Surgical Cases

Case 1

Fracture of Calcaneus (Heel Bone), Surgical Fixation of Avulsion fracture of Calcaneal Tuberosity

Detail:

A 35 year old male sustained calcaneal tuberosity avulsion fracture following fall from staircase. This fracture is rare type occurring less than 3% of calcaneal fractures. Immediately after accident he had severe pain in his foot and inability to bear weight on affected leg. Skin was intact no external injury was noted. X-ray was done. Back Slab support was given with strict limb elevation.

Surgery was planned. Surgery was done under spinal anesthesia, duration was 45 mins. Open Reduction Internal Fixation was done with 4 mm cannulated cancellous screws with washers. Image Intensifier was used. Surgery was done under tourniquet. Utmost care was taken in soft tissue handling as this area is notorious for wound dehiscence due to precarious blood supply. Post Surgery anterior support slab was given in plantar flexion position.

Post operatively patient had minimal pain and was mobilized non weight bearing with walker on affected leg. Wound check was done and skin condition was found intact. Patient was discharged to home on third post operative day with weekly follow up and X-rays.

Case 2

Fracture of Proximal Tibial Platue

Detail:

A 34 year old male patient sustained injury to his Right Knee following Road Traffic Accident. He was operated for patella of same side 5 years back.

Open Reduction and Internal Fixation of Lateral Tibial Condyle with plating was done under spinal anesthesia. Surgical duration was 45 min.

Post operatively, patient was given analgesics, intravenous antibiotics, and Knee Range of Motions were started on very next day, weight bearing was restricted till 4 weeks, patient used walker for that period of time.

Full range of motion was achieved in operated knee.

Case 3

Fracture of Ankle, Surgical treatment of Bimalleolar Ankle Fracture

Detail:

A 47 year old female sustained a Road Traffic Accident, immediately after accident she has sever pain in her ankle and was not able to bear weight on affected foot. In an hour she developed swelling over the ankle, she was taken to a hospital where primary management was done. She visited to us, x-ray was done. She had fracture of ankle, Bimalleolar Fracture, involving medial and lateral malleoli (inner and outer prominences of ankle). She was admitted and back slab was given for support along which analgesic medications and serratiopeptidases.

Surgery was planned. Surgery was done under spinal anesthesia, duration was 68 mins. Open Reduction Internal Fixation was done with plate for lateral malleolus and with Cannulated Cancellous Screws for medial malleolus. Back Slab for support was given post surgery. She was mobilized next day, Non Weight Bearing on operated leg with Walker. Back Slab was removed after 4 weeks, full range of motion at ankle was noted. She was allowed to bear weight post 6 weeks after check X-rays.

Case 4

Crush Injury of Thumb

Detail:

A 47 year old industrial worker was injured at workplace, sustained crush injury to his thumb. Such patients are attended on priority basis, he was given wound wash with normal saline, local anesthesia, tetanus prophylaxis, antibiotics, analgesics and surgery was planned urgently.

Reconstruction of thumb was done, phalanx fracture was stabilized with K wires, tendons repaired and wound closure was done. Support slab was given. Surgical time was 35 mins, and wrist block was used.

Post operatively, wound check was done for 2 days, intravenous antibiotics were given and patient was discharged on 3 day.

Follow up recovery was good, no infection was found and desirable function was achieved.