Functional outcome of surgery in patients with acetabular fractures

High velocity injuries due to road traffic accidents can be managed conservatively or surgically depending whether the fracture is displaced or not. The objective of this study was to evaluate functional outcome of surgery in patients of acetabular fractures. It was a case series study conducted in Department of Orthopaedic Surgery, Pakistan Institute of Medical Sciences from 1[st] october 2007 to 15[th] December 2008. Thirty patients were included in the study fulfilling the inclusion criteria. Patients were followed up in the OPD and were evaluated for functional outcome by using Harris Hip Scoring System. Total 30 patients were operated during the study period. Mean age of patients was 33.5 years. Males were 22 and females were 8. Twenty-three patients had road traffic accident as a cause of injury and 7 were due to fall. Ninety-three percent of patients were operated within 2 weeks. Most common type of fracture was both column fractures. In only one patient sciatic nerve injury was present postoperatively. Average hospital stay was 7 days. Out of 30 patients, 21 patients were classified to have good score, 4 patients were classified to have excellent score while 5 patients were having poor result. The surgical management of displaced acetabular fractures yields good results

Total Thyroidectomy for benign bilateral multinodular goitre in an endemic region

To assess the safety and efficacy of total thyroidectomy as the primary treatment modality for all patients presenting with a benign bilateral multinodular goitre and to highlight its importance in an endemic region. A retrospective study from June 1998 to December 2005. Setting: Department of Surgery, Khyber Teaching Hospital, Peshawar. 106 patients who underwent total thyroidectomy for bilateral benign multinodular goitre. The data of all the above mentioned patients was recorded and analyzed. Amongst the total 106 patients, the female to male ratio was 5:1. Most patients were euthyroid biochemically. The most common indication for thyroidectomy was compressive symptoms. In the vast majority of patients the final diagnosis was benign adenomatous colloid goitre; the incidence of occult carcinoma was 8.4%. The incidence of permanent unilateral recurrent laryngeal nerve injury and permanent hypoparathyroidism was 1.8% and 0.9% res-pectively. There were no postoperative deaths in this series. The results of this study confirms the safety and efficacy of total thyroidectomy for all patients presenting with bilateral multinodular goitre. This is particularly relevant in endemic regions, where patients present with large, longstanding goitres, which grossly involve both lobes, with virtually no normal thyroid tissue. This approach avoids disease recurrence and the increased morbidity associated with secondary operations

Combined open prostatectomy and pre peritoneal repair of concurrent inguinal hernia

To determine whether concurrent inguinal hernia in patients undergoing open prostatectomy can be safely and effectively repaired by the preperitoneal approach. A retrospective descriptive study from 1994 to 2004. Surgical Department of Khyber Teaching Hospital, Peshawar. Four hundred and ninety eight patients with Benign Prostatic Hypertrophy. All the patients had their history taken, and thorough examination and appropriate investigations done. They underwent open prostatectomy and pre peritoneal repair of the inguinal hernias. Postoperative complications including wound infection, pelvic collection, secondary hydrocoeles, nerve injuries, persistent groin pain, testicular atrophy, hernia recurrence, etc. were assessed during each follow-up visit. Out of the 498 patients that underwent open prostatectomy during the study period, 47 [9.4%] underwent additional 53 preperitoneal hernioplasties; in six patients the hernias were bilateral. In 39 [73.5%] cases the hernias were indirect and in 14 [26.5%] direct. Apart from two [3.7%] recurrences no other postoperative complications were noted that were attributable to the hernia repair. Hernia repair can be performed safely and expeditiously during open prostatectomy using the pre peritoneal approach. This approach avoids a potential future operation as well as the potential complications of unrepaired hernias