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Articles 61 - 90 of 97
Full-Text Articles in Medicine and Health Sciences
Systemic Sclerosis: Clinical Manifestations, Anesthetic And Orthopedic Considerations In A Patient, Obada Hasan, Muneeba Jessar, Muhammad Ashar, Shahryar Noordin, Tashfeen Ahmad
Systemic Sclerosis: Clinical Manifestations, Anesthetic And Orthopedic Considerations In A Patient, Obada Hasan, Muneeba Jessar, Muhammad Ashar, Shahryar Noordin, Tashfeen Ahmad
Section of Orthopaedic Surgery
Introduction: Systemic sclerosis is a rare and progressive multisystem autoimmune disorder that is characterized pathologically by vascular abnormalities, connective tissue sclerosis and atrophy of skin and various internal organs (e.g., alimentary tract, lungs, heart, kidney, CNS), and autoantibodies. With an unknown etiology, Scleroderma is a complex polygenetic disease. A recent Genome Wide Association Study (GWAS) confirmed a strong association with the Major Histocompatibility Complex (MHC) and autoimmunity. We provide a case scenario along with a review of the systems involved and challenges physicians can face in dealing with this rare disease.
Case Presentation: Our patient, a known case of systemic …
Toe-Tourniquet Syndrome: A Rare Potentially Devastating Entity, Naveed Baloch, M Atif, Rizwan Hussain Rashid, Pervaiz Mahmood Hashmi
Toe-Tourniquet Syndrome: A Rare Potentially Devastating Entity, Naveed Baloch, M Atif, Rizwan Hussain Rashid, Pervaiz Mahmood Hashmi
Section of Orthopaedic Surgery
Toe-tourniquet syndrome is a rare and commonly misdiagnosed condition caused by a hair or a fiber wrapped around digits (fingers and toes). A four months baby girl who was crying and presented with redness and swelling at her 2nd and 3rd toes of right foot. Child had red and swollen 2nd and 3rd toes of right foot with hair end protruding through wounds. Constricting hairs were cut and removed. Toetourniquet syndrome is a rare entity which is caused by hair wrapped around a toe or a digit. Diagnosis is mostly clinical. In order to prevent this condition to happen, education …
Long Term Follow-Up Of A Successful Lower Limb Replantation In A 3-Year-Old Child, Akbar Jaleel Zubairi, Pervaiz Mahmood Hashmi
Long Term Follow-Up Of A Successful Lower Limb Replantation In A 3-Year-Old Child, Akbar Jaleel Zubairi, Pervaiz Mahmood Hashmi
Section of Orthopaedic Surgery
Replantation of the lower extremity has controversial indications but nevertheless it may be considered in carefully selected patients who present early and are expected to show good functional recoveries. Here we present a successful replantation in a 3-year-old boy who has made excellent recovery with no functional deficit evident at 12 years of follow-up. He sustained a traumatic amputation at the level of distal tibia when he fell of a "Qing Qi" (motorcycle rickshaw). Replantation was attempted at 8 hours cold ischemia time with the tibia shortened 4cm and all tendons, vessels, and nerves repaired. Patient required a second procedure …
Vacuum Assisted Closure-Utilization As Home Based Therapy In The Management Of Complex Diabetic Extremity Wounds, Kamran Hafeez, Haroon Ur Rashid, Ghulam Mustafa Karim Khani, Darshan Kumar, Sunil Kumar
Vacuum Assisted Closure-Utilization As Home Based Therapy In The Management Of Complex Diabetic Extremity Wounds, Kamran Hafeez, Haroon Ur Rashid, Ghulam Mustafa Karim Khani, Darshan Kumar, Sunil Kumar
Section of Orthopaedic Surgery
Objective: Vacuum assisted closure is a reported technique to manage complex wounds. We have utilized this technique by using simple locally available material in the management of our patients on outpatient basis. The objective of this study is to present our experience.
