Browsing by Author "Hamal, Bhadra"
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Publication Clinical and Radiological Outcome of Anterior only Stabilization for AO Type B And C Subaxial Cervical Spine Injury: An Observational Study(Nepal Medical Association, 2025) Subedi, Ram Sharma; Hamal, Bhadra; Baral, Kabita Devi; Rijal, Badri; Karmacharya, Mahesh; Sah, Prem Kumar; Dhakal, Gaurav RajAbstract Introduction: AO type B and C subaxial cervical spine injuries are highly unstable and require surgical fixation for the stabilization. This study aims to determine their outcome after anterior stabilization clinically and radiologically. Methods: This was an observational longitudinal study conducted at tertiary level trauma center, from March 2021 to April 2022 after ethical approval from Institutional Review Board (Reference Number: 665/2077/78). Based on inclusion criteria total sampling was done. Cervical spine injuries AO type B and C operated with anterior cervical stabilization were included. Descriptive statistics were used to analyze data. Results: Among 21 total cases, 14 (66.67%) were male and 7 (33.33%) were female with the median age of 40 (IQR 32-51) years. Eleven (52.38%) patients sustained AO type B injury and 10 (47.61%) patients sustained AO type C injury. The commonest mode of injury was fall from height 14 (66.66%) followed by RTA 6 (28.57%) and physical assault 1 (4.76%). Postoperatively there was 33% improvement in incomplete neurology by one grade on ASIA neurology. Pain was evaluated using Visual Analogue Score and disability was evaluated using Neck disability Index scoring with the median value of 2 (IQR 0.4-3) and 10 (IQR 3-13) respectively. Radiographic failure was present in 2 (9.52%) patients. Forteen (66.66%) patients showed Grade 1 fusion, six (28.57%) showed Grade 2 fusion, and one (4.76%) showed Grade 3 fusion.. Conclusions: Most of the patients experienced mild pain and disability, stable fusion and low rate of radiographic failure with no new neurological deterioration. Almost half of the injuries occurred at the level of C5-C6.Publication Functional Outcome of Single-Stage Reconstruction for the Multi-Ligament Injuries of the Knee(Nepal Health Research Council, 2024) Hamal, Bhadra; Karmacharya, Mahesh; Bhattachan, Sijan; Hamal, Pawan KumarBackground: Multi-ligament injuries of the knee are rare injuries that can cause significant impairment of the knee function. There is controversy in the treatment regarding staged versus single-stage surgery. This study was performed to assess the outcome of the single-staged reconstruction of the multi-ligament injury of the knee. Methods: This prospective observational study was done from January 15, 2022 to January 14, 2023. The outcome was analyzed by comparing the preoperative and 12-month postoperative Visual Analog Scale score, Lysholm Score, and International Knee Documentation Committee Score. Results: The mean age of the patients was 28.35 years. among 12 patients 9 were male and 3 were female. Single-staged multi-ligament reconstruction was done in all the cases. The Lysholm score was improved from preoperatively 36.42 ± 1.46 to 95.36 ± 2.84, IKDC score was improved from 24.38 ± 1.64 to 93.86 ± 3.14, VAS score 8.14 ± 1.44 to 0.40 ± 0.60 at 12 months postoperative follow-up which all came to be clinically significant with p-value < 0.001. Conclusions: Single-stage multi-ligament reconstruction of the knee is an effective method of treatment and has excellent outcomes. Keywords: Multi-ligament injury; reconstruction; single-stage.