Study of effects of negative pressure wound therapy in contaminated wounds

Background: Negative pressure wound therapy is an advanced wound therapy technique that helps in healing the wounds and accelerates granulation tissue as well as wound closure.Methods: Prospective randomized interventional study was done in Dept. of Orthopedics, Dr. BRAM Hospital, Pt. JNM Medical college, Raipur during period from January 2016 to December 2016 involving 25 patients with open fractures up to Gustilo Anderson grade IIIB. All were subjected to this wound technique and response was observed as granulation, size of wound and closure duration.Results: There was up to 10 to 20 mm reduction in wound size with each dressing in half the patients and up to 10 mm in other half of the patients. There was significant reduction in the bacterial growth in all patients and closure was attained in all the subjects after a few therapies.Conclusions: Negative pressure wound therapy is a promising technique to reduce the size of the wound in large wound associated with compound fractures and hasten the healing of wound and its closure

Intra articular distal radius fractures and volar plate fixation: a prospective study

Background: Despite being one of the most common fractures encountered in patients, intra-articular distal radius fractures still pose therapeutic challenge to Orthopaedic surgeons. With the advent of locking plates, the fixation of these fractures has been made better, specifically by fixed angle volar locking plate. This study investigates the efficacy of these plates using volar approach, functional and clinical outcome, in addition to the radiological alignment.Methods: Thirty patients with closed distal radius fractures, with AO TYPE B3, B4, AND C fracture pattern, operated with distal radius plate fixation using volar approach, were included in the study during the period of August 2014 to August 2016. With a minimum follow up of six months, radiological outcome was analysed and functional outcome recorded (Gartland and Werley’s demerit scoring system).Results: With a mean age of 42 years and follow up of six months, the range of movement of the wrist was very satisfactory, and the mean grip strength was 80% of the opposite wrist. Radiological parameters were well‑maintained, and functional parameters by Gartland and Werley showed a significant improvement in most of the patients during the follow‑up period. The complication rate was less and insignificant.Conclusions: Primary volar plate fixation of intraarticular distal radius fracture provides a stable construct that helps in early mobilization, thereby better functional outcomes and minimizes chances of delayed/malunion

A young lady presented with limited pulmonary Wegener′s granulomatosis

A 19 year old female college student presented with fever, dry cough, chest pain, blood tinged sputum with subsequent development of polyarthralgia with radiological evidence of bilateral multiple unevenly distributed pulmonary nodular opacities with cavitation. There was no other systemic involvement and the patient was cytoplasmic antineutrophil antibody (c-ANCA) positive with more than four times the normal upper limit of anti PR3 antibody. Excellent response to oral steroid with antimicrobial agent “trimethoprim – sulphamethoxazole” was noted

A young lady presented with limited pulmonary <i>Wegener&#x2032;s granulomatosis</i>

A 19 year old female college student presented with fever, dry cough, chest pain, blood tinged sputum with subsequent development of polyarthralgia with radiological evidence of bilateral multiple unevenly distributed pulmonary nodular opacities with cavitation. There was no other systemic involvement and the patient was cytoplasmic antineutrophil antibody (c-ANCA) positive with more than four times the normal upper limit of anti PR3 antibody. Excellent response to oral steroid with antimicrobial agent "trimethoprim - sulphamethoxazole" was noted