Latest Articles
Original Research Article
ABSTRACT
Background: Ghee and honey has been advocated and used as dressing for infected wounds by Sushruta (600BC). The gratifying results observed with the dressing have prompted this study which aims to establish its efficacy in chronic infected wounds over one year period A standardised ghee and honey dressing was used to treat: chronic post- operative wounds and infected per op wounds, Honey and ghee dressing markedly reduces the foul odour and discharge, significantly improving the quality of life. The study will tell us comparative result of honey and ghee dressing as compared to expensive vacuum dressing and the regular dressing materials. Innumerable Randomised Control Trials (RCTs) reported on honey dressing for infected wounds, there is substantial evidence that ghee and honey dressing has at least comparable results to other modes of treatment. The easy availability and low cost of this treatment makes it significant in developing countries. Specially in rural population, Required permission has been from the HOD of orthopaedics. Material and Methods: Total 20 patients with compound fracture and chronic infected wound, were studied during the period of March 2023 to June 2023 at BVP RMC Loni, Maharashtra. Honey and ghee were taken from a fresh sealed box in 50:50 portion according to size of wound and mixed well then it was applied on the wound directly and covered with gauge and, the dressing was changed is cleaned with sterile normal saline as compared to normal dressing materials ie betadin, povidon iodine ointment, spirit. All Patients data was collected and compiled in Microsoft excel and were statistically analysed using appropriate statistical test using SPSS software. Results: Majority patient were males. Mean duration of wound healing among honey and ghee dressing was 15.3 and of regular dressing was 8.9 days. Conclusion: Honey is one alternative solution that can be used for non-pharmacological therapy. Honey can be used as a topical dressing .........
Original Research Article
ABSTRACT
Background: Paediatric femoral shaft fractures are common in orthopaedic practice and can be managed using various modalities, each with its advantages and disadvantages. The Titanium Elastic Nailing System has emerged as a promising treatment option, offering potential advantages over traditional methods. Objective: This study aimed to evaluate the functional and radiological outcomes and operative complications of paediatric femoral shaft fractures treated with the Titanium Elastic Nailing System. Methods: A prospective interventional study was conducted from July 2020 to July 2021. Thirty children aged 6-14 years (mean age 11.32 ±3.76) were selected using purposive sampling and strict inclusion/exclusion criteria. Patients were followed up for at least 24 weeks at four-week intervals, and outcomes were assessed using Flynn's TEN scoring criteria. Results: All 30 patients completed the study. Radiological union was achieved in 80.0% of cases within 7-10 weeks, with 90.0% of patients able to bear full weight by the 12th week. Minor complications occurred in 20.0% of cases, while no major complications were reported. 80.0% of cases had excellent outcomes, 20.0% were satisfactory, and no poor outcomes were observed. Conclusion: The Titanium Elastic Nailing System is an excellent method for treating paediatric femoral shaft fractures, demonstrating high rates of radiological union and functional recovery with a low incidence of complications.
ABSTRACT
Introduction: Legg-Calvé-Perthes-Disease (LCPD) most commonly affects boys between the ages of 4 and 8. It is an avascular necrosis of the upper femoral epiphysis. Its etiopathogenesis is unknown. Advanced cases necessitate innovative approaches beyond conservative measures. We report a challenging case involving radical treatment for advanced LCPD already complicated by hip and knee stiffness, managed with a two-stage total hip arthroplasty. Case presentation: We report the case of a 14-year-old with chronic left hip impairment and concurrent knee stiffness due to advanced LCPD. Initial conservative interventions proved ineffective. We decided to opt for a two-stage surgical strategy. The first stage involved femoral head ostectomy, cervico-cephalic prosthesis placement, and soft tissue tenotomy. Subsequent intensive rehabilitation achieved improved joint mobility. The second stage comprised total hip replacement using a ceramic-ceramic prosthesis. At last follow up, a favorable functional outcome was observed, and radiographs demonstrated a well-positioned and osteo-integrated prosthesis. Conclusions: LCPD is a serious condition, and the prognosis is significantly influenced by early diagnosis and appropriate management. In cases of advanced staged LCPD, prosthetic replacement becomes a suitable option, even in younger patients. Despite potential complications, the use of a two-stage approach, integrating surgical intervention and tailored rehabilitation, proved effective in restoring joint function. This case highlights the importance of personalized planning and a staged approach in addressing the multifaceted aspects of LCPD.
