Browsing by Author "Mahara, DP"
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Publication Functional outcome of single bundle anatomical anterior cruciate ligament reconstruction using either quadruple hamstring or bone patellar tendon bone graft by medial portal technique(Institute of Medicine, 2018) Thapa, SS; Neupane, P; Lamichhane, AP; Mahara, DPAbstract Introduction: The anterior cruciate ligament (ACL) is the most frequently injured knee ligament. Abnormal knee kinematics in ACL deficient knee causes early osteoarthritis. Single bundle anatomical ACL reconstruction by medial portal technique provides better knee stability then transtibial technique. Many studies suggests that there is no difference in outcome of ACL reconstruction using hamstring or bone patellar tendon autograft. In this study we evaluated functional outcome(based on mean Lysholm score) at 6 month of single bundle ACL reconstruction by medial portal technique using bone patellar tendon bone or quadruple hamstring graft Methods: This was a prospective longitudinal study on functional outcome(using Lysholm score) of 75 patients who underwent single bundle anatomical ACL reconstruction by medial portal technique by using either quadruple graft hamstring or bone patellar tendon bone graft in sports and arthroplasty unit in Tribhuvan University teaching hospital, Kathmandu, Nepal between March 2014 to February 2016. Mean Pre op and 6 month postop Lysholm score of two groups was compared using paired-t test to evaluate the functional outcome of the surgery. Results: In this study overall mean preop Lysholm score was 48.48±6.50 (36-62) and 6 month postop Lysholm knee score was91.58±3.10 (85-95), with p value 0.0000. The mean preop and post op Lysholm score for Quadruple hamstring group was 47.7 and 91.5 respectively, while that for bone patellar tendon bone group was 54 and 91.7. Conclusion: The functional outcome (based on mean Lysholm score) at 6 month postop of single bundle anatomical ACL reconstruction was similar irrespective of type of graft used. Keywords: Anterior Cruciate Ligament (ACL), Lysholmscore, Medial Portal techniquePublication Injury Epidemiology after 7.8 Richter Gorkha Earthquake in Nepal: A Retrospective Study of Injuries Treated at Tribhuvan University Teaching Hospital(Institute of Medicine, 2018) Thapa, SS; Lamichhane, A; Mahara, DPAbstract Introduction: Earthquakes are one of the most catastrophic natural disasters that occur without prewarning, Nepal experienced a massive earthquake of 7.8 Richter scale on 25th April 2015.It claimed 8,962 lives across several districts in Nepal with 22,302 injuries. After the earthquake, hospitals are confronted with large number of disaster trauma victims making it challenging for management of such mass casualty. Despite such crisis Tribhuvan University Teaching Hospital (TUTH) provided all possible services round the clock to all disaster victims brought to hospital from very first hour after the earthquake. Methods: This is a retrospective analysis of management of the injured patients admitted in TUTH after the Gorkha earthquake. Patient’s details including demographic data, injuries sustained and treatment carried out was retrieved from medical record section of the hospital. Injury pattern were categorized broadly into orthopedics related and non-orthopedics injure. Frequency distribution of these data’s was calculated using Microsoft excel. Results: Out of 1812 earthquake related injuries treated in hospital, 493 injured cases required admission. Their mean age was 35.84±21.84 years. Of them 153(31.6%) cases were from Kathmandu and 133 (27.0%) from Sindhupalchowk and Ramechhap.364 cases had single injury and 129 cases had multiple injuries, 81% of the injuries were orthopedic related and 19 % were non-orthopedic injury. Out of them 361(73.2%) cases required surgery, 119 (24.1%) were managed conservatively, 13(2.6%) died. Conclusion: Earthquake is the most unpredictable catastrophic natural disaster. Limb fractures and soft tissue injuries are most common among the injury survivors. Knowing the nature and epidemiology of the injuries will help in effective management of available resources for benefit of maximum number of victims. Keywords: Earthquake, Orthopedics, Tribhuvan University Teaching Hospital (TUTH)Publication Neglected Medial Hoffa Fracture for 9 years -A Case Report(Institute of Medicine, 2016) Thapa, SS; Lamichhane, A; Mahara, DPAbstract Hoffa fractures, coronal fractures of the femoral condyle, are uncommon injuries. It is often missed on initial plain radiographs. Medial Hoffa fractures are three times less common then lateral Hoffa. Here we present a case of neglected non-union of medial Hoffa fractures for 9 years, with good outcome after Open reduction and internal fixation. Keywords: Hoffa fracture, Non-unionPublication Pretibial Cyst after Anterior Cruciate Ligament Reconstruction with Non-bioabsorbable Interference Screw(Institute of Medicine, 2018) Thapa, SS; Lamichhane, A; Mahara, DPAbstract Pretibial cyst formation after anterior cruciate ligament reconstruction is a rare late complication. Exact etiology is not known, but it is commonly reported with use of bioabsorbable screw for fixation. Here we report a very rare case of pretibial cyst after anterior cruciate ligament reconstruction even with use of non-bioabsorbable screw for fixation. Keywords: Anterior cruciate ligament (ACL), Pretibial cyst, Titanium screw