Management protocol for different thumb injury

Treatment of ligament injuries of the thumb depends on the presence or absence of fracture fragments and on the degree of joint stability

comparative study between laparoscopic and lichtenstein tension free repair of inguinal hernia

The use of synthetic non absorbable mesh has revolutionized groin hernia repair. This method is mentioned to reduce the tension on the repair which used to predispose to hernia recurrence. This study was conducted on 100 male patients of different age [20-60] years with unilateral inguinal hernia [85 indirect and 15 direct] who are distributed randomly into two groups each of 50 patients. One group was repaired by the trans-abdominal transperitoneal laparoscopic technique and the other group was repaired by the Open tension free approach of Lichtenstein. The median values for the operative time were 86 minutes [range 65-200] in the laparoscopic group and 36 minutes [range 25-72] in the Lichtenstein group with a statistical significance between both groups [P value is less than 0.001]. Discharge within 24 hours of operation was the rule in both groups with no significant difference. Rehabilitation and return to normal activity and work was shorter in the laparoscopic group than the Lichtenstein group [mean 14 and 19 days respectively] with a statistical significance between both groups [P value is less than 0.05]. As regards complications encountered during and after the operation and recurrence in one year, we have found, no significant differences between both groups. The conclusion is that our initial results showed that laparoscopic hernia repair may be associated with more rapid rehabilitation compared with that of Lichtenstein technique, but requires a significantly longer operative time and carries the same rate of complications and recurrence in one year time of follow up