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Assessment Of Landing Biomechanics And Rehabilitation After Anterior Cruciate Ligament Reconstruction, Sheila S. Gagnon

Electronic Thesis and Dissertation Repository

Aberrant landing biomechanics increase the risk of anterior cruciate ligament (ACL) injury and are a focus of rehabilitation after ACL reconstruction. The purpose of the present thesis was to develop and evaluate methods of assessing landing mechanics and investigate the effects of different rehabilitation strategies after ACL reconstruction. Three studies were conducted. The first study used a Delphi process to develop the content of a Clinician-Rated Drop Vertical Jump Scale to evaluate jump landing mechanics during rehabilitation after ACL reconstruction. Twenty experts participated in four rounds of questioning, resulting in 92% agreement for knee valgus collapse, lateral trunk lean, insufficient …

Comparative Study Between Intramedullary K Wires Versus Mini-Plates And Screws In Fixation Of Metacarpal Shaft Fractures In Adults, Mahmoud Abdel-Hamid, Mohamed Abulsoud, Mohamed Bissar

Al-Azhar International Medical Journal

Abstract Background: Percutaneous intramedullary K. wires fixation and mini-plates fixation are reasonable options for treating unstable metacarpal fractures as they provide anatomical reduction and rigid fixation, which is adequate to permit early mobilization. Objective: To compare between mini-plates and Kirschner wires in management of unstable metacarpal shaft fractures in adults. Patients and Methods: All patients (n=30) included in this prospective comparative study were managed and followed up at Al-Azhar University Hospital from January 2019 to February 2020. Thirty patients with fracture of shaft metacarpal were divided into 2 groups: group A (n=15) were managed by percutaneous intramedullary K-wires and group …

Management Of Distal Femoral Fractures: A Comparative Study Between Open Reduction And Internal Fixation By Distal Femur Locked Plate And Retrograde Nailing, Mohamed Atef, Adnan A .Alim Al Sebaie, Ahmed Ismail Hamoda

Al-Azhar International Medical Journal

Background: Fractures of the distal femur are usually rare and severe , The usual context is a high energy trauma in a young patient and a domestic accident in an elderly person. There are different modalities of management of distal femur fractures among which are the retrograde intramedullary nail and locked compression plate. Both operative stabilizing systems follow the principle of biological osteosynthesis . Aim of work: To evaluate and compare the outcome of each method of fixation of distal femur fractures as regard; operative time; early mobilization; knee range of motion; time of healing and complications. Materials and Methods: …

The Effectiveness Of Platelet-Rich Plasma Injection In Management Of Rotator Cuff Tendinopathy, Wael Abd El Tawab, Ismail Hammoda, Emad Zayed

Al-Azhar International Medical Journal

Background: A significant upper extremity condition impacting 1 in 50 people is rotator cuff tendinopathy; with age, the incidence increases, causing a regular musculoskeletal complaint in adults over 65 years of age. Shoulder pain and fatigue are correlated with severe morbidity, impacting everyday life, leisure, and working life. Objective: To assess the efficacy of platelet-rich plasma injection in the treatment of rotator cuff tendinopathy. Patients and methods: From September 2018 till March 2020, twenty patients were treated by injection of single PRP in subacromial space for chronic rotator cuff tendinopathy. Preinjection and postinjection visual analogue scale (VAS) and constant Murley …

Classifying Complications: Assessing Adult Spinal Deformity 2-Year Surgical Outcomes., Eric O Klineberg, Peter G Passias, Gregory W Poorman, Cyrus M Jalai, Abiola Atanda, Nancy Worley, Samantha Horn, Daniel M Sciubba, D Kojo Hamilton, Douglas C Burton, Munish Chandra Gupta, Justin S Smith, Alexandra Soroceanu, Robert A Hart, Brian Neuman, Christopher P Ames, Frank J Schwab, Virginie Lafage

Articles, Abstracts, and Reports

STUDY DESIGN: Retrospective review of prospective database.

OBJECTIVE: Complication rates for adult spinal deformity (ASD) surgery vary widely because there is no accepted system for categorization. Our objective was to identify the impact of complication occurrence, minor-major complication, and Clavien-Dindo complication classification (Cc) on clinical variables and patient-reported outcomes.

