No abstract

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">This study was conducted to compare accuracy of MRI findings taking arthroscopy as standard in knee injuries.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">All patients attending our hospital with knee injury underwent clinical examination. Out of them 100 patients with knee injury were subjected to clinical examination, MRI and then Arthroscopy. The results were compared and analyzed using various statistical tests. The accuracy, sensitivity and specificity were calculated based on these arthroscopic and MRI findings</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The accuracy of clinical diagnosis in our study was 88% for ACL tears and 85% for meniscal tears. Our study proved high sensitivity and specificity and almost high accuracy for ACL injuries of knee joint in comparison to arthroscopy. MRI is an excellent screening tool for therapeutic arthroscopy. We can avoid diagnostic arthroscopy in patients with knee injuries having equivocal clinical and MRI examination and go on for therapeutic modality. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">For the assessment of ligamentous and meniscal injuries magnetic resonance imaging (MRI) is accurate and noninvasive modality. It can be used as a first line investigation but arthroscopy still remains gold standard in diagnosing ACL and meniscal injuries.</span></p><p class="abstract"> </p>

No abstract

Background: In most of the institutes Lumbar Microdiscectomy surgery is done under General Anaesthesia. However, it is not uncommon to do these surgeries under Spinal Anaesthesia Aims and objectives: To compare the analgesic effectiveness in postoperative pain, cost-effectiveness and complications of spinal anaesthesia and general anaesthesia who underwent single Level Lumbar Microdiscectomy under General Anaesthesia vs who were administered Spinal anaesthesia for the same Materials and methods: A prospective observational study was conducted on patients undergoing lumbar micro-discectomy in the department of orthopaedics of a tertiary care hospital in Maharashtra, India. The study duration was two years [January 2020 to December 2020]. The patients older than 18 years who were not responding to 6 weeks of conservative therapy, epidural steroid injection, physiotherapy, and having low back pain with radiculopathy with claudication with or without neurological deficit were included in the study. We included 25 cases each in the spinal anaesthesia (SA) and general anaesthesia (GA) group. Outcome variables like peri-operative complications (blood loss, urinary retention, PONV), surgery length, length of stay (LOS), time from entering OT to incision, time from bandaging to exit time, and time of stay in the recovery room were studied among both the groups. Chi-square or fishers exact test to test the difference between proportions and student t-test to test between the means were statistical tests used. Results: The VAS score reduction immediately post-operative among GA group was 79% and SA group was 75% and this difference was not significant. (p>0.05)The time from post anaesthesia care unit from operation theatre [GA Vs. SA; 60.44 minutes Vs. 20.45 minutes] , time of surgery (time to enter in OT to incision) [GA Vs. SA; 30.22 minutes Vs. 15.55 minutes], time from bandaging to exit from OT[GA Vs. SA; 16.34 minutes Vs. 6.12 minutes] and average hospital stay[GA Vs. SA; 3.05 days Vs. 1.61 days] were significantly higher among GA group when compared to SA group. (p<0.05) The average cost of procedure among GA group was 26500 INR and among SA group was 18500 INR. (p<0.05) Conclusions: In terms of VAS pain score reduction, SA was comparable with GA. Our study showed that SA was superior to GA in terms of time consumption, cost, and hospital stay while maintaining better perioperative hemodynamic stability without increasing adverse side effects. Keywords: Lumbar micro-discectomy, Spinal Anaesthesia, General Anaesthesia, Cost-effectiveness

Background: Proximal humeral fracture, whether caused by trauma or osteoporosis, requires meticulously planned individual treatment. The technique and devices used are determined by the quality of bone and soft tissue, age, and reliability of the patients. The purpose of this study is to evaluate the functional outcomes and complications of surgical neck humerus fractures (two part and three part) treated by percutaneous K-wire fixation and PHILOS plating. Methodology: The study includes patients with proximal neck humerus fractures (two-part and three-part) according to Neer's classification who underwent open reduction and internal fixation with a PHILOS locking plate and percutaneous K-wire fixation. Functional outcomes and complications were evaluated by the Shoulder Constant score (SCS). Patients were followed up at 1, 3, and 6 month intervals until fracture union. In this study, a total of 76 patients were chosen and divided into two groups, i.e., Group A and Group B, each comprising 38 patients. Patients of Group A were treated with ORIF PHILOS plating and patients of Group B were treated with closed reduction and internal fixation (CRIF) percutaneous K-wire fixation. Results: ORIF PHILOS plating was used on 20 (26%) of patients who had an excellent SCS. 10 (13%) patients exhibited a good grade, 5 (6%) patients had a fair grade, and the remaining 3 (4%) patients displayed a poor grade. In Group B, 12 (16%) of patients treated with closed reduction with K-wire fixation had excellent grades, 7 (9%) patients had good grades, 16 (21%) received fair grades, and the remaining 3 (4%) received poor grades. After comparing both treatments, a P value was found to be 0.0403, which shows Group A was more efficient than Group B. Conclusion: The results of our study concluded that, as compared to ORIFPHILOS plating treatment with the CRIF K-wire fixation treatment has poor functional outcomes and a high failure rate. In addition, the surgical treatment of proximal neck humerus fractures (two part and three part) in both groups showed that the PHILOS plating provides an excellent way to achieve the goal, including time of union, fewer complications, and good functional outcomes as compared to percutaneous K-wire.