Background The aim of our study was to evaluate the efficacy of Modified Stoppa approach for surgical treatment of acetabulum fractures by analyzing clinical and radiological outcomes. Also, we assess intraoperative and postoperative complications of fracture treated by using Modified Stoppa approach. Objectives To evaluate clinical outcomes of Modified Stoppa approach by using Merle d'Aubigne hip score. To evaluate the radiological reduction quality of Modified Stoppa approach by using the criteria of Matta, and to assess complications of Modified Stoppa approach. Method Thirty-two patients participated in this study (mean age 40 years; range 18-60 years) and the male to female ratio was 4:1, patients who underwent surgical intervention for acetabular fracture by using Modified Stoppa approach from Oct 2017 to April 2019 were included. Out of 32 patients, two were lost in follow up, leaving 30 of 32 patients for clinico-radiological analysis. We classified the fracture pattern according to Judet and Letournel classification based on preoperative X-ray AP view, Judet View, and 3D-CT pelvis. Operative time, blood loss, reduction quality, and perioperative complications were assessed in each patient. Clinical outcomes were assessed by Merle d'Aubigne hip score and radiological outcomes by criteria of Matta. Results Out of 30 acetabulum fractures in 30 patients, three (10%) were categorized as anterior column fracture, one (3.3%) as transverse with posterior wall, one (3.33%) as T-type, six (20%) as anterior column with posterior hemi-transverse and 19 (63.33%) as both column fractures. In our study, most patients have trauma due to road traffic accident (RTA) in 25 (83.3%) and fall from stairs in three (10%) patients. Timing of surgery after trauma was average 5.83 days (range three to 15 days), Mean surgical time determined to be 214.66 min (range 150-350 min) and mean intraoperative loss 683.33 ml (range 230-1250 ml). Clinical outcomes by Merle d'Aubigne hip score was excellent in 13 (43.33%), good in 15 (50%), fair in two (6.66%) patients whereas poor results in 0 (0%) patient (p=0.001). Quality of reduction by Matta criteria was found to be an anatomical reduction in 26 (86.6%), imperfect reduction in three (10%), and poor reduction in one patient (3.33%) (p<0.001). Radiological grading by Matta criteria was excellent in 24 (80%), good in five (16.66%), and fair in one (3.33%) patient, and no patients met criteria for poor results (p<0.001). In operative complications one patient developed an external iliac vein injury which was repaired by a vascular surgeon, one patient had a superficial infection for which debridement, regular dressing, and IV antibiotics given and resolve in one month, obturator nerve injury in one patient which was resolve in five to six months, lateral femoral cutaneous nerve injury in one patient which resolved within three months and one patient urinary bladder injury which was repaired by a general surgeon. Conclusion Our experience with Modified Stoppa approach for surgical treatment ...

<p class="abstract"><strong>Background:</strong> Ganglion is the one of the common soft tissue swellings in the hand and wrist. Treatment options available include reassurance, nonsurgical means like aspiration with or without steroid or hyaluronidase injection and surgical or arthroscopic excision. All current treatment options produce suboptimal results. This study endeavours to compare the outcome and recurrence rate and other complications after treatment of wrist ganglion by aspiration and methylprednisolone injection by double Intravenous cannula versus single needle technique.</p><p class="abstract"><strong>Methods:</strong> A prospective comparative clinical study was done with a total of 72 patients. 36 patients in group 1 were treated with double intravenous cannula technique and 36 patients in group 2 were treated with single needle technique. All the patients were followed up for 6 months to look for recurrence and any complication. The patient’s age, sex and various characteristics of the ganglion cyst like side, site, size, etc. were recorded.<strong></strong></p><p class="abstract"><strong>Results:</strong> In group 1, recurrence was seen in 6 patients (15.7%) while in group 2, recurrence were seen in 14 (38.8%) patients. There was statistical significant difference between the two groups with p value of 0.04. No complication was seen in both groups due to methylprednisolone injection.</p><p class="abstract"><strong>Conclusions:</strong> Inspired by the results we advise to use aspiration and methylprednisolone injection by double intravenous cannula technique in the treatment of wrist ganglion before any surgical intervention. It is safe, simple, cost effective method and is less invasive and less time consuming with recurrence rate comparable to surgical and arthroscopic interventions.</p>

<p class="abstract">Dislocations of the carpometacarpal (CMC) joints are uncommon injuries. Up to 70% of carpometacarpal dislocations are missed or misdiagnosed. Post traumatic dislocation of carpal and CMC joint results most commonly due to high energy trauma. A 24 year old male with right hand dominant presented 5 days after in emergency room with alleged history of fall from 4 feet height on right hand with wrist in extension. On clinical examination revealed marked swelling over dorsum of right hand with wound over volar aspect of hand. There was minimal movement of fingers due to pain. There was no finger paresthesia. CRT was normal. Radiography revealed a volar dislocation of 2nd to 5th CMC joint with intra-articular fracture of base of proximal phalanx of the thumb. He was treated by open reduction and percutaneous fixation using Kirschner wires. The functional results were excellent at 6 months of follow-up.</p>