Browsing by Author "RL, Pradhan"
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Publication Acute sacrococcygeal dislocation (anterior type): A case report(Kathmandu University, 2004) KP, Rijal; RL, Pradhan; S, Sharma; S, Lakhey; BK, PandeySacrococcygeal dislocation is a rare injury. A twenty-nine year old male presented to us with pain over the lowest part of spine of 5 days duration. He fell down on stairs with his buttock landing directly over the edge of the stairs. On examination, a step was felt in the continuity of sacrum and coccyx. The tip of the coccyx was not palpable. Per rectal examination revealed a small bump on running the finger along the sacrococcygeal curvature. On plain radiographs of sacro-coccygeal region, lateral view revealed anterior dislocation of the coccyx over the sacrum. On antero-posterior view, the injury could not be identified. Under general anaesthesia, an attempt to reduce the dislocation per rectally was tried, but failed. The patient was treated conservatively with analgesics. He refused surgery, as he was relieved of pain with analgesics. Key Words: - Sacrococcygeal dislocation, coccydynia, conservative treatment.Publication Pre-operative assessment of K-nail length in fracture shaft of femur(Kathmandu University, 2006) S, Lakhey; RL, Pradhan; M, Bishwakarma; S, Pradhan; S, Pradhanaga; BK, Pandey; KP, RijalIntroduction: Internal fixation of diaphyseal fracture of shaft of femur in an adult by Kuntscher nail is the most common operative method of treatment in Nepal where operative facilities for the same exist. Since the complete range of K-nail sizes and length are not available in most operation theatres in Nepal, most orthopaedic surgeons assess the size and length of the K-nail pre-operatively by various methods and keep one size above and below the assessed length for the planned surgery. Materials and Methods: The following measurements were taken in five hundred people involved in the study: Measurement No. 1: Tip of the greater trochanter to lateral knee joint line minus 2cms. Measurement No. 2: Tip of the olecranon process to the tip of little finger, and Measurement No. 3: Tip of the greater trochanter to the upper pole of patella. An average of all three lengths were analysed to see if there were any differences in their mean lengths. Results: Analysis showed that there were significant differences between the mean lengths measured by the three different methods. The average length of measurement no: 2 was 3 cm longer than the average length of measurement no: 1, which is the reference pre-operative length of K.nail. Conclusion: However, in practice since measurement no:2 is more convenient to perform and can also be used when the patient has sustained bilateral fractures of femur, an accurate pre-operative K-nail length assessment can be done by subtracting 3 cm from measurement no:2, i.e. the tip of the olecranon process to the tip of the little finger.Publication Reduction of Acute Anterior Shoulder Dislocations under Local Anaesthesia – A Prospective Study(Kathmandu University, 2004) K, Paudel; RL, Pradhan; KP, RijalObjective: To evaluate the application of local anaesthesia for reduction of acute anterior shoulder dislocation Design: A prospective study of patients coming with anterior dislocation of shoulder to KMCTH from July 2002 to Sep 2003. Subjects: Patients of aged 15-55 years with no associated fractures of adjoining bones. Results: A total of fifteen patients with anterior inferior shoulder dislocation were studied and all were reduced safely under local anaesthesia. Conclusion: Use of intra-articular lignocaine for reduction of shoulder dislocation is safe and effective and is beneficial for countries like Nepal where health facilities are minimum in rural and suburban areas. Key words: Shoulder dislocation, intra-articular injection, local anaesthesia, reduction