Articles
Traurma
Open Fractures
The department of orthopaedics and traumatology has been dealing with severe open fractures, multiple trauma and polytrauma with degloving injuries. All the patients are definitely treated primarily at presentation. GIIIA and GIIIB fractures are definitely fixed initially after thorough irrigation and debridement, provided the patient came early within golden hour and are fit for surgery from anaesthesia side.
During short term follow up, there was no infection, and the patients are doing well. The overall hospital stay, treatment period and the cost of treatment is markedly reduced.
Doctor what is the treatment to my father?
70 years old man with GIIIA distal third shaft of tibia fracture presented with in 1 hour of injury. Surgery was done with in 6 hours of injury after thorough irrigation and debridement definitely with intramedullary nail. Wounds healed and was discharged at two weeks. At 3 months patient is walking with full weight bearing and the healing is on progress.
Open Fractures
34 years old gentleman with floating elbow with GIIIB shaft of ulna fracture and distal third shaft of humerus fracture presented with in thirty minutes. Thorough irrigation done and definitely fixed with DCP within six hours. The wound gap in forearm was covered with STSG on 18th day and discharged at 4 weeks of admission. There was no wound infection, healing is on progress and the patient is on regular follow up. His radial nerve palsy is improving.
Twenty two years old gentleman with open dislocation of the right knee with comminuted patella fracture with lacerated wound on anterior aspect of right proximal leg with pulse less leg, with closed right second metacarpal # presented within one hour of injury.
Through irrigation was done in emergency and in OT and definitive surgery was done. Thorough debridement, relocation of the knee, Tension band wiring of the patella fracture and repair of the collateral ligament done with primary closure of the wound. Wounds healed, ROM gained and discharged on 14th day of admission.
Reconstructive Surgery
The another speciality of the hospital is the plastic and reconstructive surgery. We have been doing deformity correction, leg lengthening, extensive skin grafting and surgery for the bed sores. The results are promising.
Can I Survive?
A 38 years old gentleman presented with 20 degrees of deep burn on anterior of chest, whole circumference of neck, left forearm and right hand with in 3 hours of road traffic accident. He had right shaft of
femur fracture, left both bones fracture below the deep burn.done, daily dressing of the wound was done and shaft of femur fracture fixed 1 week later. STSG of anterior chest wall, neck and left forearm was done at 3 weeks of admission. Nearly amputed right thumb and remaining grafting of the left forearm was done later. He was admitted in the ICU, resuscitation was
Patient improved, chest and neck wounds healed, left forearm fixed with DCP and STSG done healed and was discharged at 2 months of admission. Patient is doing well.
