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This is a prospective study of sixty long posterior flap below-the-knee amputations done by the KhonKaen University externs under closed Supervision of qualified orthopedists. Post-operatively red rubber bulb drainage was used instead of the hemovac.The patients were all leprotic and held in custody by Nonsomboon Leprosarium. Twenty-nine cases were affected by malignant change of the long standing trophic ulcer, while 29 had chronic ulceration and osteomyelittis of the tarsal bones with useless deforned feet. One was due to painful Boyd’s stump and the other form persistent infection after transmetatarsal amputation. Eighteen cases of stitch abscess and two cases of hematoma collection were detceted but no any wound disruption were seen in our series.
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The purpose of this study was to compare the efficacy and the results of bowel training with soap and bowel training with Dulcolax rectal suppositories in paraplegic patients who had spinal cord lesions. The subjects were 8 males (average age 24.6 years) and 2 females (average age 30.5 years) who had spinal cord injuries at the level of T4-L1. The subjects were divided into 2 groups, 5 each, by the block randomization method. The first group received soap rectal suppositories once a day for 4 days, then changed to Dulcolax rectal suppositories for another 4 days. The second group received Dulcolax rectal suppositories during the first 4 days and then changed to soap rectal suppositories for 4 days. The purpose of the suppositories was to induce bowel movements so that the patients would defecate only when using suppositories and avoid accidental bowel movements there after. The efficacy of the suppositories in inducing defecation was 32% for soap and 41% for Dulcolax, which rates were not statistically significant. The result of bowel training with soap rectal suppositories which caused no accidental bowel movement was 100%. The result with Dulcolax rectal suppositories was 90% because there were 4 accidental bowel movements. Proctoscopic examination showed no complications in any cases. Two patients had mild abdominal discomfort and one had diarrhea after using Dulcolax.
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Background : There are many conditions of phalangeal fractures require digital external fixators both commercial and disposable. The biomechanical comparative studies of these fixators have not been reported especially for disposable digital external fixators(DDEFs). The new design, adjustable length digital external fixator (ALDiEs) was innovated Purpose : To compare the biomechanical properties of various DDEFs.Materials and Methods : Synbone ; Swiss made, Model 4060 900285 were used to be the phalangeal model for the biomechanical testing. Three types of DDEs and their applications were tested. Ten samples of each type were fixed into phalangeal models. Biomechanical analyses were performed by material testing machine, Loyed Instrument interfaced with Windap data analysis software. The structural stiffness (SS), Yield stress (YS) and ultimate stress (US) both in compression and distraction forces were recorded. Statistical analysis was performed using ANOVA and a post hoc LSD .Study design : Experimental studySetting : Orthopedics department, Faculty of Medicine, Khon Kaen UniversityResults : The SS of one frame Poorman DDEFs, Godwin DDEFs and ALDiEs were 14.54, 14.83 and 12.43 N/mm. in orderly. The Godwin DDEFs had the highest SS (P
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Background. : The point and moving two-point discrimination are the useful test for the patients who had nerve injuries in the hand and for following up after nerve recovery. The compasses are cheap and available instrument for those tests. But there was no study showing the reliability of the compasses compared with the Disk-criminator.Objective: To assess reliability of the compasses for measuring two-point discrimination and moving two-point discrimination test compared with Disk-criminatorStudy design: Prospective, descriptive studyMaterials and Methods: The static and moving two-point discrimination test of the thumb and long fingers of the dominant hand were done in the healthy volunteers aged 20-27 years. The compasses and the disk-criminator were used by two orthopedic residents in this study. The test was performed two times 1-2 weeks interval. The Pearson’s correlation coefficient and limit-agreement were used to analyze the reliability of inter- and intra-observers comparing between compasses and the disk-criminator.Results: The means inter-observer correlation coefficient for the two-point discrimination test using the compasses and the disk-criminator were 0.73 (0.69-0.76), and 0.72 (0.69-0.75) respectively. The means intra-observer correlation coefficient for the two-point discrimination test using the compasses and the disk-criminator were 0.73 (0.65-0.82), and 0.82 (0.81-0.83) respectively. The means limit agreement of the two- observer for the two-point discrimination test using the compasses and the disk-criminator were 89.1% (86.7%-91.4%), and 86.9% ( 86.3%-87.5%) respectively. The means limit agreement of the same observer for the two-point discrimination test using the compasses and the disk-criminator were 95.7% (94.5%-96.9%), and 93.9% (92.6%-95.3%) respectively.Conclusion: For two-point discrimination and moving two-point discrimination, the compasses had a high intra-observer reliability similar to the Disk-criminator. It had moderate inter-observer reliability similarly to the Disk-criminator. Using a clinically acceptable error of 1mm, the study found that the compasses had the high limit agreement similar to the Disk-criminator, both in the same observer or between two observers.