Epidemiology of non-disaster spinal injuries at a spine unit

To describe the demography, types of injuries and their management in all non-disaster spinal injury patients admitted to the Spine Unit of a tertiary care hospital in Pakistan from 2001-2008. Case series. Spine Unit, Orthopaedic Department, Combined Military Hospital, Rawalpindi, from April 2001 to December 2008. Data of all new non-disaster spinal injury patient admissions, kept in a custom-built database at Spine Unit, was analyzed. Demography, type of injuries and their management was described in percentages. Five hundred and twenty one non-disaster patients were selected out of a total 671 new admissions with spinal injuries. Mean age was 39.1 years and 77% were males. Mechanisms of injury included; fall in 62% and road traffic accidents in 32%. Fracture dislocations and burst fractures were equally distributed [36% each]. Most of the injuries [43.6%] were at T11-L1 level. Forty three percent patients had complete spinal cord injury [SCI], 33% had incomplete SCI and 24% did not have any SCI. Eight patients had concomitant spinal injury at a different level. Twelve percent patients had associated other major injuries. Seventy percent patients were treated surgically. Average follow-up was for 4 years. Non-disaster spinal injury was frequent in young males usually due to fall or road traffic accident. It involved fracture dislocation or burst fracture at T11-L1, level in most cases requiring surgical treatment

Deep vein thrombosis in pelvic and femoral fractures in earth quake victims

The aim of this prospective cum descriptive study was to determine the frequency of deep vein thrombosis using Duplex ultrasound scan, in a group of earth quake victims of 08 October, 2005. All these patients belonged to the high mountain northern areas of Pakistan and were admitted in Combined Military Hospital Rawalpindi with pelvic and/ or femoral fractures without additional risk factors for DVT. None of the patients had prior thromboprophylaxis. Study was conducted in thirty female patients admitted in Family wing of Combined Military Hospital Rawalpindi from Oct 2005 to Feb 2006. Although we managed about 75 such cases, only 30 could be assessed for DVT by duplex ultrasound scan partly due to excessive work load on part of Ultrasound department but also because of early post operative mobilization of the patients as per policy, thus offering little chance of having positive results. Out of thirty patients studied, DVT was found in 01[3.3%] patient, who belonged to Balakot and had pelvic fracture. Clinically she was asymptomatic and had no signs of DVT, but her duplex scan revealed calf veins involvement on the right side, with extension of the thrombus in to the femoral veins as well. Another patient with bilateral upper femoral fractures had painful swelling of both thighs, but her duplex scan for DVT was normal. The percentage of DVT observed in patients belonging to the northern areas is low in comparison to both our urban population research data as well the internationally conducted studies. Factors responsible might be dietary, racial or geographical, either alone or in combination, which need to be determined in focused, prolonged studies