Methods: This study was conducted from June 2011 to June 2013 at Dow University Hospital and Aga Khan University Hospital, Karachi. There were 38 patients managed with vacuum assisted closure. Mean age was 56±7.8 years. Twenty three patients presented with necrotizing fasciitis and 15 patients with gangrene. Lower limbs were involved in majority of the patients. Debridement or …
Cervical Vertebral Anomalies In Skeletal Malocclusions: A Cross-Sectional Study On Orthodontic Patients At The Aga Khan University Hospital, Pakistan, Saman Faruqui, Mubassar Fida, Attiya Shaikh
Cervical Vertebral Anomalies In Skeletal Malocclusions: A Cross-Sectional Study On Orthodontic Patients At The Aga Khan University Hospital, Pakistan, Saman Faruqui, Mubassar Fida, Attiya Shaikh
Section of Orthopaedic Surgery
Introduction: Morphological deviations of the cervical vertebral column have been described in relation to craniofacial aberrations and syndromes. Furthermore, it has recently been shown that abnormal morphology of upper cervical vertebrae is associated with malformation of the jaws and occlusion. Accordingly, it is relevant to focus on similar associations in patients with skeletal malocclusions. Therefore, the objectives of this study are to: (a) Identify the anomalies of the cervical column in patients with skeletal malocclusions (b) Determine the association between cervical vertebral anomalies and skeletal malocclusions.
Materials and Methods: This cross-sectional study was conducted on a total of 90 subjects …
Bifocal Metachronous Giant-Cell Tumour Of Ulna And Distal Radius, Hasnain Raza, Pervaiz Hashmi
Bifocal Metachronous Giant-Cell Tumour Of Ulna And Distal Radius, Hasnain Raza, Pervaiz Hashmi
Section of Orthopaedic Surgery
A 36 years old gentleman had giant cell tumour (GCT) in distal ulna for which he underwent resection of distal half of ulna but developed recurrence of the tumour. Following proper evaluation (grading and staging), he underwent wide margin excision of tumour including removal of distal three-fourth of ulna and reconstruction by free vascularised osteocutaneous fibular transfer. The distal reconstructed fibula was stabilized with extensor carpi ulnaris (ECU). Two years after the surgery, he developed a metachronous GCT lesion in ipsilateral distal radius for which he had curettage and bone grafting with preservation of articular surface.
Use Of Femoral Nail With Spiral Blade In Subtrochanteric Fractures, Masood Umer, Haroon Rashid, Idrees Shah, Irfan Qadir
Use Of Femoral Nail With Spiral Blade In Subtrochanteric Fractures, Masood Umer, Haroon Rashid, Idrees Shah, Irfan Qadir
Section of Orthopaedic Surgery
Objective: The aim of this study was to evaluate the outcome of acute subtrochanteric fractures managed with intramedullary nail and spiral blade fixation of the proximal fragment.
Methods: Charts of 33 patients (17 males and 16 females) with acute subtrochanteric fractures operated with intramedullary nail and spiral blade at our institution between March 2006 and February 2011 were retrospectively reviewed. The most common (67%) mechanism of injury was ground-level fall, predominantly involving elderly patients. Results were evaluated in terms of union time, implant failure rate, infection rate and functional outcome.
Results: Mean duration of surgery was 2.4 hours and average …
Effect Of Early Release Of Tourniquet In Total Knee Arthroplasty, Kashif Abbas, Hasnain Raza, Masood Umer, Kamran Hafeez
Effect Of Early Release Of Tourniquet In Total Knee Arthroplasty, Kashif Abbas, Hasnain Raza, Masood Umer, Kamran Hafeez
Section of Orthopaedic Surgery
Objective: To evaluate whether tourniquet release intraoperatively is better than postoperative release in reducing overall blood loss, duration of surgery, duration of tourniquet, length of hospital stay, wound related complications and transfusion requirement. Study Design: Comparative study. Place and Duration of Study: Department of Surgery, The Aga Khan University Hospital, Karachi, from January 2004 to June 2007.
