Epidemiological study of thoracolumbar spine fracture patients reported to tertiary care center of Central India

Background: Thoracic and lumbar spine fractures account for 90% of all spine fractures recorded. In low- and middle-income countries, spinal injuries are associated with significant disability and decreased life expectancy. Non-operatively, these injuries can be managed with a thoracolumbar orthosis or hyperextension cast. The operative management with a posterior, anterior or combined approach will offer immediate mobilization and earlier rehabilitation, providing a better environment for restoration of neurological function. Aim of the study was to find out epidemiology of patients with thoracolumbar spine fracture patients. Methods: A cross sectional observational study was conducted in department of orthopaedics at tertiary care, teaching hospital among patients with traumatic thoracolumbar spine fractures. Epidemiological data variables were collected. In statistical analysis data from 60 patient reported was recorded and analysed. Results: Fall from height is the leading mechanism of injury among middle aged people (30-60years) with male predominance, accounting for 58.33 percent of all spinal cord injury cases. The majority (45%) of fractures were of the burst kind, followed by compression (28.3%), and then translation/rotation (21.6%). And the most-rare of all was the distracted type (just 5%). An only 15% of patients had had a complete spinal injury, whereas the remaining 85% had sustained incomplete/ no spinal cord injury. Conclusions: Knowledge about the burden brought on by spinal cord injury makes it clear that preventing such injuries is the backbone of care. preventive measures for high-risk individuals and early definitive response by paramedics can help reducing the load caused by these injuries.

Six month old neglected metacarpophalangeal joint volar complex dislocation: a case study

Metacarpophalanegal dislocations are rare, accounting for 3-5% of all dislocations with thumb being the most common finger affected. these dislocations can be decided into volar and dorsal and further into simple and complex, depending upon direction of dislocation and reducibility respectively. Although there is no approach superior over another, we selected volar approach for better visualization and direct reduction of dislocation and found reduction was unstable. hence a temporary fixation was attempted with K-wire which was removed 7th day postoperative and started with physiotherapy. Postoperatively patient was having near total range of motion (25-90 degree) and patient was able to do all the routine daily activities with his affected hand post operative 2 month. Complex metacarpophangeal joint dislocations needs intervention and should be combined with vigorous postoperative physiotherapy to achieve good clinical outcomes

Post-operative complications of displaced unstable distal end radius fracture treated by volar plating

Background: Fracture of the distal radius (DRF) is one of the most common fractures present in emergency. The most common operative treatments of these fractures are open reduction and internal fixation with volar locking plates. The incidents and types of complications associated with the use of these operations is an ongoing process till date. The objective of the study was to find demographic profile of patients of displaced unstable distal end radius fracture, and to study the post-operative complications among above patients treated by volar plating.Methods: We performed a prospective study documenting types of complications and their occurrence in a group of patients who received open reduction and internal fixation. Our definition of a complication was a case in which the patient had one or more complications which required an intervention medical or surgical.Results: A total of 33 patients were included, most of the cases, (63.63%) were from the age group 21-40 years. We had 4 cases (12. 12%) females, and 29 cases (87.88%) males. Post-operative complications were noted in 7 individuals 22.2 % and no complications noted in 26 cases (78.8%). In 30 cases there was no any deformity found in postoperative one year follow up, 2 patients develop prominent ulnar styloid found in follow up of one year ,and 1 residual dorsal tilt found after one year.Conclusions: Our finding that 22.2% suffer from complication when treated using a volar locking plate must be taken into consideration when surgeons choose between conservative or operative treatment for DRF treatment. A few other studies have looked at the incidents of complications and have reported similar results

Post traumatic volar complex dislocation of first metacarpophalangeal joint: a case study

First metacarpophalangeal (MCP) joint dislocations are very uncommon injuries. These dislocations are classified as volar or dorsal, and then as simple or complicated, based on the direction of the dislocation and its reducibility. Dorsal being the most common approach as it is safer. It is found that reduction was stable and started with immobilisation for 15 days followed by physiotherapy. Postoperatively patient was having range of motion (25-50 deg) and post operative 2 months patient was able to do daily activities with his affected hand with VAS score of 1. Complex metacarpophangeal joint dislocations needs operative management combined with postoperative physiotherapy to achieve good clinical outcomes so as to reduce the risk of arthritis and decreased grip force

Epidemiology of humerus shaft fractures in children-observational study of 50 patients

Background: Objective was to study the epidemiology of humerus shaft fracture in children. Methods: This was an observational study of 50 cases of humeral diaphyseal fractures in children aged between 5 to 15 years reporting to tertiary care center over a period of 18 months. Each patient was categorized with respect to age, sex, mode of trauma, side injured, type of fracture, associated injuries, modality of treatment given. Results: Most patients belonged to upper lower class (66 %), and 80% patient belonged to rural population. Boys (60%) were more prone to have humerus shaft fracture than girls. Mean age of the patient were 10.12 years (±2.6 SD). Most common mode of trauma was accidental fall on arm (68%). Traumatic fracture was noted in 94% of cases while 6 % cases were having pathological fracture. Most patients were having middle third shaft fracture (40%), followed by distal third (30%) and lastly proximal third (22%), and left side involvement (58%) was more. Out of the 50 patients, poly trauma was observed in 4 cases, multiple bone fracture was noted in 2 cases, while 2 patients were having fibrous dysplasia and 1 with bony cyst as an associated cause of pathological fracture and 1 patient had radial nerve injury pre-operatively. Conclusions: The findings of this study provide valuable insights into the epidemiology of humerus shaft fractures in children in respect to age, sex, socio-economic status, mode of trauma. These data can help understand the risk factors and help in preventing the incidence. Most of these fracture can be managed successfully with retrograde titanium elastic nailing system (TENS) nailing with minimal complications.

