The patient adequately recovered from the surgical intervention and was discharged the day after surgery. He was instructed to refrain from weight bearing over the first 6 weeks, using crutches for ambulation. At 6 weeks, progressive weight bearing was allowed. Patient was followed up every fortnightly with sequential x-rays and x-rays showed complete union at 11 weeks and patient was advised for full weight bearing. According to the criteria proposed by Beaty et al for femoral fracture in individuals older than age 8 years, the patient obtained a satisfactory
In most cases, the cause of pain originating inside multiple joints is arthritis. Disorders that cause arthritis may differ from each other in certain tendencies, such as the following: • How many and which joints they usually involve • Whether the central part of the skeleton, such as the spine or pelvis, is typically involved • Whether arthritis is sudden (acute) or longstanding (chronic) Acute arthritis affecting multiple joints is most often due to • Viral infection • The beginning of a joint disorder or a flare up of an existing chronic joint disorder (such as rheumatoid arthritis or psoriatic
The patient was monitored for postoperative complications. Ureteric catheter was removed along with Foley catheter in first post-operative day. DJ stent was removed after 4weeks. The patients were re-evaluated with KUB to assess the stone free rate at day 1 and 1-month follow up. Clearance was defined as no residual stone on KUB and ultrasound.
The patient was diagnosed with atrial septal defect(ASD). The patient underwent surgical heart repair of the defect and post-operatively was uneventful. Three months follow-up shows improvement of the voice and endoscopic examination showed a partial medialization of the left vocal cord(Figure
1. Superior hypogastric plexus block: the posteromedian transdiscal approach. www.painphysicianjournal.com E51 Superior Hypogastric Plexus Combined with Ganglion Impar Neurolytic Blocks otic was given 30 minutes before the procedure, which were all performed under sterile conditions with c-arm fluoroscopic guidance. This approach is performed with the patient in the lateral or prone position. The L5-S1 interspace was identified under fluoroscopy, the skin overlying the interspace was sterilized and infiltrated with 2 – 3 mL of local anesthetic (lidocaine 2%), a 20-gauge, 15 cm needle with a 30° short bevel (Chiba needle) was inserted perpendicular to the skin at the center of the L5-S1 intrelaminar space under anteroposterior fluoroscopic vision.
Schirmer?s test was performed after the installation of local anesthetic agent (Schirmer-1). Then the filter paper was inserted at lower lid after folding its lower 5 mm at the junction between the outer and the middle third; the patient keeps his eyes closed, and the paper was removed was removed after 5 min with measurement of the wetting distance from the site of the folding in millimeters. BUT test was conducted by instilling a fluorescein drop in the eye. The patient blinks many times, after which the te ar fi lm was examined with slit lamp using cobalt-blue filter with a broad beam. After an interval of time, black spots or lines appeared in the fluorescein stained fi lm indicating formation of dry areas.
Several of these fibers may be part of the formation of the tunnel for the flexor hallucis longus tendon. In addition, a band of strands merge with the posterior intermalleolar ligament . The posterior intermalleolar tendon has been the focus of current studies as a result of its contribution in the posterior soft tissue impingement disorder at the ankle joint[17, 27]. Its high frequency in incidence in radiological, and anatomical studies contrast extensively, extending from 19% up to 100% [24, 27, 30]. Springer ( ) noted that in cadaveric dissection the intermalleolar ligament was found consistently.
These resulted in significant reduction in pain score (1/10) and swelling of this lesion. Right patellectomy with repair of quadriceps and patellar tendon was done for the patellar lesion. The involved patella was egg shell like in consistency and had ballooned out due to expansile nature of the lesion, but the articular surface of it was found intact, at surgery. She also underwent curettage and cementing of distal femoral lesion with prophylactic distal femoral locked plate fixation (Fig ) and curettage and autologous bone grafting for talar lesion. After 6 months of follow up with repeated embolisation the pelvic lesion started showing improvement and signs of calcification could easily be well appreciated on X-Rays (Fig ).
Approximately after 6 weeks, depending upon soft tissue condition, second stage was undertaken. Cancellous autograft was harvested from iliac crest. If the bone defect was too large allograft was mixed, making upto 33% of volume of the graft. In a few cases, cortical sliver from the iliac crest were also mixed with the graft. The bone defect was approached from the previous incision and careful dissection performed down to the defect.