METHODS: Complications in surgical ASD patients with complete baseline and 2-year data were considered intraoperatively, perioperatively (<6 >weeks), and postoperatively (>6 weeks). Primary outcome measures were complication timing and severity according to 3 scales: complication presence (yes/no), minor-major, and Cc score. Secondary outcomes were surgical outcomes (estimated blood loss [EBL], …

Comparative Study: Arthroscopic Versus Open Tennis Elbow Release, Faisal Zayed

Al-Azhar International Medical Journal

Abstract Background: Tennis elbow is a very common elbow pathology that caused by repetitive trauma over the tendon of Extensor Carpi Radialis Brevis (ECRB) at the common extensor origin. Most cases respond to conservative treatment while resistant cases may need arthroscopic or open surgical release. Objective: This study aimed to compare the clinical and functional outcomes of arthroscopic and open release for resistant tennis elbow in selected patients. Patients and Methods: This prospective study was conducted over three years (between 2015 and 2018) and included 30 patients with resistant tennis elbow. The patients were randomized into two equal groups with …

Evaluation Of Tendon Transfer For Radial Nerve Palsy, Ibrahim Dawood, Magdydy Abd-Almoktader Abdel-Kreem, Mohamed Fareed

Al-Azhar International Medical Journal

ABSTRACT Background: Radial nerve palsy had disabling effect on hand function, leads to loss of power grip due to lost extension. Many surgical procedure was described to restoring function, tendon transfer is an important option due to bad reputation of nerve repair. The donor site from muscle supplied by the median and ulnar nerves. Aim of work: Evaluation of different methods of tendon transfer for management of wrist and finger drop in radial or PIN palsy. Patient and Methods: 20 patients with radial or PIN palsy. Presented with post traumatic injury, 14cases in the arm with total radial nerve, 6cases …

Effects Of Coronavirus (Covid-19) Pandemic On Orthopedic Residency Program In The Seventh Largest City Of The World: Recommendations From A Resource-Constrained Setting, Marij Zahid, Syed Arif Ali, Naveed Baloch, Shahryar Noordin

Section of Orthopaedic Surgery

The coronavirus (COVID-19) pandemic has hit the entire world hard. Since its inception from Wuhan China the whole world is affected now. Health care facilities and workers are overwhelmed and the situation is changing on daily basis. With the changes in the dynamics of the hospitals, residency and fellowships training programs have also suffered undoubtedly. Due to decreased elective cases and outpatient clinics surgical training gets compromised, however on the other side this physical distancing and isolation have proven to be effective measures in controlling the disease. In this article we share our experience of effect of COVID-19 pandemic on …

Seasonal Influence On Postoperative Hip Fracture Complications: Retrospective Cohort Of More Than 1000 Patients From A Tertiary-Care University Hospital, Obada Hasan, Mashal Amin, Fatima Mahmood, Amna Rabbani, Umar Rabbani, Shahryar Noordin

Department of Paediatrics and Child Health

Background: Hip fractures account for one of the most debilitating conditions affecting the general population amongst the developed and developing nations. Investigators aimed to study the influence of the ongoing season i.e. whether patients operated upon in summer or winter, on post-operative complications occurring within 30 days of surgical procedure for hip fractures at a tertiary care hospital and level 1 trauma center.
Materials and methods: Investigators conducted a non-funded, non-commercialized retrospective cohort of 1045 patients with hip fractures managed surgically. Primary exposure was surgical procedures undertaken during the summer months (April-September). Our primary outcome was determining post-operative complication rates …

Effectiveness Of Home-Based Rehabilitation Program In Minimizing Disability And Secondary Falls After A Hip Fracture: Protocol For A Randomized Controlled Trial, Anum Sadruddin Pidani, Saniya Sabzwari, Khabir Ahmad, Ata Khan, Shahryar Noordin

Department of Surgery

Introduction: Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population.
Methods and analysis: …

Do New Trainees Pose A Threat To Postoperative Complications After Hip Fracture Surgeries? Retrospective Cohort Of 1045 Patients Over A Decade At A University Hospital, Obada Hasan, Mashal Amin, Umar Rabbani, Amna Rabbani, Fatima Mahmood, Shahryar Noordin