Comparative study of the functional outcome of semitendinosus graft versus peroneus longus graft in arthroscopic reconstruction surgeries of anterior cruciate ligament

Background: ACL disruption is the commonest ligamentous knee injury among active adults, invariably leading to changes in knee kinematics which are most likely to result in secondary degenerative changes and long-term functional impairment. Thus, due to the ACL's crucial role as the primary restraint against anterior tibial translation, its reconstruction using varying graft options are being extensively studied for better functional outcome. Methods: In this prospective study, we analysed 30 patients having ACL tear (clinically and radiographically) and treated with arthroscopic reconstruction of ACL. Among these, 15 cases were operated using semitendinosus graft and 15 cases by using peroneus longus tendon graft. The study was conducted in a tertiary care hospital from January 2021 to June 2022 with minimum follow up of 6 months and maximum follow up of 15 months. Results: Mean Lysholm score (post op) in Group ST was 90.6±3.18 and in Group PLT was 92.2±2.65. The Lysholm Score and IKDC grading between the two groups was comparable and showed no significant difference. Post-Op laxity assessed using the Lachman’s grading showed normal findings in 70% patients, and of the remaining 30% (9 patients), 5 patients from ST group and 4 patients from PLT group showed 1+ laxity at follow up examination. Conclusions: Arthroscopy assisted ACL reconstruction with peroneus longus tendon autograft provides a steady knee, reduces postoperative donor site morbidity and enables early rehabilitation, similar to the traditional semitendinosus tendon autograft

An overview on concept of Jatharagni and its role in Amotpatti

Agni in Ayurveda has a significant role to maintain body homeostasis, body functioning, metabolism of body and proper functioning of body. Agni in Ayurveda is correlated with digestive power of the body. There are many reasons behind the maintenance of Agni in Ayurveda. The main reason behind its maintenance is that it helps in growth and development of the body. Agni is innumerable because of its presence in each and every Paramanu of the body, according to the functions and site of action Agni has been divided in three types those are Jhataragni (digestive fire), Bhutagni and Dhatwagni. They work together to maintain the balance in the body as Jhatragni is maintaining metabolism. Imbalance is the physiology of Agni is the main cause for the formation of Ama which is the main reason for many diseases. It is also widely thought that if Agni is strong, then one is free from disease. So Jatharagni is important for every function of body. This article shows the importance of Jatharagni and its role in Amotpatti

Concept of Greeshma Rutucharya w.s.r. to Sarvanga Sundara and Ayurveda Rasayana Teekas of Ashtang Hrudayam

Health is the supreme foundation for the achievement of happy life, objective of Ayurveda is to accomplish the physical, mental, social and spiritual well being by adopting the preventive and promotive approach as well as treating the disease with its various remissive approaches. Ayurveda has given first priorty in maintaining the health of the individuals rather than treating diseases. It deals with different regimens maintain person’s health one of them is Rutucharya. Not following proper Rutucharya provoke the Doshas in turn causes diseases. Thus proper and thorough study of Rutucharya helps to adapt and prevent helath problems majorly those occurs in Greeshma Rutu (Summer Season). Acharya Vagbhata, the last among Brahattrayi collected many points from Charaka Samhita and Sushruta Samhita. So it is better to refer Ashtang Hrudayam is upgraded from among these Samhitas. So commentators of Ashtang Hrudayam, Sarvanga Sundara and Ayurveda Rasayana are studied regarding Greeshma Rutucharya

Cervical spine Injury clearance protocol in Polytrauma patients

Abstract: It is very common in General Hospita

Deep neck space infection â A retrospective study of 270 cases at tertiary care center

Objective: To review the clinical findings in deep neck infections and identification predisposing factors of these complications. Methods: In this study, 270 patients with deep neck infections were studied retrospectively, study conducted in the Department of Ear, Nose and Throat, Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra, India, from March 2013 to March 2016. Results: Analysis showed that males are most likely to have deep neck space infections (DNSI). Odontogenic and tonsillar causes were the more frequent ones. Staphylococcus aureus and Streptococcus species were the microorganisms more commonly isolated. Conclusion: DNSI remains a common and challenging disease for otorhinolaryngologists, and should be treated on emergency basis. In developing countries, lack of adequate nutrition, poor oral hygiene, tobacco chewing, smoking and beetle nut chewing has led to an increased prevalence of dental and periodontal diseases. In present study, Odontogenic infections were the most common etiological factor for DNSI. Keywords: Deep neck space infection, Incision and drainage, Odontogenic infections, Tracheotom