<p><strong>Abstract</strong></p><p><strong>Background: </strong>Femur fractures are among the commonest pediatric injuries. Until recent past, traction and hip spica were the standard treatment for all femoral shaft fractures which required long duration of hospitalization. The management of femoral shaft fractures in children above the age of six years has evolved more towards operative approaches in the last two decades to minimize the post plaster complications i.e. decrease in incidence of malunion, short hospital stay, better nursing care and early ambulation. Recently, a variety of therapeutic alternatives such as intramedullary nailing and dynamic compression plating have become available to decrease impairment, increase convenience and decrease cost of care.</p><p><strong>Objective: </strong>To compare the results of fracture shaft of femur in children (6 to 12 years of age) treated with Titanium Elastic Nail vs. AO – Dynamic Compression Plate fixation.</p><p><strong>Methods: </strong>This prospective, comparative and interventional study was carried out in the department of orthopedic surgery, PGMI Lahore General Hospital, Lahore. A total of 64 patients were enrolled in this study and randomly divided into 2 groups of 32 patients each. In Group-A patients were treated with Titanium Elastic Nail and in Group – B patients were treated with AO – Dynamic Compression Plate fixation. Sample selection was done by using a pre-defined inclusion and exclusion criteria. Variables of interest were duration of operation, Infection, Limb Length discrepancy, Angulation, Time of union and implant failure. Patients were followed up from 2nd week till 24th week respectively. SPSS was used for data entry and analysis.</p><p><strong>Results: </strong>Age range of patients was 6 – 12 years. Male patients were 51 and 13 patients were female. Eleven patients had Proximal 1/3, 45 mid shaft fracture and 8 distal 1/3 fracture. Mean operative time for DCP was 53.28 minutes and for elastic intramedullary nailing was 29.91 minutes. None of the patients in both treatment groups had limb length discrepancy. Infection and implant failure rate were the same in both treatment groups. Union was rapid till 8th week in Group-A patients after 8th week both treatment groups had equal union rate.</p><p><strong>Conclusion: </strong>Union was achieved in all cases in both groups. Angulation, Infection and implant failure was not seen in any of the patients in both treatment gro-ups. An earlier union of bone was earlier in Group-A (Elastic Intramedullay Nail) patients as compared to Group-B (DCP).</p><strong>Key Words: </strong>AO – DCP, Titanium Elastic Nail, Pediatric Mid Shaft Femur, Infection, Union.
A 51-year-old diabetic man diagnosed with prostatic abscess underwent its drainage twice. Following surgery he developed fever and right-sided painless visual loss due to endophthalmitis. To rule out its endogenous source CT scan was done which showed multisystem aetiology and complications. His pelvic CT and CT cystogram revealed postsurgical urethral injury along with urinary extravasation, perineal and pelvic soft tissues air densities with fat stranding ascribed to Fournier gangrene, air in distended urinary bladder due to emphysematous cystitis and right common iliac vein air containing septic thrombus. CT chest spotted bilateral multiple septic pulmonary emboli. These radiological findings were promptly handled by uro-surgical team followed by alliance with other relevant departments. With hasty surgical drainage/debridement, urological restoration of urinary obstruction, aggressive broad spectrum antibiotics, anticoagulation and radiological follow-ups the patient withstood multisystem lethal complications and come up with excellent outcome except evisceration.
Background: From several decades, in case of pediatric oral surgeries, Uncuffed endotracheal tubes are preferred due to insufficient availability of evidences, Aim: To compare morbidity post-operatively after using uncuffed and cuffed endotracheal tubes in case of children undergoing surgery of cleft lip-palate. Methods: This study was carried out on children aging from 3 to 10 years. About 40 candidates participated and divided into two groups according to the list generated via computer. The comparison was made between sore throat, extubation stridor, regaining of normal voice and first oral intake postoperatively between two members of groups. Results: In case of uncuffed group of candidates, the sore throat was evident more P value > 0.005 as compared to members belonging to cuffed group postoperatively . In case of cuffed members, regaining normal voice and first oral intake was earlier significantly as compared to members belonging to uncuffed. Conclusion: Cuffed Et depicted lesser prevalence of sore throat as compared to members belonging to uncuffed , after following standard protocols .Moreover, regaining of normal voice as well as first oral intake was also earlier in case of uncuffed group as compared to cuffed group postoperatively. Keywords: Cleft palate, cuffed, postoperative morbidity, preformed tracheal, uncuffed
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