: Intra-articular distal humeral fractures can be approached in a variety of ways. The purpose of this study is to evaluate and compare the functional outcomes of two approaches: one with olecranon osteotomy and other with triceps-lifting approach; for the treatment of intra-articular distal humeral fractures.: In this study, 10 patients in Group A were compared with 10 patients in Group B. Both the groups were comparable in terms of age, gender, duration of injury and degree of comminution of the fracture. Results were compared in terms of operative time, hospital stay, union, range of motion and complications. Functional evaluation was done using the Mayos’ elbow performance score (MEPS).: Patients were followed for a minimum of 12 months. Fracture union was seen at or before 4 months in all the patients of both the groups, except in 1 case of Group A where it was seen at 7 months. Average time to union was comparable in both the groups. In Group A, mean range of flexion was found to be 118 degrees (SD 7.33) and extension lag was found to be 11 degrees (SD 3.84). In Group B, mean degree of flexion was found to be 118.25 (SD 4.94) and extension loss of 12 degrees (SD 4.70). Average range of motion was comparable in both groups. There were no significant differences noted between the two groups in terms of mean MEPS (p= 0.573). The overall complication rate was 40% in the TRAP group and 30% in the olecranon osteotomy group.: Intra-articular distal humerus fractures mandate surgical fixation for best functional outcomes. Although technically demanding, TRAP exposure can prove to be as effective as olecranon osteotomy approach. Both approaches appear to yield no significant differences in clinical and functional results for intra-articular distal humerus fracture management.
Background: Most of the emergency abdominal surgeries are either contaminated or dirty, they carry a higher rate of complications, aided by lack of optimization of the patient before surgery as opposed to elective surgeries. Complications related to surgical site encompasses a majority and may be aggravated by pre-existing co-morbid conditions. Seroma, hematoma, wound dehiscence, surgical site infection (SSI) are some of the major complications of surgical wounds. A prospective study was carried out in Department of General Surgery, Assam Medical College and Hospital (AMCH), Dibrugarh, Assam to find out the incidence of surgical site infection (SSI), clinical presentations and causative organisms including their antibiogram.Methods: Total 280 patients undergoing emergency abdominal surgeries in Department of General Surgery, AMCH from June 2017 to May 2018 were included in the study. Preoperative, intraoperative and post-operative details were collected, recorded and analysed. In case of SSI, wound swab was taken for culture and sensitivity and antibiotics tailored accordingly. Regular follow-up for at least 30 days post-operatively was maintained.Results: The incidence of SSI was 21.43%, with male: female ratio being 1.22:1. SSI was highest in the age group above 50 years; 33.33%, and with co-morbidities. SSI seen highest in class 4 wounds (55%). Commonest clinical features were erythema, tenderness, edema around the wound in superficial SSI and deep SSI. Organ space SSI was associated with fever, trachycardia and leucocytosis. The most common isolates were Staphylococcus aereus (55%), Escherichia coli (21.67%), Pseudomonas aeruginosa (11.67%), Klebsiella species (3.3%). Conclusions: To reduce the incidence of SSI, strict adherence to antisepsis protocol specially during intraoperative and postoperative is of paramount importance in emergency surgeries.
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