role of early mobilization in the prevention of post operative wound infection after lower extremity orthopedic surgeries

To determine effects of early mobilization in reducing post operative wound infection after lower extremity orthopedic surgeries. Quasi Experimental Study. This study was carried out at department of orthopedics Pakistan Railway General Hospital Rawalpindi, from August 2010 to July 2012. Eighty nine patients who had undergone lower extremity surgery were conveniently placed into early mobilization group A and delayed mobilization group B. All the patients mobilized within first week after surgery were included in group A, and those mobilized after one week of surgery were included in group B. Patients' wound infection was defined as local redness, pain, and pus discharge within three weeks after surgery. Results were analyzed using Chi-square test with SPSS-16.0. Minimum age of patients in this study was 10 and maximum 90 years with a mean of 45 in group A and 44 in group B. The total number of the cases of wound infections was 6 [6.74%]; 2 [4.4%] in the early mobilized group and 4 [9%] in the delayed mobilized group. Statistical analysis showed significant difference in the number of wound infections in both groups and the result for group A was statistically more significant [p value=0.03] as compared to result] for group B [p value =0.06]. We conclude that after lower extremity orthopedic surgeries, early mobilization is needed, as it significantly reduces the postoperative wound infection rates, and early mobility is achieved

Comparison of suprascapular nerve block and intra-articular injection in the treatment of frozen shoulder

The objective of this study was to compare the effect of supra scapular nerve block and intra articular injection to relieve pain and reduce disability in the patients of frozen shoulder. It was a quasi experimental study. The study was conducted at the department of Orthopedics, Pakistan Railway Hospital, Rawalpindi, fromAugust 2011 toSeptember 2012. Patients diagnosed as the cases of frozen shoulder in outpatient department of Orthopedics irrespective of their gender were included in the study. Forty patients and 50 shoulders were divided into two groups by randomization, one group received single suprascapular nerve block and second group received single intra-articular steroid injection. Both groups were advised for physiotherapy after injection. Patients' pain levels and ranges of movement were assessed over a period of twelve weeks. The study included 40 patients and 50 shoulders to a single suprascapular nerve block and intra articular steroid injection. The mean age of the patients was 49.4 + 9.97 and the range was 40-60 years. There were 16 females and 24 male patients. Post injection assessment of patients was done at two, six, eight and twelve weeks. There was a significant decrease in pain and marked improvement in range of movement with supra scapular nerve block than with intra articular injection. Patients' pain levels and ranges of movement were assessed over a twelve week period. Suprascapular nerve block produced a faster and more complete resolution of pain and restoration of range of movement than intra articular injection

Closed interlocking tibial nailing without using an image intensifier

Internal fixation with interlocking nails is commonly performed using an image intensifier which is expensive and is not readily available in most resource-poor countries of the world. The aim of this study was to achieve internal fixation with interlocking nail without the use of an image intensifier and to study the mean union time and complications in these patients. It was a quasi-experimental study. This study was carried out at Railway General Hospital [RGH], Rawalpindi over duration of two years from January 2010 till December 2011. 22 closed tibial shaft fractures were fixed with interlocking intramedullary nails without using an image intensifier. The study included 22 closed tibial shaft fractures. The mean age of the patients was 39.4 +/- 9.97 years and the range was 2255 years. There were 8 females and 14 males. Postoperative plain radiographs confirmed that all of the cases had satisfactory positioning of the inserted nails and interlocking screws. The mean union time was 13.8 +/- 4.2 weeks. Two cases of delayed union were seen [union occurred at 24 and 28 weeks]. One case of infection occurred and presented with an infrapatellar abscess. Shortening of 12 mm and valgus deformity occurred in one case due to loosening of distal screw. Internal fixation with interlocking of tibial shaft fractures can be achieved successfully without an image intensifier