RESUMO
Objective: To find the outcome of bipolar hemiarthroplasty using posteriolateral and lateral approaches
Study design: Descriptive case series
Place and Duration of study: Departments of Orthopaedics and Spine Centre, Ghurki Trust Teaching Hospital Lahore, from January 2015 to December 2016
Methodology: Patients of either sex and of age above 40 year, who presented in Emergency Department with femoral neck fractures, were included in the study. Data included basic demorgraphic profile, Harris hip scoring, duration of surgery, hospital stay and blood loss
Results: A total of 200 patients were included in the study. There were 77 [38.5%] males and 133 [61.5%] females. Male to female ratio was 0.58:1 with mean age of 58.2 +/- 6.02 year. Mean follow up was 14.2 +/- 2.5 months. In 134 [67.0%] patients there was history of fall, 41 [20.5%] presented with fracture after low energy vehicle accident, 20 [10.0%] presented after high energy vehicle accident. Duration of surgery and blood loss were less in posteriolateral approach. The complication rate and Harris hip scoring was similar in both the approaches
Conclusions: Outcome of surgery in terms of infection, mobility and pain as well as dislocations were similar in both the approaches. The posterior approach was superior in terms of short duration of surgery and less blood loss
RESUMO
[1] To look into clinical presentations of intra-abdominal foreign bodies; [2] To document surgical procedure performed. [3] To see measures for prevention. Observational case series. Bahawal Victoria Hospital Bahawalpur. Period: From 1 .06.07 to 31 .5.08. Eleven patients with retained having intra-abdominal foreign body were treated. Relevant history, clinical examination and necessary investigations were done. Exploratory laparotomy was done in 1 0 cases to remove the foreign body and in one case foreign body passed from the rectum without laparotomy. Out of 11 cases, 54.54% are males and 45.45% were females. Operated in emergency 81.81% and elective 18.18%. 90.91% were operated in periphery and 9.09% in the tertiary care centre. Clinical presentations were intestinal obstruction [27.27%], intraabdominal abscess [13.18%], Discharging sinus [18.18%], mass abdomen [18.18%], entero cutaneous fistula [9.09%], peritonitis [9.09%]. Exploratory laparotomy was done in 90.91%, to remove the foreign body and in 1 case passed per rectum. Retained foreign bodies presented as intestinal obstruction, abscess, sinus fistula mass, or peritonitis. It is avoidable iatrogenic surgical complication, mostly found in operations done in emergency and at peripheral hospitals. Exploratory laparotomy remains the mainstay of treatment to remove the intra-abdominal foreign body. Surgeon should be vigilant to avoid mishap by check on counting, tucking sponge, blackboard counting, examining abdomen, screening in suspicious case and claim for radio-opaque sponges. Referral system needs improvements for in time adequate treatment