Frequency of DVT after total knee replacement in Pakistani population by employing color duplex scan

To determine the frequency of Deep Vein Thrombosis [DVT] by Color Duplex Scanning [CDS] after total knee replacement [TKR] in Pakistani population. Interventional study. Department of Orthopaedic Surgery, Combined Military Hospital Lahore, from 1st Sep 2007 to 1st Sep 2008. Thirty five patients, both male and female, age 50 to 80 years, ASA physical status II and III scheduled for total knee replacement [TKR] were subjected to preoperative and postoperative color Doppler to determine the presence of asymptomatic DVT in both legs. None of the patients were administered anticoagulant. DVT was not detected in any case after TKR. One patient developed nonfatal pulmonary embolism on 10th postoperative day. CDS did not pick DVT in this patient. CDS is a useful investigation tool to determine the presence of DVT in total knee replacements surgery. In the West all patients undergoing TKR are administered anticoagulant therapy. This practice is however, not universally accepted in Pakistan. Few studies conducted in Pakistan are equivocal. Present study was done to detect asymptomatic DVT in our patients after TKR. Our study does not show any evidence of DVT as picked up by CDS. The difference could be due to racial factor or the sample size was too small or the yield of CDS may not be very high

Leiomyosarcoma of femoral vein in an adult

A middle aged female presented with a swelling in the groin on the left side. On examination, it was an oval mildly tender firm mass, adherent to underlying structures and extending into the pelvis with pulsatility and bruit. It was diagnosed as leiomyosarcoma of femoral vein on fine needle aspiration cytology and selective left common iliac and common femoral angiography of the lesion. En-bloc wide excision of the mass including the femoral vessels was carried out with saphenous vein graft interposition for restoration of vascular continuity for both vessels. Femoral nerve was sacrificed for tissue clearance. The defect was large and led to permanent limp and walk with a support. The lady was followed up for two years. She was found to have no local recurrence or detectable metastases

Management and outcome of extremity soft tissue sarcomas

To analyze the results of various treatment modalities applied to soft tissue sarcomas of the extremity. Design: An analytical study. Place and Duration of Study: Combined Military Hospital, Rawalpindi during the period January 1994 - January 1996. Subjects and Data was collected from 32 patients. It included age, gender, presentation, diagnostic work-up, treatment instituted followed by evaluation of management. All patients were followed up for 24 months. Seventeen [53%] were males and 15 [46%] were females. Mean age of presentation for males was 50 years and for females 40 years. Most common presentation was a lump on proximal part of the limbs. Surgery was the primary treatment modality in 20 [62.5%] patients followed by adjuvant radio-chemotherapy, whereas in 12 [37.5%] only radiotherapy was employed to local site. In this latter group, 6 [18.75%] were subjected to chemotherapy as well, due to metastatic disease. The management of soft tissue sarcomas of the extremity carried out in our set up was not satisfactory leading to increased incidence of local recurrence and mortality. Appropriate management requires updated knowledge and its application by health professionals. Preferably these tumours should be managed by a dedicated multi-disciplinary team