Gururaj Joshi | Bharati Vidyapeeth University (original) (raw)

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$Research paper thumbnail of Outcomes of patients treated with minimally invasive plate osteosynthesis in the management of distal tibial fractures$

International Journal of Research in Orthopaedics

Background: Distal tibial fractures are a common injury, often caused by high-energy trauma, and ... more Background: Distal tibial fractures are a common injury, often caused by high-energy trauma, and can result in significant morbidity. Traditional surgical management with open reduction internal fixation (ORIF) is associated with complications including infection and soft tissue injury. Minimally invasive plate osteosynthesis (MIPO) has emerged as a potential alternative, with advantages including less soft tissue injury and a faster return to function. The study aimed to evaluate the outcomes of MIPO for distal tibial fractures. Method: Sample size of 38 patients between 18-80 years of age with distal tibial fractures treated with MIPO was included. Patient demographics, fracture characteristics, surgical details and postop outcomes collected. Results: A total of 38 patients with distal tibia fractures with a mean age of 44.36 years were included in the study. The mean duration of hospital stay was 12.71 days, and the time required for a union was 18.61 weeks. The AOFAS score impr...

International Journal of Research in Medical Sciences, 2016

A 21 year old female, suffered accidental burns in April 2008 resulting in severe soft tissue con... more A 21 year old female, suffered accidental burns in April 2008 resulting in severe soft tissue contractures and bony ankylosis of both elbows. She was disabled with both nonfunctional upper extremities and reported to our center with deformity and dysfunction of both elbows for past 02 years. On evaluation her elbows were fixed in 40° flexion on right side and 30° flexion on left side. She was completely dependent on her mother for her daily activities like feeding and hygiene care, though she had acceptable wrist and hand function. She was managed with interposition arthroplasty with ipsilateral autogenous tensor fascia lata graft on both elbows. At 5 year follow-up, she has pain free elbows with functional range of motion and no neurovascular deficits. She is able to use both upper extremities for all activities of daily living. Most importantly she is independent and has taken up a job for her livelihood.

Indian Journal of Orthopaedics, 2013

Background: Postoperative thromboprophylaxis with low molecular weight heparin (LMWH) for an exte... more Background: Postoperative thromboprophylaxis with low molecular weight heparin (LMWH) for an extended period of 4 weeks is now preferred over short term thromboprophylaxis in patients undergoing total hip/knee arthroplasty (THA/TKA). However, most of the data demonstrating the efficacy and safety of extended thromboprophylaxis and short term thromboprophylaxis is from clinical trials done in the West. In India, the data of the incidence of venous thromboembolism (VTE) following THA/TKA has been conflicting and the duration has not been clearly defined. The aim of the study was to evaluate and compare the efficacy of extended thromboprophylaxis over short term thromboprophylaxis in Indian patients undergoing elective THA/TKA surgeries. Materials and Methods: A prospective arm of 197 consecutive patients undergoing elective THA/TKA surgeries who were administered extended thromboprophylaxis for 4 weeks was compared with a historical group of 795 patients who were administered short term thromboprophylaxis for only 7-11 days. In both groups, LMWH (enoxaparin) was used in a dose of 40 mg subcutaneously, in addition to mechanical thromboprophylaxis. Primary efficacy endpoint was objectively confirmed venous thromboembolism (VTE). The presence of DVT was confirmed by a combination of pretest scoring, D-dimer, and Color Doppler Flow Imaging (CDFI) of deep veins of the legs, and pulmonary thromboembolism (PTE) was confirmed by ventilation perfusion (V/Q) scan or pulmonary angiography. Fisher's exact test and t test were used for the statistical analysis. The baseline confounding factors were compared between the two groups using t test for comparing the means for continuous data and Fisher's exact test for categorical data. Results: In the prospective arm, only 1 patient developed symptomatic PTE compared to 26 (3.27%) cases of VTE (20 cases of PTE and 6 cases of DVT) in the retrospective group. Conclusion: Extended thromboprophylaxis (for 4 weeks) was found to be more effective than short term thromboprophylaxis in minimizing the risk of postoperative VTE in patients who underwent THA/TKA.