Department of Paediatrics and Child Health

Introduction: Induction of new residents and surgical trainees in most institutes occurs once a year. Fresh residents with no experience, may pose a threat to the surgical procedure outcome and there can be a potential increase in patients' morbidity and mortality as a result of this turnover. Literature is inconclusive about this effect. Our aim was to study the "new residents' induction effect" on postoperative complications after hip fracture surgeries.
Methodology: This is non funded non commercialized study from a university hospital. Investigators studied a retrospective cohort of 1045 adult hip fracture patients who were operated at our tertiary care …

Functional Results Of Osteosynthesis With Mini-Plate And Screws In Metacarpal Shaft Fractures, Hossam Abdelhady, Faisal Zayed, Mohamed Salah

Al-Azhar International Medical Journal

ABSTRACTBackground: Metacarpal fractures are usually managed by conservative methods, but using these conservative methods in unstable fractures usually showed poor results. Surgical intervention is recommended in this fracture types.Purposes: This study aims to assess the functional outcomes of plate fixation in metacarpal shaft fractures. The assessment was done by using Total Active Flexion score according to the American Society for Surgery of the Hand.Patient and Methods: This study was a prospective study conducted at Al-Hussein University Hospital in a period between April 2017 and November 2019. This study was conducted on a total of 20 patients diagnosed with displaced, irreducible, …

Posteromedial Plate As Strategy For Fixation Of Posterior Column Of Tibial Plateau Fracture, Mohamed Sabry, Adnan Sebaie, Ahmed El Geushy

Al-Azhar International Medical Journal

Background: A posteromedial tibial plateau fracture is considered a challenging injury pattern of the tibial plateau. Fracture line lies in the coronal plane leading to separation of a posteromedial fragment of variable size. This type of fracture is not rare, but it has been underappreciated previously. Objectives: This study is aiming to spot light on posteromedial approach as new concept in treatment of tibial plateau fracture as regarding to clinical and radiological outcome and to assess its surgical efficacy and advantages in such cases and to show is it beneficial to the patients or not? Patients and Methods: This is …

Immediate Changes In Hemodynamics And Gas Exchange After Initiation Of Noninvasive Ventilation In Cardiac Surgical Patients, Mohammad Hamid, Mohammad Irfan Akhtar, Saba Ahmed

Department of Anaesthesia

Introduction: Cardiac surgery is associated with pulmonary dysfunction and complications such as prolonged intubation and reintubation. Bilevel positive airway pressure (BiPAP) machine has been used in the clinical settings to improve oxygenation, reduce work of breathing, and avoid reintubation. The effect of BiPAP on cardiovascular parameters is not well established, and very few studies have targeted hemodynamic changes. The aim of the study was to assess the immediate effect of BiPAP on respiratory and hemodynamic parameters in post-cardiac surgery patients.
Materials and methods: This quasi-experimental study was done on 33 adult cardiac surgery patients. Ethical review committee approval was sought …

Management Of Laryngotracheal Trauma: A Review Of Current Trends And Future Directions, Muhammad Wasif, Rahim Dhanani, Shayan Khalid, Mohammad Sohail Awan, Muhammad Hassan Danish, Huzaifa Moiz, Hamdan Ahmed Pasha

Section of Otolaryngology, Head & Neck Surgery

Laryngotracheal trauma is rare but can pose serious threats to one's life. Presenting symptoms vary according to the severity of injury. Immediate Airway control is first step in the management, intubation should be considered by a senior member of the trauma team if the injury is minor while tracheostomy should be reserved for more severe injuries. Evaluation by a fibre-optic laryngoscopy and CT scan should be done whenever possible. Reconstruction is done according to the site involved using suture, titanium miniplates and stents. Tissue engineering has added a new horizon in this management but up till now complete laryngotracheal regeneration …

Health Care Professionals’ Compliance To Tracheal Suctioning Policy At A Tertiary Care Hospital, Rozina Khimani, Fauziya Ali, Salma Amin Rattani, Mohammad Sohail Awan

Department of Surgery

Objective: To assess the compliance of tracheal suctioning practices against the standard guidelines of a tertiary care hospital, with regard to the participants’ professional characteristics.
Methods: Using cross sectional study design, forty health care professionals (HCPs) were assessed twice, using a quantitative structured observational design, for tracheal suctioning practices, in one of the surgical care units of the tertiary care hospital. Tracheal suctioning policy which was used as a tool, its inter-rater reliability was tested and each step showed the Kappa value of 0.65 to 1.000. Data was analyzed using epidata info version 3.5.1 and SPSS version 19.
Results: From …