Effectiveness of the ligation of intersphincteric fistula tract in the treatment of high lying perianal fistula

Background: Intersphincteric fistula may be ligated during surgery of high lying perianal fistula

Objective: To evaluate the effectiveness of the Intersphincteric ligation technique of the fistulous tract in the treatment of high lying anal fistula

Methodology: Study Design. Quasi Experimental study. Study Setting: Surgical deptt- II BVH Bahawalpur. Sampling Technique: Non-probability purposive sampling. Duration: 1 February to 31 July 2016. A total of thirty patients were recruited for this study, of high lying perianal fistula, and transsphincteric variety. Diagnosis verified by EUA, fistulogram and by MRI. They were subjected to ligation of Intersphincteric fistula tract on elective operation list. All these patients were observed in ward meticulously for 5 days then discharged and follow up done on OPD basis for 3 month for recurrence of fistula and for development of complications like incontinence. The data was entered and analyzed by using SPSS version 20

Results: Twenty five patients were cured. Only 5 patients were declared of recurrence of fistula, all 5 patients were having abscess cavity and that's why fistula tract have not healed. No patient presented with incontinence. The effectiveness of LIFT procedure remained about 83% in this model

Conclusion: The Ligation of Intersphincteric Fistula Tract [LIFT] technique in mid-term evaluation is effective for the treatment of high lying anal fistula

Evaluation of union of neglected femoral neck fractures treated with free fibular graft

To evaluate the frequency of union of neglected femoral neck fractures treated with free fibular graft. Descriptive case series. Department of Orthopedics Bahawal Victoria Hospital Bahawalpur, from April 2009 to January 2010. Patients of neglected femoral neck fracture [one month postinjury] were included in the study. They were operated and internal fixation was done with concellous screws and free fibular graft placed. They were followed till the evidence of radiological union. Out of 55 patients there were 40 males and 15 females. Ages ranged from 20 year to 50 year. The duration of injury was from 4 weeks to 6 months. Fifty patients achieved complete union while five patients developed non-union with complaint of pain. There was no wound infection and hardware failure. Fracture reduction and internal fixation with use of free fibular graft and concellous screws for neglected femoral neck fractures is the treatment of choice

Diabetic hand; management

A case series study held at surgical unit 1. BV Hospital Bahawalpur. Study was conducted from June 2006 to May 2009, to evaluate various aspects of diabetic hand and to establish a protocol to manage it. All diabetic patients presented with hand infection to the unit during this time were included in the study but patients having classical diabetic hand syndrome were excluded. Total 48 patients were admitted during the period under review. Male to female ratio was 2:1 and age was ranged from 31 to 48 years. Data was collected on Performa and shifted to computer program SPSS version 12. All patients were manual workers or house wives and 40 patients gave history of minor trauma to the digits during work. All patients were either undiagnosed [16 patients] or had uncontrolled diabetes. Most of them delayed seeking advice for their trauma and infection of hand properly. During treatment, 30 patients [62.5%] required amputation of one or more digits of the dominant hand including amputation of thumb in 19. Only 4 patients [8.33%] ended up in amputation of hand, whereas, no patient required amputation of forearm. No mortality was seen during study period. It was concluded that diabetic hand involves persons in active life period relatively in younger age group. Undiagnosed or uncontrolled diabetes is major contributory factor. Health education, early diagnosis and prompt treatment in specialized units may be helpful

Role of distant flaps in soft tissue defects of the hand

To evaluate the role of different distant [groin, hypogastric] flaps in soft tissue defects of the hand. Design and Observational case series from Jan. 2002 to Jan. 2005.Bahawal Victoria Hospital, Bahawalpur.32 patients, 28 males and four females with large skin defects on hand due to agricultural machine injury 16], road traffic accidents [8], blast injuries [6] and electric burns [2].In 18 cases groin flap while in 14 cases hypogastric flaps were employed to cover the defects. Results: Two flaps were lost completely, partial flap loss occured in one, marginal necrosis in three, while infection was noted in one case.Distal flaps are useful for the coverage of the soft tissue defects of the hand when applied with proper. indications