Methodology: One hundred and thirty patient files were reviewed retrospectively. Patients were divided into two groups. Group-A consisted of 65 patients with early deflation of tourniquet and group-B comprised of 65 patients with the release of tourniquet after applying compressive dressing. Total blood …
Giant Cell Tumour Of The Sacrum: Function-Preserving Surgery With Extended Curettage And Ilio-Lumbar Fusion, Riaz Hussain Lakhdawala, Tashfeen Ahmad, Ather Enam
Giant Cell Tumour Of The Sacrum: Function-Preserving Surgery With Extended Curettage And Ilio-Lumbar Fusion, Riaz Hussain Lakhdawala, Tashfeen Ahmad, Ather Enam
Section of Orthopaedic Surgery
Giant cell tumours of the sacrum pose a unique therapeutic challenge due to the inaccessibility of the tumour, significant intra-operative blood loss from extensive vascularity, high rate of local recurrence with conservative surgery, and loss of neurological function and mechanical instability with en-bloc excision. We present a case where successful outcome was achieved by tailoring treatment in consideration of the above issues. A 28 year old male diagnosed on biopsy to have giant cell tumour of the sacrum presented to us with low-back pain, left-sided S1 radiculopathy, ankle weakness and urinary incontinence. MRI showed a tumour involving the S1 and …
Single Stage Oncologic Resection And Reconstruction: A Step Toward Development Of Sarcoma Service In Resource Constrained Country, Haroon Ur Rashid, Kashif Abbas, Masood Umer
Single Stage Oncologic Resection And Reconstruction: A Step Toward Development Of Sarcoma Service In Resource Constrained Country, Haroon Ur Rashid, Kashif Abbas, Masood Umer
Section of Orthopaedic Surgery
Tumor free-margin surgical resection remains the single most important treatment in the curative therapy of musculoskeletal tumor of limbs. Refinements in surgical techniques have led to increased function preservation and limb salvage.
Patients and Methods: The records of patients (n = 24) who underwent microsurgical soft tissue reconstruction subsequent to resection of limb tumour during the period 2006 to 2011 were reviewed. Primary outcome i.e. uptake of the flap was evaluated. Perioperative morbidities were also noted including donor as well as recipient site complications. Assessment of Functional outcome (Musculoskeletal Tumor Society score, MSTS) local recurrence, free survival, and disease-specific …
Impact Of Unplanned Excision On Prognosis Of Patients With Extremity Soft Tissue Sarcoma, Hafiz Muhammad Umer, Masood Umer, Irfan Qadir, Nadeem Abbasi, Nehal Masood
Impact Of Unplanned Excision On Prognosis Of Patients With Extremity Soft Tissue Sarcoma, Hafiz Muhammad Umer, Masood Umer, Irfan Qadir, Nadeem Abbasi, Nehal Masood
Section of Orthopaedic Surgery
Unplanned excision of soft tissue sarcomas (STSs) outside comprehensive tumor management centers necessitates the need for wide reexcision to achieve adequate margins. We retrospectively reviewed medical records of 135 patients with STS operated at our hospital with the goal of examining outcomes, in terms of local recurrence (LR) and metastasis rate (MR), of reexcision following unplanned excision of STS and comparing results with those of first-time planned surgery. Eighty-four patients had their first-time surgery and 51 patients had come to us following unplanned excision at prereferral hospital. Mean age of all patients was 41.8 ± 21.9 years. The LR and …
Complex Biological Reconstruction After Wide Excision Of Osteogenic Sarcoma In Lower Extremities, Kashif Abbas, Masood Umer, Haroon Ur Rashid
Complex Biological Reconstruction After Wide Excision Of Osteogenic Sarcoma In Lower Extremities, Kashif Abbas, Masood Umer, Haroon Ur Rashid
Section of Orthopaedic Surgery
Wide margin resection of extremity tumor sometimes leaves a huge soft tissue and bony defects in limb salvage surgery. Adequate management of these defects is an absolute requirement when aiming for functional limb. Multidisciplinary management in such cases is an answer when complex biologic reconstruction is desired. We aim to present cases of osteogenic sarcoma of lower extremity requiring combined surgical approach to achieve effective musculoskeletal reconstruction. Patients and Methods. From 2006 to 2010 ten patients were operated on for osteogenic sarcoma of lower extremity requiring complex musculoskeletal reconstruction. Results. Six patients had pathology around knee joint, whereas one each …
Autoclaved Tumor Bone For Skeletal Reconstruction In Paediatric Patients: A Low Cost Alternative In Developing Countries, Masood Umer, Hafiz Muhammad Umer, Irfan Qadir, Haroon Rashid, Rabia Awan, Raza Askari, Shamvil Ashraf
Autoclaved Tumor Bone For Skeletal Reconstruction In Paediatric Patients: A Low Cost Alternative In Developing Countries, Masood Umer, Hafiz Muhammad Umer, Irfan Qadir, Haroon Rashid, Rabia Awan, Raza Askari, Shamvil Ashraf
Section of Orthopaedic Surgery
We reviewed in this series forty patients of pediatric age who underwent resection for malignant tumors of musculoskeletal system followed by biological reconstruction. Our surgical procedure for reconstruction included (1) wide en bloc resection of the tumor; (2) curettage of tumor from the resected bone; (3) autoclaving for 8 minutes (4) bone grafting from the fibula (both vascularized and nonvascularized fibular grafts used); (5) reimplantation of the autoclaved bone into the host bone defect and fixation with plates. Functional evaluation was done using MSTS scoring system. At final followup of at least 18 months (mean 29.2 months), 31 patients had …
Complications Of Total Hip Replacement, Kashif Abbas, Ghulam Murtaza, Masood Umer, Haroon Rashid, Irfan Qadir
Complications Of Total Hip Replacement, Kashif Abbas, Ghulam Murtaza, Masood Umer, Haroon Rashid, Irfan Qadir
Section of Orthopaedic Surgery
Objective: To determine the factors causing complications in unilateral total hip replacement.
