Browsing by Author "Lakhey, Rajesh B"
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Publication Clinical Profile of Patients Presenting with Low Back Pain to Out Patient Department of a Tertiary Level Hospital(Institute of Medicine, 2020) Thapa, Pradeep; Lakhey, Rajesh B; Shrestha, Binay LABSTRACT Introduction: Low back pain is experienced by most of the people at some point of life. In our setting, there are very limited data on low back pain. This study aims to elaborate demographic and clinical profile of patients presenting to outpatient department of Orthopedics, in Tribhuvan University Teaching Hospital with complaints of low back pain. Methods: A descriptive cross-sectional observational study was carried out in 150 patients who presented with complaints of lower back pain in outpatient department of Orthopedics of TU Teaching Hospital from May to November 2019. The demographics including age, gender, occupation, and clinical data- duration of symptoms, body mass index, VAS score and radiculopathy along with Body Mass Index of each patient were recorded in a proforma separately. Results: Out of total 150 patients, male: female ratio was 1:1.9. The average age of patients was 42.1 years The average height, weight and body mass index of patients were 157 cm, 61.81kg and 24.83kg/m2 respectively. The mean visual analogue score of patients was 5.41. Occupationally, predominant number of patients were housewives (41.3%). Seventy nine patients (52.7%) had low back pain alone. Seventy one patients (47.3%) had low back pain associated with radicular symptoms, out of which 74.6% had unilateral radiculopathy. Conclusion: Low back pain is most commonly seen in fourth decade of life. More females as compared to males are affected with low back pain. The radiculopathy associated with low backache is mostly unilateral. Keywords: Body mass index, low back pain, radiculopathy, visual analogue scorePublication Multilevel Spinal Injury: Incidence, Distribution and Neurological Patterns(Institute of Medicine, 2020) Khadka, Yagya; Lakhey, Rajesh B; Kafle, DineshABSTRACT Introduction: Fractures and dislocation of spine are serious injuries that most commonly occur in young people. Spinal injury at more than one level is not uncommon. Awareness of multilevel injury of the spine and associated neurological patterns is important for the proper initial management of the patient. Methods: This was a prospective observational study carried out in Department of Orthopedics, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal from February 2012 to September 2013. Sixty cases of age group between 18 to 63 years of traumatic spinal injury were enrolled. Patients were examined clinically and radiographically. Results: Out of 60 patients, multilevel spinal injury occurred in 26 (43.3%) patients; 10 (16.67%) had contiguous spinal injury and 16 (26.67%) had non-contiguous spinal injury. There were 5 type A pattern spinal injury. Contiguous spinal injury most commonly occurred at level L1/L2 (n=4, 40%) and most had Frankel grade E neurology (n=6, 60%) followed by Frankel grade D (n=2, 20%). Non-contiguous lesions most commonly occurred at thoracic spine and had Frankel grade E neurology in most cases (n=10, 16.67%) followed by grade B and C (n= 2, 2.33% each). Conclusion: Multiple spinal injury was a common pattern of injury, which occurred in 26 (43.3%) patients out of 60 patients enrolled in our study. Multilevel spinal injury is common. We should be aware about its occurrence. We should evaluate for multilevel spinal injuries, so as not to miss them, especialy non-contiguous injuries, in the patients presenting with spinal injury. Keywords: Contiguous lesion, Frankel grade, multilevel spinal injury, non-contiguous lesionPublication Single Stage Surgery for Open Lisfranc Injury: A Case Report(Institute of Medicine, 2021) Lakhey, Rajesh B; Bhandari, Prawesh S; KC, GovindaABSTRACT Management of open Lisfranc injuries is challenging. The improper management of the injuries might lead to bad results like skin necrosis and arthritis of Lisfranc’s joints. A case of Myerson type A Gustilo Grade IIIB open Lisfranc injury was managed with single stage debridement and internal fixation. At three years follow-up, the result was excellent with American Orthopedic Foot and Ankle Society (AOFAS) midfoot score of 100 and the patient had rejoined his previous occupation requiring prolonged walking. Keywords: Open Lisfranc injury, single stage internal fixation