Efficacy of Mechanical Thrombectomy in Preventing Post-Thrombotic Syndrome in Acute DVT: A Retrospective Study.

Background Lower limb deep vein thrombosis (DVT) is associated with significant morbidity and death. DVT can result in complications such as postphlebitic syndrome, pulmonary embolism, and death. Combining pretest probability, D-dimer testing, and compression ultrasound imaging enables a safe and convenient study of suspected lower-extremity thrombosis. This study aimed to assess the expanding body of research supporting thrombectomy as a form of DVT therapy. Materials and Methods A retrospective study was performed on individuals with venous Doppler-confirmed DVT and occlusive thrombus. Four-hundred fifty-one consecutive patients were selected for the study based on the inclusion and exclusion criteria. In this investigation, thrombectomy was the preferred therapeutic approach. Results The study reports a male predominance of 56.1%. Most patients (25.7%) were between the age of 51 and 60, with 84.7% reporting pain and lower-extremity swelling as the two most common clinical symptoms. The femoral vein was noted as the most frequent site of thrombus in the current research (51.0%), with acute DVT accounting for most cases (85.1%). Most of the patients (97.3%) were primarily asymptomatic after one year of follow-up. Conclusion Thrombectomy is a reliable treatment modality for DVT patients in regaining venous patency, preventing DVT recurrence, treating post-thrombotic syndrome, and preventing pulmonary embolism.

Traction splints: effective nonsurgical way of managing proximal phalanx fractures.

BACKGROUND: Treating proximal phalanx fracture without compromising the mobility is difficult. METHODS: Clinical and radiologic results of 30 patients with proximal phalangeal fracture of the hand treated conservatively from January 2004 to December 2006 were evaluated. Application of traction splint was followed by supervised rehabilitation. Patients were followed for 6 months. Results were evaluated using "Total Active Motion Scores" and grip strength. RESULTS: The results were excellent in 72% of the patients, good in 22%, and poor in 6%. For long-term assessment patients were contacted and reviewed in October 2007. Eighty percent patient responded to call and the results achieved were found to be stable in most of the patients. CONCLUSIONS: Proximal phalangeal fractures can be effectively treated by closed methods, using the stabilizing effect of soft tissues (zancolli complex-metacarpophalangeal retention apparatus) and external devices (traction splints), thus enabling bone healing and movement recovery at the same time.

Extensor digitorum brevis muscle flap: modified approach preserving extensor retinaculum.

BACKGROUND: Although numerous reconstructive options for covering defects over distal third of leg and dorsum of foot have been suggested, obtaining satisfactory cover remains difficult problem. Extensor digitorum brevis muscle flap as proximally or distally based island flap has been well described to be a promising alternative. METHODS: Between 2004 and 2005, 10 defects over dorsum of foot and around malleoli were reconstructed with extensor digitorum brevis muscle flap. Six were proximally based and four were distally based flaps. Retrospectively, data were collected from these patients records like age, gender, type of injury, flap used, flap survival, complications, hospital stay, return to work. RESULTS: Mean follow-up period was 17.5 months (26-12 months). Of 10 flaps, one flap had failed (approximately 10%). Minor donor site problem presented in one case (10%). All patients returned to work after variable periods of rest (average 1(1/2) month). First web hypoesthesia was present only in two patients. CONCLUSIONS: This flap provides an excellent local option for small defects around ankle and over dorsum of foot. The advantages of this flap are its easy dissection, reliable blood supply. Disadvantages related to donor site can be minimized with careful technique.

Coverage of defects over toes with distally based local flaps: A report of four cases.

Reconstruction of the distal foot, especially of the toe has always been a challenging problem. Various methods have been tried with variable success rates and limitations. Presented here is a series of four cases, where distally based flaps were used. Two of them were Extensor Digitorum Brevis (EDB) muscle flaps and the other two were first dorsal metatarsal artery (FDMA) based skin flaps. One in each of the two was augmented with a plantar V-Y advancement flap. All flaps survived completely without any flap- or donor site-related complications. The patients were ambulated two weeks following the reconstruction and were symptom-free after an average follow-up of thirteen months. Distal flaps based on the dorsalis pedis system provide a reliable cover for distal foot defects.