Study Design: Analytical study.
Place and Duration of Study: The Aga Khan University Hospital, Karachi, between 2000 and 2010.
Methodology: During the study period, 199 patients underwent elective unilateral total hip replacement at the Aga Khan University Hospital. Patients were divided into two groups on the basis of postoperative complications within 30 days of surgery. Significant factors at 5% significance level on univariate analysis were further analyzed by multivariate logistic regression.
Results: Postoperative complications occurred in 39 patients (19.6%); dislocation being most common in 13 patients (6.5%), followed …
Short Term Results Of Ligament Reconstruction And Tendon Interposition Resection Arthroplasty For Basal Joint Arthritis, Kashif Abbas, Pervaiz Hashmi, Hasnain Raza
Short Term Results Of Ligament Reconstruction And Tendon Interposition Resection Arthroplasty For Basal Joint Arthritis, Kashif Abbas, Pervaiz Hashmi, Hasnain Raza
Section of Orthopaedic Surgery
Carpometacarpal (CMC) joint of the thumb is the second most common site afflicted by osteoarthritis. Non surgical measures forms the first line of treatment with aim of preventing progression of disease, however, surgery becomes an option when symptoms are refractory to nonsurgical methods. Different procedures have been described in literature. Ligament reconstruction with tendon interposition (LRTI) is the most commonly performed procedure in North America for this problem. The Aim of study was to evaluate early results of ligament reconstruction and tendon interposition for CMC joint arthritis. This is a case series of ten patients operated in a tertiary care …
Glenohumeral Tuberculous Arthritis Complicated With Beta Haemolytic Streptococcus: An Extraordinary Rare Association: A Case Report, Rizwan Haroon Rashid, Muhammad Usman Sarwar, Jaweed Akhter, Shahryar Noordin
Glenohumeral Tuberculous Arthritis Complicated With Beta Haemolytic Streptococcus: An Extraordinary Rare Association: A Case Report, Rizwan Haroon Rashid, Muhammad Usman Sarwar, Jaweed Akhter, Shahryar Noordin
Section of Orthopaedic Surgery
Introduction: Septic arthritis of the glenohumeral joint is a rare entity and its diagnosis is difficult with a superadded infection in the presence of underlying tuberculosis. We report the first case of group B beta haemolytic streptococcal glenohumeral arthritis with underlying tuberculosis.
Case Presentation: A 40 year old lady previously diagnosed to have poliomyelitis, rheumatoid arthritis, hepatitis C, and diabetes mellitus for the last 10 years, presented to the emergency room with diabetic ketoacidosis. Two weeks prior to presentation she developed fever along with pain and swelling in left shoulder with uncontrolled blood sugars. Local examination of the shoulder revealed …
Managing Soft Tissue Sarcomas In A Developing Country: Are Prognostic Factors Similar To Those Of Developed World?, Irfan Qadir, Masood Umer, Hafiz Muhammad Umer, Nasir Uddin, Farrok Karson, Muhammad Sharoz Rabbani
Managing Soft Tissue Sarcomas In A Developing Country: Are Prognostic Factors Similar To Those Of Developed World?, Irfan Qadir, Masood Umer, Hafiz Muhammad Umer, Nasir Uddin, Farrok Karson, Muhammad Sharoz Rabbani
Section of Orthopaedic Surgery
Background: Managing soft tissue sarcomas (STS) in a developing country with limited financial resources and a poor health referral system is a challenge. Presenting late, these extremity STS are prone to recurrence despite apparently complete resection. This study aimed to explore and compare the impact of clinico-pathological factors on recurrence and survival in Pakistan with the corresponding figures quoted from the developed world.
