RESUMEN
Introduction: Trapezio metacarpal joint arthritis is the commonest of arthritis in hand. It occurs more in females after age of 40 years (post menopausal women). Pain appears in all thumb movements which incapacitates them to do their daily household work. There are various methods of treating this disease like conservative methods including NSAIDS and hot water fomentation; surgical methods like trapeziectomy, stabilizing ligamentoplasty, prosthetic replacement (silicon implats, steffee prosthesis etc, fusion of trapezio metacarpal joint and tapeziectomy with tendon interposition arthroplasty. Non surgical measures forms the first line of treatment with aim of preventing progression of disease, however, surgery becomes an option when symptoms are refractory to nonsurgical methods. Aim: To evaluate the outcomes of trapeziectomy with free rolled tendon palmaris longus interposition arthroplasty for moderate to severe osteoarthritis of trapezio metacarpal joint. Material and methods: We evaluated 10 patients (mean age 50, Eaton Littler stage 3 and 4) who underwent trapeziectomy and palmaris longus interposition arthroplasy for end stage osteoarthritis of thumb carpometacarpal joint. Clinical outcome parameters were determined preoperatively and at 3, 6, and 12 months postoperatively. Results: We have got excellent in 7 cases (9 thumbs), good in 2 cases, poor in 1 case. Conclusion: Rolled tendon arthroplasty using free rolled palmaris longus tendon with trapeziectomy is able to provide high quality results in moderate to severe osteoarthritis of trapezio metacarpal joint.
RESUMEN
Introduction: Fine Needle Aspiration Cytology (FNAC) is a simple, quick and inexpensive method in the head and neck region. It also affords a practicable and means of rationally planning surgery and causes minimal trauma to the patient and carries no risk of complications. Aim and objectives: The aim of this study was to see the frequency of various pathological conditions detected on FNAC in patients presenting with head and neck swellings and to evaluate the role of FNAC in diagnosis of head and neck swelling. Material and methods: A retrospective study was conducted in Department of Pathology, SMIMER Medical College, Surat from July 2014 to June 2015which included 250 patients with head and neck swellings presenting to Outpatient clinics. Fine Needle Aspiration Diagnosis was correlated with detail of relevant clinical findings and investigation. Results: Maximum incidence was observed in the age group 31-40 years with higher incidence among males. Out of 250 cases, 160 cases of lymph node lesions were diagnosed of which non- specific lymphadenitis was the commonest diagnosis (47%) followed by Tuberculous lymphadentities (25%). 57 cases of thyroid lesions were diagnosed, in which incidence rate of benign thyroid lesions was (84%). 12 cases of salivary gland lesions were found, among which pleomorphic adenoma was common (67%). Conclusion: It was concluded that non-Specific lymphadenitis is the commonest condition in patients presenting with neck swellings. FNAC is a simple, safe and inexpensive tool for the assessment of patients with head and neck swellings. It could differentiate the infective process from neoplastic one and avoids unnecessary surgeries. Thus, FNAC can be recommended as a first line of investigation in the diagnosis of head and neck swellings.