Outcome of operative and non operative treatment of glenoid fossa fractures in a tertiary care hospital in Peshawar

This study was aimed at reviewing operative and nonoperative treatment of Glenoid fossa fractures in our hospital and view to identifying measures necessary to improve outcome. Retrospective study. This study was conducted at Orthopedic Department of Lady Reading Hospital, Peshawar from March 2012 to July 2014. 21 patients of glenoid fossa fractures were included in this series with 14 males and 7 females. Patients with displacement of >5 mm who were fit to undergo surgery within 3 weeks of injury were operated using a posterior Judet's approach. Overall 8 patients with displaced fractures were operated [Group A] while 9 patients with displaced fractures [Group B] and 4 patients with undisplaced fractures [Group C] were managed nonoperatively. The incidence of associated injuries was 57.14%. The mean length of hospital stay was 15.3, 32.5, and 3.9 days in groups A, B, and C, respectively. In group A, average constant score was 86.98. The least constant score was observed for group B [57.97] while group C had an average constant score of 85.9. Brachial plexus injury and fracture-dislocations had poorer outcome. Operative treatment for displaced glenoid fractures is a viable option at centers equipped to handle critically ill patients and subset of patients with fracture-dislocation as opposed to fracture alone should always be treated operatively due to persistent loss of function

Rectal atresia with complete absence of posterior vaginal wall [large rectovaginal fistula] a case report

A case report of congenital anorectal malformation in 21 years old female patient is presented who had history of passing urine and stools per vaginum since birth. Examination under anesthesia revealed absence of anal orifice. Ultrasonography reported a big gas filled mass in the lower abdomen. Barium contrast study was inconclusive. The diagnosis made was high anorectal malformation with big recto vaginal fistula

Tension Free Mesh Hernioplasty Is safe and effective

To evaluate clinically the outcome of mesh hernioplasty in terms of operation time, patient comfort, hospital stay, return to work, post-operative complications and cost.: Descriptive prospective study conducted from July 2003 to June 2005.Khyber Teaching Hospital and Lady Reading Hospital, Peshawar.A total of 80 patients, age >20 years, who presented with inguinal hernia.The data of all these patients was analyzed as regard to the clinical outcome, complications and cost. Inguinal hernia repair was performed on 80 patients with a mean age of 52.6 years. Fifty patients had direct while 30 had indirect hernia. The average duration of surgery was 30 minutes. Three patients had wound infection, four had scrotal oedema, and one had haematoma; but none had persistent pain. The length of follow-up ranged from 2-24 months and no recurrence has been reported so far The extra expenditure for the mesh and antibiotics make the whole procedure more expensive as compared to simple repair.The tension free mesh repair for the inguinal hernia is a safe, very simple and effective technique, and the overall morbidity is very low The clinical outcome and a very low recurrence rate has made it the procedure of choice for all hernia patients, inspite of the fact that it is a bit expensive

Early surgical intervention in penile fracture

To know the mechanism of injuries resulting in penile fractures and the of early surgical intervention in these cases. Material and 24 consecutive patients who presented with a history of blunt penile trauma and clinical signs and symptoms indicating penile fracture during a period of 03 years i.e. from Jan 2000 to December 2002, were included in the study. All of them underwent an emergency operation within 6 hours to 4 days after the incident. Vicryl 3/0 was used as a suture material for repair. Patients were followed upto one year. Among the 24 patients, 18 turned up for follow-up. Fifteen with excellent functional Results:, while 03 had penile curvature and pain during coitus. These three patients had undergone surgery more than 48 hours after the incident. Fracture penis is not very rare and manipulation resulting into blunt trauma to the penis was the commonest cause. An immediate surgical intervention is recommended to avoid serious complications