Original Research Article
ABSTRACT
Background: Stroke can greatly impact both physical capabilities and overall quality of life (An and Shaughnessy, 2011, Bártlová et al., 2022). While the 2019 novel Coronavirus (COVID-19) significantly impacted various sectors including access to healthcare services, access to routine stroke rehabilitation were not well documented in referral hospitals of Lusaka. Objectives: To assess factors affecting routine rehabilitation of stroke survivors during COVID-19 in referral hospital settings of Lusaka. Method: This was a cross-sectional study involving 26 stroke survivors who were present before and during the COVID-19 pandemic lockdown. All respondents were from 5 referral hospitals in Lusaka. Data was collected using researcher-administered structured questionnaires and analyzed using SPSS v27.0. Bivariate analysis was carried out using chi-squared and Fishers exact test of association. Results: There was an overall higher stroke patient response rate from females (57.7%, n=15) than males (42.3%, n=11). The outcome variable was significantly associated with only two intrinsic factors namely fear (mean rank of 1.69) seconded by patients’ perception of physiotherapist’s attitude (mean rank of 2.50). An overall decline in physiotherapy attendance from 2-3 times a week (69.2%, n=18) to once in a week (54%, n=14) was observed. Conclusion: A notable shift inclination towards home-based rehabilitation raises important considerations for healthcare practitioners and policymakers. It prompts a critical examination of the potential consequences of this shift on the quality and effectiveness of rehabilitation. Clinical implications: The identified barriers, particularly fear, highlight the need for targeted interventions. The study serves as a reminder of the complexities inherent in balancing patient needs, safety considerations, and healthcare system capacities.
Original Research Article
ABSTRACT
Introduction: Neglected Achilles tendon ruptures present a significant challenge in orthopedic surgery, with varied outcomes and complications. This study aims to evaluate the effectiveness of Baker's Procedure in the reconstruction of neglected Achilles tendon ruptures and to analyze the associated postoperative outcomes and complications. Methods: This prospective interventional study was conducted from January 1, 2012, to May 31, 2013, at multiple centers in Dhaka, Bangladesh. It included 42 patients aged 18 to 60 years with neglected Tendo-Achilles ruptures, defined as injuries untreated for over 4 weeks. Baker's Procedure, involving gastrocnemius aponeurosis advancement, was employed for reconstruction. Result: Of the 42 participants, 71.43% were male, with a mean age of 30.7 years. Injuries predominantly occurred in the right Achilles tendon (57.14%) and were mainly caused by sharp-metal objects (57.14%) and toilet-pan accidents (35.71%). Postoperative complications included stitch or wound infections (21.43%), pain (14.29%), stiffness (28.57%), and calf-muscle weakness (35.71%). Excellent, good, and fair outcomes were achieved in 64.29%, 21.43%, and 14.29% of patients, respectively. Conclusion: Baker’s Procedure is effective in reconstructing neglected Achilles tendon ruptures, with a majority of patients achieving excellent or good outcomes. However, the relatively high rate of postoperative complications, particularly infections, calf muscle weakness and stiffness, highlights the need for improved surgical and postoperative strategies. These findings underscore the importance of tailored.
Original Research Article
ABSTRACT
Introduction: Lumbar spondylolisthesis, a condition characterized by the displacement of one vertebra over another, often leads to chronic back pain and functional impairment. Posterior decompression and TLIF are used as surgical options for patients with lumbar spondylolisthesis. Aim of the Study: The aim of this study was to assess the clinical & radiological outcomes of posterior decompression & transforaminal lumbar interbody fusion (TLIF) among patients with lumbar spondylolisthesis. Methods: This prospective observational study was carried out at NITOR, Dhaka, Bangladesh, during the period from January 2020 to December 2021. Total 30 patients with degenerative lumbar spondylolisthesis were included in this study. Result: In this study, majority of participants were aged 41-50 (47%), predominantly female (60%). Clinical outcomes showed significant improvements post-treatment: low back pain and leg pain, measured by VAS, decreased substantially, and disability scores (ODI and Roland-Morris) also improved markedly. Quality of life, assessed by SF-36, showed notable enhancements in both physical and mental scores. Radiologically, there were significant improvements in disc and foraminal height, reduction in spondylolisthesis severity, and restoration of lumbar lordosis and spinal stability. The average surgery time was around 147.5 minutes, with a mean blood loss of 382.7 mL and an average hospital stay of 7.1 days. A 90% fusion rate was achieved at 1-year follow-up, with dural tears being the most common complication. Despite some complications, the majority of surgeries were completed safely. Conclusion: Posterior decompression and TLIF appear to be effective in treating lumbar spondylolisthesis, as evidenced by improved clinical and radiological outcomes.
Original Research Article
ABSTRACT
Background: For patients undergoing surgery for peritrochanteric fractures, blood loss is a big issue. The purpose of this study was to see if tranexamic acid (TXA) could reduce postoperative blood loss in individuals who had hip surgery for peritrochanteric fracture. Methods: A total of 69 patients with intertrochanteric fractures were enrolled in this prospective study. Patients are randomly divided into two groups. Group A patients received 200 mL (1 g) of TXA intravenously before peritrochanter surgery and Group B patients did not receive an injection of TXA. Haemoglobin and hematocrit values were measured preoperatively and postoperatively at days 1 and 3. Visible and hidden blood loss volumes were calculated on postoperative day 3. Results: The blood transfusion rate was reduced significantly in patients by injecting tranexamic acid before surgery. However, mean haemoglobin and hematocrit levels were not significantly different between patients who received injection tranexamic acid and those who did not receive injection tranexamic acid. Conclusion: TXA significantly reduced postoperative blood loss in patients with Peritrochanteric fractures who underwent surgery.