Early results in repair of abdominal hernia with AlloDerm appear to have a complication rate of 24%. Recurrence is the most common complication. Thinner AlloDerm use has better outcomes with less recurrence. Careful analysis regarding the technical aspects and presence of comorbidities may be explored to improve the present outcomes to prevent recurrences.
<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures occur in people with poor bone quality, about half of the intertrochanteric fractures are comminuted and unstable. <span>The purpose of the present study was to compare the outcome of surgical treatment of proximal femoral fracture by dynamic hip screw (DHS), proximal femoral nail (PFN) and proximal femoral locking compression plate (PFLCP)</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span>This prospective comparative observational study had included cases presented with intertrochanteric fractures of femur attended orthopedic OPD and emergency department were treated with dynamic hip screw (DHS), proximal femoral nailing (PFN) or proximal femoral locking compression plate. Post-operative x-rays were done to assess reduction and progress of union (non-union/mal-union), any post-operative complications e.g. operative wound infection, implant failure etc</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, we found that PFNs prove to be more useful in difficult fractures with a subtrochanteric extension or reversed obliquity. The rotational stability was higher when proximal femoral nail is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> In our study, we found that proximal femoral nails prove to be more useful in difficult fractures with a sub-trochanteric extension or reversed obliquity. The rotational stability was higher when PFN is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients. Non-union of trochanteric fracture although is a rare entity<span lang="EN-IN">.</span></p>
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Distal radius fracture is one of the most common fractures. It may be sustained due to low-energy trauma or high-energy trauma. Objectives: To compare the clinical effectiveness of Kirschner wire fixation with and plaster immobilization for patients with fracture of the distal radius.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Interventions Kirschner wire fixation: wires are passed through the skin over the dorsal aspect of the distal radius and into the bone to hold the fracture in the correct anatomical position. About 79 patients with Distal Radial Fractures presented to MGM Medical College and LSK Hospital, Kishanganj between November 2012 and June 2014 were included in the study</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The majority were men (60.4%). Majority of the patients (69.8%) sustained the injury due to fall. The side of involvement was nearly equal and that there was no predominance of the either sides. In our study, according to AO classification, 31 cases were of Type A, 17 were of Type B and 5 were of Type C. The Anatomical evaluation by Sarmiento’s Criteria showed 33 patients with excellent result, 15 patients with good result and 5 with a fair result. At final follow-up by ‘The Gartland and Werley criteria for functional outcome’ 37 patients had excellent result, 13 had good result, 2 had fair result and 1 had a poor result. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">This study demonstrates that percutaneous Kirschner<strong> </strong>wire pinning is a minimally invasive technique that provides an effective means of maintaining the anatomical<strong> </strong>fracture reduction. It does not required highly skilled<strong> </strong>personnel or sophisticated tools for application. It is a<strong> </strong>suitable method for fixation of displaced Colles fracture with minimal intra-articular involvement. The technique involves a minimal procedure that provides anatomic reduction, fracture fixation, and maintenance of reduction with an adequate method of immobilization.</span></p>
Fractures of the thoracic and lumbar region constitute a spectrum of injuries ranging from the simple undisplaced fractures to complex fracture dislocations. Anatomically and functionally, the thoracic and lumbar spine can be divided into three regions-thoracic spine (T1-T10), thoracolumbar junction (T10-L2) and the lumbar spine ABSTRACT Background: Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. Aim of this study was to evaluate the results of surgical management of traumatic paraplegia, complete or incomplete as classified by Frankel scoring. Methods: A prospective study was conducted in patients attending outdoor and emergency department of Orthopedics of a tertiary care teaching institute in Kolkata, West Bengal with traumatic paraplegia involving the dorsolumbar spine. The important objectives are the time for recovery of various functions like sensory, motor and bowel and bladder function, comparison between early and late decompression, results of posterolateral fusion and time taken for solid bony fusion after operation. Total 46 cases were selected within a minimum of 6-month postoperative follow-up of which 4 cases lost in follow-up. Data collected from patient records included age, sex, time from injury to hospitalization, initial neurological status as per Frankel Score, MRI findings, surgery performed, postoperative course and neurological status at the time of discharge and latest follow up. Patients lost to follow up were not studied for outcome analysis. Results: When decompression done within 1 st week in incomplete paraplegia, 80% of the patients showed return of grade 3 power. In complete paraplegia cases, 11% of the patients had return of power up to grade 3 when decompression done within 1 week, where no cases showed return of grade 3 power when decompression done after 2 nd or 3 rd week. Conclusions: After recovery from spinal shock, the earlier the surgical compression done, the better the neurological and bowel/bladder function recovery both in complete and incomplete paraplegic cases. Reduction is better and easy and less time consuming in early decompression than in late. Motor recovery can continue for over 6 months after decompression.
Background: Traumatic paraplegia is an unanticipated catastrophe in an individual’s life, posing a huge economic as well as social burden. We evaluated all the patients for neurological improvement after surgical management of traumatic paraplegia in traumatic thoracolumbar fractures. Materials and Methods: The prospective study was conducted in the department of orthopedics of a tertiary care teaching institute in Kolkata, West Bengal, India. The patients were evaluated by X-ray of spine (anteroposterior and lateral view) and sometimes computed tomography scan. In most cases, pedicle screw with plate or rod was used and posterior stabilization and posterior fusion with corticocancellous bone graft from posterior iliac crest were done. Pre-operative and post-operative neurological charts (according to Frankel’s grade and American Spinal Cord Injury Association score [motor and sensory]) were maintained with regular assessment for proper post- operative neurological recovery assessment. Results: Forty-six patients in whom posterior stabilization of the spine was done in this institution and followed up for a period ranging from 6 months to 2 years, 4 of 46 patients lost follow-up. Remaining 42 patients were considered for the study. When decompression done within the 1st week in incomplete paraplegia, 80% of the patients show Grade 3 power return, whereas 25% of the patients show return of Grade 3 power when decompression done in the 3rd week in incomplete paraplegia cases. In complete paraplegia cases, 11% of the patients had return of power up to Grade 3 when decompression done within the 1 week, where no cases showed return of Grade 3 power when decompression done after the 2nd or 3rd week. In incomplete paraplegia, 80% of the patients had onset of sensory recovery within 1 week, when the decompression done within the 1st week. In complete paraplegia, 11% of the patients had sensory recovery within 2 weeks when decompression done within 1 week. Conclusion: Hence, our conclusion is that early decompression definitely has some role regarding motor and sensory function return, both in complete and incomplete paraplegia.
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