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Outcomes of resection of giant splenic cysts

100%
Żyluk A.
Polish Journal of Surgery
|
2020
|
vol. 92(5)
31-36
EN
Three cases of giant, nonparasitic splenic cysts in young patients are presented. The cysts were poorly-symptomatic and manifested with mild upper-abdominal pain and discrete change of abdominal contour. The diagnosis was made based on USG and abdominal CT. Upon operation, the cysts were successfully excised, sparing almost the whole spleen, using standard instruments: electric knife and LigaSure instrument. The postoperative course was uneventful in all cases. At the 4–6-months follow-up, all patients were in good shape and CT showed no signs of recurrence. The results of this case series show that giant splenic cysts may be relatively safely resected, sparing almost the whole spleen.
2
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Early and Long-Term Results Following Surgery for Dupuytren's Disease

100%
Sobierajska-Rek A., Dobosz M.
Polish Journal of Surgery
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2010
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vol. 82
|
issue 9
497-503
EN
The aim of the study was assessment of the early and long-term results following surgery for Dupuytren's disease.Material and methods. In this study the treatment results of 74 patients with Dupuytren's disease were revealed. Patients were treated using fasciotomy, selective fasciectomy, subtotal fasciecotmy and dermofasciectomy. Patients were divided into two groups. Group I (n=35) was examined prospectively 3 times: prior to the surgery, 1 and 3 months after it. Group II (n=39) was examined retrospectively once between 3 to 7 years after the surgery. The examination took into account: occurrence of factors predisposing the disease to reappear (Dupuytren's diathesis), hand's function in patient's subjective opinion evaluated with DASH questionnaire and goniometrical measurement of the contracture.Results. Contracture reduction was observed in group I in 94% of patients. The average Total Loss of Extension before surgery was 123.85°, 3 months after operation - 54.51°. In group II the average Total Loss of Extension was 42.63°. Average DASH score in group 1 before surgery was 17.5. One month after the surgery a significant aggravation was observed (average score - 29.95). Three months after the surgery, there was an improvement and DASH score reduced to 15.02. The average DASH score in group II was 4.34. In both groups there was a correlation between patients' age and hand's function. Elder patients evaluated hand's function as better after the surgery. Recurrence of the disease was observed in 17% of patients in group 1 and 33% of patients in group II. Occurrence of predisposing factors (diathesis) increased probability of recurrence in group II. Significant differences in treatment results were not notified because of the surgery technique.Conclusions. This study reveals numerous problems with operative treatment of Dupuytren's disease: faint improvement of hand's function in primary months after surgery, large percentage of recurrences of the disease, a small number of patients with extension of fingers obtained as an outcome of the surgery.
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Radiation-free Insertion of Interlocked Intramedullary Tibial Nail in Closed Extra-articular Displaced Tibial Shaft Fractures in an Emergency Setup

88%
Charak S. S., Chib M. S., Darokhan M. A. U. D., Jamwal P.
Ortopedia Traumatologia Rehabilitacja
|
2021
|
vol. 23(6)
427-431
EN
Background. Interlocking nailing is considered a gold standard surgical treatment of mid-shaft closed diaphyseal tibial fractures. With increasing exposure of orthopaedic surgeons to radiation, we propose a solution to this health hazard through a study wherein we perform the surgery without any radiation or C-arm exposure. Material and methods. This prospective study was done at GMC Jammu from January 2017 to February 2020 and included 218 patients, with 18 patients having bilateral tibia fractures in the age group 15 to 58 years (mean of 37.6 years), including 63.7% males (n=139) and 36.3% females (n=79). The 236 extra-articular closed tibial mid-diaphyseal fractures were operated on and intramedullary tibial nailing was performed without a single C-arm exposure. Postoperative x-rays were done and reduction assessed by standard acceptable criteria. Results. Among 236 cases in which nailing was done, 227 (96%) patients were successfully distally locked, including 128 (56.3%) locked through the jig and 99 (43.6%) by “hit and trial method.” All cases met acceptability criteria set for management of tibia by nailing. Conclusions. 1. This study strengthens the proof that closed extra-articular diaphyseal fractures of the tibia can be managed by nailing without using the C-arm with excellent results. 2. The C-arm is always available for cases where distal locking could not be achieved. 3. The technique has a great role in centres with limited facilities of intra-operative radiography in emergency operation theatres.
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