Methods: An institutional review was performed on all patients with primary STS of the extremities operated on between 1994 and 2008. The prognostic influence of clinical, pathologic, and treatment variables on local recurrence free survival (LRFS), metastasis …
Skeletal Manifestations Of Scurvy: A Case Report From Dubai, Shahryar Noordin, Naveed Baloch, Muhammad Sohail Salat, Abdul Rashid Memon, Tashfeen Ahmad
Skeletal Manifestations Of Scurvy: A Case Report From Dubai, Shahryar Noordin, Naveed Baloch, Muhammad Sohail Salat, Abdul Rashid Memon, Tashfeen Ahmad
Section of Orthopaedic Surgery
Introduction: Nutritional deficiencies are rarely reported in developed countries. We report a child of Pakistani origin brought up in Dubai who developed skeletal manifestations of scurvy due to peculiar dietary habits.
Case Presentation: A 4.5 year old boy presented with pain and swelling of multiple joints for three months and inability to walk for two months. Dietary history was significant for exclusive meat intake for the preceding two years. On examination the child's height and weight were below the 5th percentile for his age. He was pale and tachycardic. There was significant swelling and tenderness over the wrist, knee and …
Use Of Tranexamic Acid Is A Cost Effective Method In Preventing Blood Loss During And After Total Knee Replacement, Yasir Jamal Sepah, Masood Umer, Tashfeen Ahmad, Faria Nasim, Muhammad Umer Chaudhry, Muhammad Umar
Use Of Tranexamic Acid Is A Cost Effective Method In Preventing Blood Loss During And After Total Knee Replacement, Yasir Jamal Sepah, Masood Umer, Tashfeen Ahmad, Faria Nasim, Muhammad Umer Chaudhry, Muhammad Umar
Section of Orthopaedic Surgery
Background & Purpose: Allogenic blood transfusion in elective orthopaedic surgery is best avoided owing to its associated risks. Total knee replacement often requires blood transfusion, more so when bilateral surgery is performed. Many strategies are currently being employed to reduce the amount of peri-operative allogenic transfusions. Anti-fibrinolytic compounds such as aminocaproic acid and tranexamic acid have been used systemically in perioperative settings with promising results. This study aimed to evaluate the effectiveness of tranexamic acid in reducing allogenic blood transfusion in total knee replacement surgery.
Methodology: This was a retrospective cohort study conducted on patients undergoing total knee replacement during …
Osteochondral Grafting Of Knee Joint Using Mosaicplasty, Muhammad Abdul Wajid, Muhammad Idrees Shah, Mohsin E. Azam, Tashfeen Ahmad
Osteochondral Grafting Of Knee Joint Using Mosaicplasty, Muhammad Abdul Wajid, Muhammad Idrees Shah, Mohsin E. Azam, Tashfeen Ahmad
Section of Orthopaedic Surgery
Focal cartilage defects of articular surface-traumatic and degenerative are difficult to treat, thus a variety of surgical techniques have been developed and reported for treatment of such defects. Procedures such as Priddies perforations, microfracture, abrasion chondroplasty have shown long-term results which are often less than adequate. One of the reasons is that all these techniques lead to the formation of fibrocartilage which has inferior mechanical properties as compared to the native hyaline cartilage. Mosaicplasty is a procedure which aims at replacing the lost articular cartilage with hyaline cartilage including underlying bone support, thus providing adequate stability to the cartilage and …
Arthroscopic Repair Of Meniscal Tears With Inside-Out Technique, Hasnain Raza, Kashif Abbas, Masood Umer
Arthroscopic Repair Of Meniscal Tears With Inside-Out Technique, Hasnain Raza, Kashif Abbas, Masood Umer
Section of Orthopaedic Surgery
Objective: To review the clinical results of arthroscopic meniscal repair and to identify factors that may affect the outcome.
Methods: A total of 15 arthroscopic meniscal repairs with inside-out in 14 patients over a 7-year period were evaluated retrospectively. The mean age was 41.2 +/- 11.5 years with a range of 26-64 years. Eleven patients underwent repair for medial meniscal tear, two patients for lateral meniscus and one patient for both in the same knee. All patients were functionally evaluated by Lysholm functional knee scores over an average follow-up of 1 year and 5 months (range: 0.5-7 years).
