Open appendicectomy stump: invaginate or not to invaginate.

Acute appendicitis remains the most common abdominal surgical emergency. Appendicectomy is the standard treatment of acute appendicitis, which performed by open or laparoscopic approach. During open method, after removal of appendix, stump simple ligation or simple ligation and invagination. A prospective randomized study conducted at Smt SCL General Hospital, Smt NHL municipal Medical College, Ahmedabad between October 2009 to September 2011 to evaluate the necessity of appendicular stump invagination during appendicectomy. A total 110 patients were studied and randomized into two group, Group I stump simple ligation, transfixation and invagination and Group II stump simple ligation and transfixation only. There was no statically significant difference in the rate of postoperative complication and post operative hospital stay between the two groups. The mean operating time was significantly shorter in group without invagination. The rate of postoperative paralytic ileus was more in group I. We conclude that simple ligation of the appendicular stump during appendicectomy is safe, simple and shortens operating time.

Treatment of intertrochanteric fra ctures with percutaneous transfixation and multi-axis bond fixation / 中华创伤骨科杂志

Objective To explore a simple and effective method for the treatment of senile in-tertrochanteric fracture.Methods The cadaveric bone was used for a mech anical test of intertrochanteric fracture fixed with a multi-axis bon d.The patient ' s reduction of fracture was performe d under the X-ray.Three schanz needles were penetrated into the neck of femur 2～3centimeters under the greater trochanter and a lateral screw was driven into the femur 7～8centimeters under the greater trochan ter.One of the schanz needles and the screw were firmly connected with the multi-axis bond.Results There was no a obvious outward angula tion in the experimental group of mechanical test,and the statistical treatmen t showed 0.01

Treatment of Unstable Interochanteric Femoral Fracture using Compression Hip Screw with additional Transfixations Screw / 대한정형외과학회잡지

There are many difficult problems of reduction and its maintaining in the treatment of unstable intertrochanteric fractures. Especially, in cases of elderly patients with marked osteoporosis, prolonged immobilization brings more serious complication. In order to solve these problems, in cases of unstable intertrochanteric fractures with large lesser trochanteric fragment, we have carried out anatomical reduction and rigid internal fixation with compression hip screw and additional transfixation screw on posteromedial fragment. The unstable fractures have been convrted into the stable fractures by transfixation screw. We analyzed the 1 1cases with additional transfixation screw and they showed good results in one year follow up.

Clinical Evaluation Of Surgical Treatments For Displaced Lens: Tranafixation And Para Plana Technique

We experienced 20 patient's 21 eyes of lens displacement including subluxation(16 eyes) and luxation(5 eyes) which were surgically treated by two methods; trans-scleral fixation(14 eyes) and pars plana approach(7 eyes). The causes of lens displacement were trauma(10 eyes), unknown or spontaneous(6 eyes), congenital(2 eyes) and iatrogenic(3 eyes). All patients were male, except 2 female and aging from 11 to 75 years(mean 48.4 years). Post-operative vision showed varying degrees of improvement although 3 showed no change and 1 eye was enucleated for accompanying disorders. Increased intraocular pressures were noticed in 13/21(61.9%) eyes preoperatively, but 3/12(25%) eyes excluding 1 enucleated eye remained high postoperatively, meaning that the intraocular pressure can be normalized by the removal of lens itself. We concluded that these two methods would be adequate modalities for the management of displaced lens, and these two methods share some benifit/drawback over each other. In case of hard nucleus, the pars plana technique must be done very carefully because the fallen, whirling nuclear debris might damage the posterior pole. It may be necessary to switch to the transfixation mehtod.