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ABSTRACT Abstract: The trapezo-metacarpal dislocation is an uncommon event. Usually caused by indirect mechanism. We present a case of a 26-year-old man patient who developed a chronic instability of the right thumb carpometacarpal joint, after two episodes of recurrent dislocation. The patient underwent rewarding management by Eaton-Littler's ligamentoplasty technique using flexor carpi radialis tendon. Functional result was satisfactory.
ABSTRACT Abstract: Background: In era of increased air travel, airport security screening measures has been increased. A lot of anxiety to the patient that may trigger an alarm at airport securities post-surgery. The purpose of this study is to find out experiences of patients after total knee arthroplasty (TKA) passing through airport security. Methods: A retrospective case series of 250 TKA patients in a single high-volume center from January 2017 to January 2019, who had passed through airport security and met inclusion criteria. Patients were contacted during their regular follow ups or via phone. The patients were asked for alarm trigger, perceived inconvenience, whether security officials asked to show documentation regarding prosthesis, and any extra screening procedures check measures. Results: Out of 250 patients, 52 patients met inclusion criteria travelling by airplane. 27 patients reported alarm trigger. 7 patients had to undergo additional security check measures. 43% of the patients believed that having their TKA increased the inconvenience while traveling. Conclusions: This study provides information to surgeons regarding airport travel post TKA. Patients can be counselled regarding the inconvenience and to be prepared for delays in airport and to be prepared to present documentation of their prosthesis.
ABSTRACT Abstract: Osteochondroma is a developmental anomaly of the bone that results in the formation of an exophytic outgrowth on the surface of the bone. It is the most common benign bone tumor. Distal Femur and Proximal Tibia are the most common sites for this tumor. Osteochondroma is rare in the Pelvis. Osteochondroma is also known as Exostosis. We hereby report a case of solitary osteochondroma from the Anterior Superior Iliac Spine in a 22-year-old boy which was managed in our Centre.
ABSTRACT Abstract: Anxiety is the commonest anticipated problem of patients during the perioperative period. Preoperative anxiety can produce poor postoperative outcome and make the management and control of postoperative pain more difficult. Studies have demonstrated a strong relationship between anxiety and pain. Anxiety leads to elevated pain, likewise pain results in an increased level of anxiety. Therefore, it can be postulated that reducing the amount of anxiety experienced preoperatively with an anxiolytic will reduce the burden of pain experienced by patients postoperatively. This study assessed the clinical effect of preoperative anxiolysis with Lorazepam on postoperative pain perception in patients undergoing elective lower limb major orthopaedic surgeries under combined spinal epidural (CSE) anaesthesia. This was a prospective study of 122 patients who presented for surgeries at the University of Abuja Teaching Hospital, Nigeria. Patients were randomly assigned to receive either Lorazepam 2mg (n=56) or placebo (n=56) the night before surgery and 2h before scheduled surgery. Postoperative pain scores, analgesic requirements and satisfaction with pain control were evaluated during the first 24h following surgery.We found that patients who received Lorazepam reported a significantly lower pain score than placebo group during the first12h (p= 0.031) while morphine requirement was significantly greater in the placebo group than Lorazepam group (8.20±1.91mg vs 14.8 ±2.10mg; p= 0.036) and patients treated with anxiolytics showed a greater satisfaction with pain relief (p=0.0185). In summary, preoperative Lorazepam produced significant anxiolysis that led to reduced pain, lower analgesic consumption, and better satisfaction but with modest side effects.
ABSTRACT Background: The argument on whether extracorporeal shock-wave therapy (ESWT) proves to be beneficial in short- term intervention in adults with plantar fasciitis. It is important and necessary to conduct a meta-analysis to make a comparatively more reliable and overall assessment about the outcomes of ESWT in the less than 6 months. Methods: we conducted A Systematic Review and meta-analysis of randomized control trials from MEDLINE, Embase and CINAHL database from 2000 to 2020. We included randomized trials which evaluated extracorporeal shock wave therapy used to treat plantar heel pain. Trials comparing extra corporeal shock wave therapy with placebo were considered for inclusion in the review. We independently applied the inclusion and exclusion criteria to each identified randomized controlled trial, extracted data and assessed the methodological quality of each trial. Results: Four studies involving 645 patients were included. 3 RCTs (n=605) permitted a pooled estimate of effectiveness based on overall success rate and composite score of visual analogue scales for pain at the follow-up 1 (12 Weeks) .The pooled data showed no significant heterogeneity at three-month follow-up (p-value of chi-square = 0.61 P=0.74 and I2 = 0%). The ESWT group had a better success rate than the control group at three-month follow-up (OR = 2.26, 95% CI = 1.62-3.15, p < 0.00001). For reduction of pain the pooled data showed no significant heterogeneity (P Value of chi-Square 0.28 and I2 22% ) There were significant differences between the ESWT and control groups for all the follow-up visits (random-effect model, three trials, MD = 15.14, 95% CI = 13.86 to 16.42, P <0.00001 at three-month). Conclusion: A meta-analysis of data from three randomized-controlled trials that included a total of 605 patients was statistically significant in favour of extracorporeal shock wave therapy at follow-up 1(12 weeks).
ABSTRACT Charcot osteoarthropathy is a debilitating disease associated with uncontrolled diabetes mellitus that has multiple orthopedic complications. Severe degenerative foot and ankle changes have been cited in the literature and remain a challenging pathology for treatment. A 61 year old female with severe Charcot osteoarthropathy to the left tibiotalar and subtalar joints treated successfully with a minimally invasive tibiotalocalcaneal hindfoot fusion nail construct. While multiple stabilization techniques exist to include cross screws, plates, and intramedullary devices, hindfoot nailing systems offer a technique with minimal periosteal stripping and soft tissue dissection. Tibiotalocalcaneal hindfoot fusion nails show promise to fast post-operative return to activities of daily living.
ABSTRACT Introduction:- Tibio-talar arthrodesis remains the surgical procedure used most frequently for post-traumatic arthritis after conservative measures have been exhausted. Minimal invasive ankle arthrodesis with arthroscopic assistance have advantages over conventional one. Methods: - An evaluation of prospectively case series study done on 32 patients that underwent arthroscopic ankle arthrodesis in 2015-19. Clinical assessment was done foot and ankle disability index and visual analog scale score for pain. Radiological assessment was done by serial x rays. All patients underwent arthroscopic assisted ankle arthrodesis. Regular follow-ups were taken till one year. Results: - All cases showed radiological evidence of fusion at 3 months. After a mean 6 months follow up there was significant improvement in terms of foot and ankle disability index and visual analog scale in terms of pain. Conclusions: - Arthroscopic assisted ankle arthrodesis is a effective way to treat ankle arthritis where conservative management has failed.
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