modalities were equally good for treatment of distal tibia extra articular fractures, but IMN was better in terms of early weight bearing, early fracture union with excellent ankle score as compared to MIPPO plating.
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