RESUMO
To compare the efficacy and complications of single incision trans scrotal versus standard inguinal orchidopexy in children with palpable undescended testes. This randomized controlled trial was conducted at the Paediatric Surgery Department Bahawal Victoria Hospital Bahawalpur from April 2007 to April 2010. Children aged 9 months to 12 years, diagnosed as cases of palpable undescended testes were randomized into two groups. In group A orchidopexy was performed through single scrotal incision and in group B by standard two incision inguinal approach. The groups were compared for operative time, hospital stay, scrotal hematoma, wound infection, and secondary ascent. Each group had 134 cases. Mean operative time and hospital stay in group A and B were 28.32 +/- 0.92 minutes and 47.83 +/- 0.76 minutes [p value 0.0001] and 1.027 +/- 0.205 days and 3.023 +/- 0.203 days [p value 0.0001] respectively. There was no significant difference in the formation of scrotal haematoma, wound infection and secondary ascent of testis between the two groups. The conversion rate of surgery in group A was 7.46%.Trans scrotal orchidopexy is the simple, effective and less invasive technique as compared to the standard two incision inguinal approach.
RESUMO
To study the outcome of open reduction and fixation with K wires of supracondylar fractures of humerus in children presenting between 2-14 days after injury. Case series. Department of Orthopaedics, B.V.Hospital Bahawalpur, from April 2009 to March 2010. This study included patients with displaced extension type supracondylar fracture of the humerus [Gartland type III] who presented between 2-14 days post injury. Open reduction and internal fixation[ORIF] with crossed K-wire was done. The results were assessed by the criteria described by Flynn et al and Mark et al. The average age of patients was 4.5 year. The average hospital stay was 2 days [range 1-3 day]. The average duration of follow-up was 15 months [range: 12-24 months]. Forty patients were managed during the study period. Eighteen [45%] patients had excellent results with less than 5 degree loss of range of motion and minimal loss of carrying angle; thirteen [32.5%] had good results out of which seven had less than 10 degree loss of carrying angle and six had less than 20 degree loss of motion. Six [15%] had fair results due to transient nerve lesions. One of the six patients had 30 degree loss of motion. The remaining three [7.5%] had poor results due to varus deformity that needed corrective surgery. Delayed presentation of displaced supracondylar humerus fractures in children did not increase complication rates or unsatisfactory results following an open reduction and internal fixation with K wires. It is a safe and effective method of treatment even with delayed presentation of supracondylar fractures of humerus in children
RESUMO
To compare the morbidity and functional outcome of tube thoracostomy and early decortication in the management of empyema thoracis in children. Comparative study. Department of Paediatric Surgery, Bahawal Victoria Hospital Bahawalpur, from September 2009 to June 2010 A total of 60 cases were included in the study and divided into two groups, each having 30 patients. Group A was managed by tube thoracostomy while group B was managed by early decortication following tube thorcostomy. Radiological lung re-expansion and hospital stay in days were calculated and subjected to statistical analysis. In group A 16 [53%] patients were males and 14 [46%] females. Out of these 10 [33%] patients between 1-4 years of age. In group B 12 [40%] patients were males, with 11 [36%] patients between 1-4 years of age. Mean hospital stay was 15.23 days in tube thoracostomy group and 8.33 days in early decortication group. Radiological lung re-expansion in patients treated with tube thoracostomy [group A] was seen in 18 [60%] patients. In group B radiological lung re-expansion was noted in 24 [80%] patients. Morbidity of early decortication in the management of empyema thoracis in children of 12 years and below was less than the tube thoracostomy with better radiological outcome