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A Double Tension Band Technique for Patellar Fractures—A New Concept

Surgical Science 2020年第6期11卷 127-132页

作者： Yogesh S. Salphale Nitin Kimmatkar Hrishikesh R. Badve shushrusha multispecialty hospital Chandrapur India

Amongst the many known techniques used for the management of fractures of the patella, the tension band wire fixation is a reliable treatment modality and has given consistently good results. In transverse patellar fractures, a combination of cerclage wiring and tension band fixation gives a good mechanical stability and an environment conducive to healing. The fracture described herein is classified as 45-C1 (based on Orthopaedic Trauma Association classification) of the right knee of a forty three years old male patient. It was fixed with three vertical 1.5 mm K wires and double cerclage wire looped proximally through the quadriceps tendon and distally through the patellar ligament in a double figure-of-eight configuration. The average follow-up period was 7 months. The Activity of Daily Living Scale (ADLS) of the Knee Outcome Survey was used to assess symptoms and functional capability of the knee. The fracture union was achieved at an average of 10 weeks. Full range of knee motion was achieved by end of the third postoperative month. No complications, such as infection and implant failure were noted. The technique aims to stress the advantage of giving a balanced fixation addressing the bony elements (the fractured ends) as well as the soft tissue (the extensor apparatus).

关键词： Transverse Patella Fracture Cerclage Wiring Tension Band Wiring Double Tension Band Wiring

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Reduction Aid in Proximal Femoral Fractures: The Thigh Support

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Surgical Science 2017年第3期8卷 169-173页

作者： Yogesh Salphale Wasudeo Mahadeo Gadegone Yogesh Deshmukh Kuldeep Deshpande Kiran Janwe Ravi Alurwar shushrusha multispecialty hospital Chandrapur India

Reducing the Unstable Intertrochanteric Fractures in a closed manner is challenging especially in the old and aged people with co morbidities. We provide a simple reducing aid to achieve the fracture reduction. This will protect your surgical resident’s or operating theatre practitioner’s back in maintaining the reduction throughout the procedure and continuing with the procedure of cephalomedullary nailing. It will also facilitate in the better rehabilitation of the patient with minimal morbidity and offer a good radiographic view.

关键词： Hip Fracture Unstable Intertrochanteric Fractures Thigh Support Proximal Femoral Nailing Reduction Aid

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The Posteroanterior Locking for the Distal Humerus Nailing. Is It a Viable Option?

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Surgical Science 2017年第11期8卷 488-492页

作者： Yogesh Salphale Jagannath Kaginalkar Wasudeo Mahadeo Gadegone Kiran Janwe shushrusha multispecialty hospital Chandrapur India

The distal interlocking is regarded as an inherent part of the antegrade humeral nailing technique. Traditionally the distal locking of intramedullary humeral nails is achieved using a freehand technique. The humerus nailing locking options in the conventional nailing systems are placed in the anterior-posterior and lateral-medial directions. It exposes both the patient and surgeon to radiation, is time consuming, and has a potential risk of damaging neurovascular structures, especially the radial and lateral cutaneous nerve when the anterior-posterior and lateral-medial locking constructs are used. We aim to present a technical tip to ease the distal locking procedure and avoid the possible neurovascular complications with the existing nailing systems.

关键词： Humerus Fracture Humerus Nailing Posteroanterior Locking Interlocking Nailing

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Analysis of Factors Influencing True Blood Loss in Navigated Total Knee Replacements

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Surgical Science 2019年第2期10卷 59-69页

作者： Laghvendu Shekhar Yogesh Salphale Wockhardt Super Speciality hospital Nagpur India shushrusha multispecialty hospital Chandrapur India

Title: Analysis of factors influencing true blood loss in navigated total knee replacements. Objectives: To evaluate true blood loss in total knee replacements and analyze the various factors such as gender, BMI, diagnosis, size of implants, duration of surgery, tourniquet usage etc. on calculated blood loss using formula by Nadler et al. All the cases included have been done using navigation system and no comparison with conventional jig based surgeries has been attempted. Methods: Retrospectively data of primary cemented total knee replacements performed from October 2012 to August 2013 were evaluated. All surgeries were performed using navigation system. The data collected included patient sex, height, weight and preoperative haemoglobin and hematocrit. The patients’ postoperative data of haemoglobin, hematocrit and drains were collected. All patients had their CBC done on 2nd post operative day. Any data on transfusions that patients received were also collected. We also collected data regarding the size of implant used. We calculated true blood based on formula given by Nadler, Hidalgo & Bloch. We excluded patients whose data were incomplete or who received tranexamic acid. Patients who needed stems (femoral or tibial) were also excluded from this study. Results: The average true calculated blood loss was 959.44 ml. BMI did not have any effect on blood loss. But larger size implants were associated with more blood loss. Conclusion: The preoperative haemoglobin is one of the most important factors in determining transfusion following the knee replacement. Male gender and larger implants are associated with more blood loss. BMI, diagnosis of OA or RA, tourniquet usage and time have no significant effect on blood loss. Our calculated blood loss compares favourably with published literature.

关键词： Navigated Total Knee Replacements Blood Loss Transfusion

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