ABSTRACT
Background: Acute resuscitation is one of the most challenging aspects of caring for burned patients. Although the Parkland formula is still the most common employed resuscitation formula worldwide, it is far from a perfect solution. Materials and Methods: This is a prospective observational study, which was carried out over a period of 3 years. A total of 50 patients were enrolled. Modified Parkland formula and heliotherapy were used in the management of moderate degree burns. Result: Out of 50 patients with Moderate degree of burns 47 survived (mortality rate: 6%). One of the deaths in occurred during the period of resuscitation (day 2). While the other two deaths were related to septic shock. Urine Output (ml/kg/h) of 0.72 ± 0.06 and 0.92 ± 0.05 was noted on day 1 and 2, respectively. Conclusion: Modified Parkland formula and heliotherapy proved to be effective in our set-up in comparison to the conventional Parkland formula and protocol for management of burns, as reflected in the published literature, thus, we recommend multicentric trials to test the efficacy of this technique, in management of burns.
ABSTRACT
Background: Management of calcaneal fractures has always been in controversy. Many treatment techniques have been described, but specific indications are vague. In this prospective study, we studied the functional outcome of surgically treated intra-articular calcaneal fracture. Aim and Objective: To study the outcomes in terms of mechanism of injury, intra-operative difficulties, post-operative complication, infection, the range of motion in the surgically managed calcaneal fracture. Materials and Methods: A total of 32 Patients with 34 calcaneal fractures operated in NCH Surat from September 2012 to December 2014 were included in the study. Pre-op computed tomography (CT) scan carried out in all patients. Maryland foot score was used to evaluate to assess the functional outcome. Results: Incidence is much more common in males (90.6%), most of the patients being in their 3rd decade of life. The spinal fracture was the most common associated injury (30%). Results according to Maryland foot score were excellent in 26.4%, good in 61.64%, and none of the patients had poor results. Complications include synovitis, broadening and superficial infection. Pre-op CT scan is very useful tool in calcaneal fractures. Conclusion: Open reduction internal fixation is the ideal treatment for Sanders type 2/3/4. Even Sanders Type IV (which was thought to be associated with poor results) had a good outcome in short-term follow-up. Use of proper surgical timing/technique/asepsis can lead to good or excellent results in more than 90% of patients and avoiding the majority of the complications. Use of beta-tricalcium phosphate is not a cost effective measure as results are similar in all patients. Earlier mobilization, early return to work, good cosmesis, better subtalar motion are all advantages of surgery.