Evaluation of Madigan Procedure in the Treatment of Habitual Dislocation of Patella

This was a clinical trial (quasi experimental) study carried outat the National Institute of Traumatology and OrthopedicRehabilitation (NITOR), Dhaka, between July 2004 to June2006, involving 16 patients with habitual dislocation of thepatella. All these cases were managed by Madigan operativeprocedure. Aim of this study was to evaluate the effectivenessof the madigan procedure in the treatment of habitualdislocation of the patella. Out of these 16 patients 2 weresubsequently lost from follow up. So, the study finally consistedof 14 patients. In this study non-random purposive techniqueas per inclusion and exclusion criteria was followed irrespectiveof sex. Most common age group in this study was 6-10 years(62.5%). The mean age of occurrence was 8.25 years.Repeated intramuscular injection on the thigh was thecommonest cause of dislocation found in 37.5% cases. Thesecond most common cause of dislocation was history of boil.Abscess or cellulitis on the thigh followed by contracture of thequadriceps muscles. Various postoperative complications likehypertrophic scar constituted (18.75%), stitch granuloma(6.25%), restriction of knee motion (6.25%) and re-dislocationoccurred in (6.25%) cases. Functional outcome in themanagement of habitual dislocation of the patella wasanalyzed by using the Hospital for Special Surgery (HSS) kneescore. Regarding the final or overall results in this series, therewere 71.43% cases were found satisfactory and the remaining28-57% were found unsatisfactory result.

The Outcome of Primary Rigid Internal Fixation of Displaced Fracture Neck Of the Femur with Muscle Pedicle Bone Graft in Young Adult

Objective: In this study our main aim to evaluate the outcomeof primary rigid internal fixation of displaced fracture neck ofthe femur with muscle pedicle bone graft in young adult.Methodology: This prospective observational study wasconducted at National institute of traumatology and orthopaedicrehabilitation (NITOR), Dhaka from July 2003 to June 2005.During the study, recent neck femur fracture 12 cases, inbetween age 20-55 years irrespective of gender were taken asa sample.Results: In the experiment, 75% were male patient and 25%were female patients. 66.67 % patients with type 1V fractureand 33.33% patients were with type III fracture. Also, after thetreatment. 83.33 % patients obtained satisfactory result and16.67% was unsatisfactory.Conclusion: From our study we can conclude that thistechnique is especially applicable in early days of fracture toachieve union and revisualization of the proximal fracturefragment and prevent non-union or avascular necrosis. Thefollow up period of this initial study is short, long-term follow upand evolution of the viability of this procedure should provideadditional useful result.

Study to Determine the Definite Percentage of the Different Analgesic Drugs and Analgesic Techniques Used At the Postoperative Ward for Pain Management in Sir Salimullah Medical College Hospital, Mitford, Dhaka

Background: The rationale of determining the percentage ofanalgesics used in postoperative period is to determine the realutilization of opioid sparing effect of nonsteroidal antiinflammatory drugs and the concept of multimodal analgesia.Objectives: To determine the cost of opioids consumptionbecause the opioids are expensive.Methods: Total 541 patients were selected to find out thetypes of analgesics are being used in the postoperative eperiod irrespective of the types of operation and anaesthesia,premedication by analgesics and intraoperative analgesicsused or not. Patients were divided into several age groups.Results: In the existing prospective cross sectional study it isviewed that combination of intramuscular injection of pethidineand nonsteroidal anti-inflammatory drugs (either in suppositoryform or intravenous or intramuscular route) have the highestpercentage in postoperative pain relief.