Results: The …
Thoracolumbar Tuberculosis: Implications For Appropriate Management Based On Disease Location And Proposal Of A Novel Scoring System, Shahryar Noordin, Salim Allana, Tashfeen Ahmad, Zafar Sajjad, Khabir Ahmad, Ather Enam, Riaz Hussain Lakdawala
Thoracolumbar Tuberculosis: Implications For Appropriate Management Based On Disease Location And Proposal Of A Novel Scoring System, Shahryar Noordin, Salim Allana, Tashfeen Ahmad, Zafar Sajjad, Khabir Ahmad, Ather Enam, Riaz Hussain Lakdawala
Section of Orthopaedic Surgery
Objective: To identify factors indicating disease severity in patients with thoracolumbar tuberculosis requiring surgical intervention.
Design: Medical charts of patients who underwent surgery for thoracic and lumbar spinal tuberculosis from 1990-2005 were reviewed. Patients with different levels of disease were compared in terms of neurological deficits, duration of symptoms, previous antituberculous therapy, nutritional status and associated co-morbids.
Results: Ninety-three patients aged 7-77 years (mean age 40 years) were included. Thoracic spine was involved in 80% of operated patients, and lumbar spine in 20%. Severe neurological impairment (Frankel A to C) was present in 68% of patients with thoracic disease, as …
Surgical Tourniquets In Orthopedics, Shahryar Noordin, James A. Mcewen, John F. Kragh, Andrew Eisen, Bassam A. Masri
Surgical Tourniquets In Orthopedics, Shahryar Noordin, James A. Mcewen, John F. Kragh, Andrew Eisen, Bassam A. Masri
Section of Orthopaedic Surgery
No abstract provided.
Lymphangiosarcoma Of The Arm Presenting With Lymphedema In A Woman 16 Years After Mastectomy: A Case Report, Yasir J. Sepah, Masood Umer, Asim Qureshi, Shaista Khan
Lymphangiosarcoma Of The Arm Presenting With Lymphedema In A Woman 16 Years After Mastectomy: A Case Report, Yasir J. Sepah, Masood Umer, Asim Qureshi, Shaista Khan
Section of Orthopaedic Surgery
Lymphangiosarcoma following breast cancer is a relatively rare entity, with around 300 cases so far reported worldwide. Affecting the long term survivors of breast cancer, lymphangiosarcoma (Stewart-Traves Syndrome) has a high mortality rate. Since lympedema following radical mastectomy or axillary clearance and radiotherapy seems to be the main predisposing factor, further research regarding modifications in the surgical technique of axillary nodes dissection as well as the development of new chemotherapeutic agents effective in lymphangiosarcoma are required.
Acetabular Morphometry And Prevalence Of Hip Dysplasia In The South Asian Population, Masood Umer, Yasir J. Sepah, Sharjeel Asif, Iqbal Azam Syed, Muhammad Umar Jawad
Acetabular Morphometry And Prevalence Of Hip Dysplasia In The South Asian Population, Masood Umer, Yasir J. Sepah, Sharjeel Asif, Iqbal Azam Syed, Muhammad Umar Jawad
Section of Orthopaedic Surgery
We carried out a cross-sectional study to measure the association of the seven acetabular parameters with pelvic morphometry and prevalence of hip dysplasia in our population. Convenience sampling was carried out and 250 consecutive patients who came to AKUH for intravenous pyelogram and had no complaints in the region of the hip joint were enrolled in the study. Post-micturition standardized plain antero-posterior pelvic radiographs of 250 asymptomatic adults (500 hip joints) was studied. There were 136 males (54.4%) and 114 females (45.6%). Mean age of our study population was 38 years (15-78 years). The average center edge angle was 35.5±6.6° …
Shoulder Impingement Syndrome: Outcome Of Arthroscopic Subacromial Decompression, Attiq Ur Rehman, Muhammad Abdul Wajid, Tashfeen Ahmad
Shoulder Impingement Syndrome: Outcome Of Arthroscopic Subacromial Decompression, Attiq Ur Rehman, Muhammad Abdul Wajid, Tashfeen Ahmad
Section of Orthopaedic Surgery
Objective: To describe the outcome of cases with subacromial impingement syndrome managed with arthroscopic subacromial decompression.
Study Design: Quasi-experimental study.
