Fingertip includes the portion of the digit which is distal to the insertion of flexor digitorum profundus (FDP) tendon and the extensor tendon. It is the most vulnerable part of the hand to be injured. So, reconstruction of this part requires a good outcome in sensation and function. To meet the goal of the reconstruction principle, "Like with Like" local flap is the most preferable. Such type of flap is a Volar oblique triangular flap based on volar perforator vessels from the Digital artery proper. The aim of the study is to identify its reconstruction outcome in viability, sensation, range of movement of DIPJ, and patients' satisfaction regarding contour. This was a prospective observational study; ten patients were included who were admitted in the Burn and Plastic surgery Department of Rajshahi Medical College Hospital, Rajshahi, from September 2019 to December 2020. Thirteen flaps were harvested to cover for the fingertip defect of ten patients; among them, three were female. The age range of our operated patient was 2- 38 years. None of the flaps was lost except marginal necrosis or epidermal loss. The range of movement of DIPJ and 2SPD were within the normal limit. Patients were satisfied with their contour. So, the modified volar oblique, triangular flap is one of the good options for fingertip defects. TAJ 2021; 34: No-1: 63-69
Background: Anterior cervical discectomy with fusion (ACDF) is challenging with respect to both patient selection and choice of surgical procedure.Objectives: The aim of this study was to evaluate the clinical outcome of anterior cervical discectomy and fusion with an artificial cage made of polyetheretherketoneMaterials & Methods: From January 2012 to January 2017, 80 consecutive patients referred to the Department of spine surgery, Bangabandhu Shekh Mujib Medical University were recruited for the study. Postoperative Clinical outcome assessed with Nurick scale for myelopathy, Odom's criteria for functional outcome and Visual Analogue Scale (VAS) for both neck and arm pain. Radiological fusion was assessed by X-ray. Operative complications were reported.Results: 36 patients were operated for one level discectomy and fusion with PEEK cages and 44 patients for two levels. There were 48 (60%) males and 32 (40%) females. The age of the patients ranged from 30-72 years, a mean ± SD 45 ± 8.34. At the 2 years clinical follow-up, there were significant post operative improvements of Nurick scale, and VAS comparative to preoperative record. According to Odom's criteria, 72/80 patients (90%) were graded excellent-good.Conclusion: Anterior cervical discectomy and fusion with polyetheretherketone (PEEK) cage is an effective treatment of cervical myelopathy having higher fusion rate and lack of donor site morbidity.KYAMC Journal Vol. 9, No.-1, April 2018, Page 32-34
The study was carried out to report the results of marginal resection in sacral chordoma using a posterior midline approach. The study was carried out between July 2008 to June 2016, there were 21 patients who underwent the operation. Fourteen patients were male and seven were female and age ranging from 28 and 76 years. All most of the patients presented with pain, sacral mass and neurological deficit. Total sacrectomy and bone reconstruction were carried out in 11 patients. Subtotal sacrectomy was carried out in the remaining ten patients. Patients were followed up for at least seven years. Recovery after the operation was good. Duration of operation ranged between three to six hours. Three to five units blood was transfused in all patients after operation .Bowel and bladder dysfunction were almost all patients. After surgery following local complications including infection and wound disruption occurs in three patients and seroma occurs in two patients. Three patients (14%) had tumor recurrence and one patient expired three years after operation. 18 patients were still tumor-free at long term (seven years) follow-up. Marginal resection of sacral chordoma through posterior approachcan be a management plan for sacral chordoma with acceptable results.TAJ 2017; 30(1): 21-26
Ewing's sarcoma is a primary bone malignancy with the highest incidence in the first decade of life. Although it mostly affects the diaphyseal as well as metaphysical region of growing long bones but involvement of spine is not very uncommon especially the sacrum. Nonsacral spinal Ewing's sarcoma is rarer and often mimics a benign condition before spreading extensively. They present with neurologic deficits due to spinal cord compression, but acute onset paraplegia is very rare.A high index of clinical suspicion can clinch the diagnosis early in the course of the disease. A prompt intervention is required to keep neurological damage to a minimum, and a correct combination of surgery, chemotherapy, and radiotherapy is required for better long-term patient outcome. We report a 15-years old male who presented with acute paraplegia and had an excellent postoperative outcome after posterior decompression of a D 11 Ewing's sarcoma.TAJ 2013; 26: 92-97
As hand is a functional part of the body, dorsal surface of digits, hand and wrist is prone to injury causing complex wound. Thin, mobile and supple skin of the dorsal wrist and hand make significant for hand functions and aesthetic. Aims of the study were feasibility of the flap in terms of survivability of Superficial Inferior Epigastric artery (SIEA) flap, complications of flap and measurement of functional & aesthetic outcomes to achieve the reconstruction goal in hugely burden regional medical college hospital. 11 SIEA flaps were done in Rajshahi Medical College Hospital from August 2019 to July 2021 on both hands among both male and female patients. Only 2 (18.18%) flaps were lost partially. Almost all the wounds were covered successfully with good functional and aesthetic outcome. So, SIEA flap is the one of the best workhorses for extensive dorsal complex wound in overburdened regional medical hospital in Bangladesh.
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