Background: Epidural steroid injection is a common intervention for symptomatic lumbar disc herniation. It is safe, but not absolutely free from complications. Visual complications and adverse intraocular events are sparse in the literature. This study is done to determine any intraocular complication after caudal epidural steroid injection for discogenic low back pain and radiculopathy. Materials and Methods: It was a prospective study, conducted from April 2018 to December 2019 by the orthopedics and ophthalmology departments of our institute. A total of 31 patients were recruited based on inclusion/exclusion criteria. All the patients presented to this institute with complaints of low back pain and sciatica were investigated. After proper diagnosis, the decision was made for caudal epidural steroid injection as per the standard principles of orthopedic surgery. Eye evaluations (intraocular pressure [IOP], visual acuity, and ocular examination) were done 1 day before, and 2–4 h, 1 week, and 2 weeks after epidural injection. The differences in eye evaluation values between time points were determined and discussed. Results: A total of 31 patients were recruited for this study, out of which the majority of the patients (27 patients) were between 41 and 60 years of age, and males (22 patients) outnumbered females (nine patients). Most of the patients (17 patients) had prolapsed IV disc of L5-S1. IOP was found to be raised after the intervention of epidural steroid injection which gradually came down to a preinjection level within 2 weeks. There was no change in visual acuity and no other intraocular complications, like hemorrhages. Conclusion: Epidural steroid injection for discogenic low backache (LBA) with radiculopathy did not adversely affect IOP, and neither had any ocular complication (in an ophthalmologically normal set of patients). A prudent approach should always be implemented.
Introduction: Capitellar fractures are rare injuries and difficult to manage, especially so if the patient presents late. Treatment is almost always operative. The purpose of this study is to evaluate the functional outcome of capitellar fractures in adults treated by open reduction and internal fixation (ORIF) with cannulated compression headless screws (Herbert screw) with an inadvertent delay of 2 weeks or more. Materials and Methods: Twelve patients (4 males and 8 females) of capitellum fracture who were reported after an inadvertent delay of at least 2 weeks, with near-normal elbow range of motion, operated by ORIF with Herbert screw, were studied retrospectively from April 2013 to March 2019. All cases were operated between 2 to 3 weeks of injury. All patients had a follow-up for a mean period of 34 months, and the final functional outcome was assessed using Mayo Elbow Performance Index (MEPI) and by radiology. Results: The mean MEPI score was 92.9 points, and as per this evaluation of the functional rating, all but one patient had excellent results. The mean range of elbow flexion/extension was 125 (90–140), while the range of movement in supination/pronation was 170 (130–180). Conclusion: ORIF of capitellum fractures with Herbert screw was found to be superior and gives excellent result, even with a delay of around 2 weeks. Preoperative computed tomography is helpful not only to know clear picture of fracture configuration but also to choose right surgical approach and right implant. Apart from stable internal fixation, early mobilization and rehabilitation are the keys for optimum functional outcome.
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