Place and Duration of Study: Section of Orthopaedics, Department of Surgery, The Aga Khan University Hospital, Karachi from April 2005 to March 2006.
Methodology: Thirty patients with impingement syndrome who underwent arthroscopic subacromial decompression after failed conservative treatment were included. The Constant and Murley shoulder scoring system was used for the clinical assessment of pain and function pre-operatively and 1, 6 and 24 weeks postoperatively.
Results: The postoperatively significant improvement was observed in the Constant and Murley scores in all …
Well Leg Compartment Syndrome: The Debit Side Of Hemilithotomy Position, Shahryar Noordin, Salim Allana, Muhammad Abdul Wajid
Well Leg Compartment Syndrome: The Debit Side Of Hemilithotomy Position, Shahryar Noordin, Salim Allana, Muhammad Abdul Wajid
Section of Orthopaedic Surgery
We describe a case of well leg compartment syndrome following unilateral lithotomy position in a patient undergoing contralateral antegrade intramedullary femoral nailing. Following two-incision four compartment fasciotomy, the patient recovered with no residual defects. We dissuade use of the hemilithotomy position for antegrade femoral nailing procedures in favour of another previously described position, because this predisposes patients to position-associated complications without offering any substantial advantage.
First Successful Autologous Chondrocyte Implantation In Pakistan, Tashfeen Ahmad, Masood Umer, Loay Lubbad, Riaz Hussain Lakdawala, Anwar Ali Siddiqui
First Successful Autologous Chondrocyte Implantation In Pakistan, Tashfeen Ahmad, Masood Umer, Loay Lubbad, Riaz Hussain Lakdawala, Anwar Ali Siddiqui
Section of Orthopaedic Surgery
Osteochondritis dissecans entails a hyaline cartilage defect of the articular surface causing pain and functional restriction in young adults, sometimes resulting in early degenerative arthritis. Conventional treatment methods such as abrasion chondroplasty and mosaicplasty have limitations in terms of quality of the resultant cartilage and donor site morbidity. A more recent technique, autologous chondrocyte implantation (ACI) results in hyaline cartilage formation and gives good long-term outcome, but requires a high-level cell culture facility and two surgical procedures. The patient was a young female with knee pain, intermittent locking and feeling of "joint mouse". MRI scan and arthroscopy showed a 2 …
Neuronal Regeneration In Denervated Muscle Following Sensory And Muscular Neurotization, Shahryar Noordin, Mahmood Ahmed, Rasham Rehman, Tashfeen Ahmad, Pervaiz Hashmi
Neuronal Regeneration In Denervated Muscle Following Sensory And Muscular Neurotization, Shahryar Noordin, Mahmood Ahmed, Rasham Rehman, Tashfeen Ahmad, Pervaiz Hashmi
Section of Orthopaedic Surgery
Background and Purpose: Neurotization of denervated muscles has been shown to improve muscle bulk, but the neuronal regeneration response has not been compared previously in different surgical techniques of neurotization. Thus, using a rat model of experimental skeletal muscle denervation, we studied neuronal regeneration following sensory neurotization by two methods: sensory nerve to motor branch of muscle and direct sensory nerve implantation to muscle.
Material and Methods: The lateral head of the gas-trocnemius muscle was denervated in 36 rats, of which the first 12 served as denervated controls. In the second group of 12, the sural nerve was anastomozed to …
Prophylaxis Of Dvt With Enoxaparin In Patients Undergoing Total Knee Replacement, Abid Ullah Khan Niazi, Masood Umer, Mohammad Umar
Prophylaxis Of Dvt With Enoxaparin In Patients Undergoing Total Knee Replacement, Abid Ullah Khan Niazi, Masood Umer, Mohammad Umar
Section of Orthopaedic Surgery
Objective: To evaluate the efficacy and safety of the low molecular weight heparin as prophylaxis against thromboembolism following total knee replacement surgery.
Methods: Post-operative bilateral lower extremity colour duplex scan was performed on 55 patients subjected to total knew arthroplasty. The scan was performed 7 days after surgery for detection of DVT. All patients were given Enoxaparin 40mg subcutaneous daily for 2 weeks as prophylaxis against DVT.
Results: Two patients were diagnosed as DVT by color duplex scanning and both were distal but only one was asymptomatic. Another patient developed pulmonary embolism and died subsequently. The major and minor wound …