Background: Fracture of the radial head constitute 1/3 rd of all the elbow fractures. It occurs as a result of a fall on an outstretched hand or a direct blow to the lateral aspect of elbow joint. This is now becoming more common due to pre existing co-morbidities like osteoporosis and chronic osteoarthritis. Surgical correction of the comminuted fractures of radial head involves reconstruction or replacement with artificial radial head prosthesis in cases where reconstruction is not possible.Aims and Objectives: To analyze the morphometric details of proximal end of radius and to describe the morphological features of head and bicipital tuberosity of the radius.Materials & Methodology: Sixty dry human adult radius bones of unknown age and sex were assessed for morphometric and morphological characters. Vernier caliper was used to measure the various parameters on the proximal ends of radius bones. The data was tabulated and analyzed using SPSS software.Results: The mean length of radius was found to be 23.98 cm. Antero-posterior diameter and transverse diameter of head was 2.01 cm and 1.98 cm respectively. The height of radial head at medial end, height of radial head at lateral end, depth of articular facet and radial head circumference were 0.91 cm ,0.73 cm, 2.91 cm, 4.78 cm respectively. The length of neck of the radius, diameter of proximal end of neck of radius, diameter of distal end of neck of radius was 1.28 cm , 1.37 cm , 1.32 cm respectively. The width of bicipital tuberocity, length of bicipital tuberocity were 1.21 cm, 2.29 cm respectively.Conclusions: Fractures of radial head and neck are more common. Surgical management of displaced and comminuted radial head fractures needs replacement with radial head prosthesis when reconstruction is not indicated. The results of our study are important in making anatomically and biomechanically suitable radial head prosthesis.
Background: With an increase in the number of emergency laparotomies performed on geriatric age group, there is an urgent need to develop preoperative optimisation strategies for these vulnerable patients. Frailty being a common occurrence in this age group and a measurable index can be used to prognosticate such patients. Hence the study was aimed to determine the prevalence and influence of frailty on mortality and morbidity of geriatric patients undergoing emergency laparotomy. Methods: A prospective observational study carried out in the Department of Surgery, SCB Medical College and Hospital, Cuttack, India from March 2021 to December 2021. All older adults undergoing emergency laparotomy were included in the study. Preoperative clinical frailty score (CFS) was calculated from 1 (very fit) to 7 (severely frail). The outcome of the study being 30 day postoperative mortality, length of hospital stay and post operative complications were analysed. Result: A total of 110 older adults underwent emergency laparotomy. Frailty was present in 30.9%. The overall 30 day post operative mortality was 12.7%. The risk of 30 day mortality was associated with frailty: CFS 6/7 odds ratio 4.2 (26.3%). Similar associations were seen with length of hospital stay and post operative complications. Conclusion: Frailty being present in nearly one third of older patients undergoing emergency laparotomy, is associated with greater risk of post operative mortality and morbidity. Frailty scoring must be integrated in routine preoperative assessment of geriatric patients undergoing emergency laparotomy which can help in the decision making process.
Presentation of gastrointestinal stromal tumours (GISTs) as perforation peritonitis is a rare entity with only few cases reported in literature. Here we present a case of a 50-year-old male with acute abdomen and signs of peritonitis. Abdominal radiography revealed dilated small bowel loops in the absence of any free intraperitoneal air. Exploratory laparotomy revealed a growth arising from the stomach wall at the distal part of the body along the greater curvature. Wide excision of the lesion was done with rent closure. Histopathological examination further confirmed the diagnosis of a GIST of the stomach. Post operatively patient received Imatinib therapy and is doing well on follow up. Although rare, GISTs should be considered in the differential diagnosis of perforated GI lesions.
Background: Thyroid cancer is the most common endocrine malignancy. The incidence of which is on the rise in the last 2 decades. The incidence of this disease varies uniquely with age, sex and ethnicity. This epidemiological study was conducted to study the frequencies and patterns of thyroid neoplasm for last 10 years in East Indian population. Methods: This retrospective study was conducted in a tertiary care center of Eastern India from January 2011 to December 2020 on all patients diagnosed with thyroid cancer. The clinical profile of all patients were analysed in the study Result: Out of the total 2007 thyroid cases, 310 (15.4%) were diagnosed as thyroid malignancy. Of which 83.5% were papillary carcinoma, 10% follicular carcinoma, 2.5% medullary variety, 3.5% anaplastic type and 0.3% lymphoma. There was female preponderance with the approximate female to male sex ratio of 3:1. There was also a distinct age distribution, with papillary and follicular carcinoma being common in younger age, medullary in middle age group and anaplastic in the elderly. A total of 295 patients underwent thyroidectomy for malignancy in the last 10 years. The incidence of postoperative complication of recurrent laryngeal nerve injury is 2.4% and hypocalcemia is 4.1%. Conclusion: Understanding the clinical profile of thyroid malignancies aides in preoperative suspicion of various types of malignancy. Papillary carcinoma thyroid is the most common malignancy, with each subtype having a unique age of presentation.
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