Browsing by Author "Regmi, Subhash"
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Publication Complete Correction following Temporary Hemiepiphysiodesis using 2-hole Reconstruction Plates among Skeletally Immature Patients with Angular Deformities around Knees: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Rajbhandary, Tarun Kumar; Regmi, Subhash; Gurung, Yam Prakash; Banskota, Bibek; Barnawal, Satish Prasad; Banskota, Ashok KumarAbstract Introduction: Studies have shown that 2-hole reconstruction plates can be used effectively as tension band plates for temporary hemiepiphysiodesis. However, limited data is available regarding the effectiveness of such plates in terms of complete correction rates. This study was aimed to find out the prevalence of complete correction following temporary hemiepiphysiodesis using 2-hole reconstruction plates among skeletally immature patients with angular deformities around knees. Methods: A descriptive cross-sectional study was carried out among skeletally immature patients with angular deformities around knees undergoing temporary hemiepiphysiodesis after getting approval from the Institutional Review Committee (Reference number: B&BIRC-23-05). The data were collected between 1 January 2012 to 31 December 2018. All skeletally immature patients with angular deformities around knees undergoing temporary hemiepiphysiodesis using 2-hole reconstruction plates were included. Patients who required additional procedures or implants for deformity correction and those who did not provide consent were excluded. Convenience sampling method was used. Point estimate at 95% Confidence Interval was calculated. Results: Among 102 patients, 66 (64.70%) patients achieved complete correction (59.97-69.43 at 95% Confidence Interval). Mean age of the patients was 8.21±3.11 years and 43 (65.15%) were males and 23 (34.84%) were females. Conclusions: The prevalence of complete correction following temporary hemiepiphysiodesis using 2-hole reconstruction plate among skeletally immature patients with angular deformities around knees was lower than that reported in other international studies.Publication High Dependency Unit Admissions among Patients with Lower Extremity Long Bone Fracture Visiting the Department of Orthopaedics in a Tertiary Care Centre(Nepal Medical Association, 2024) Barnawal, Satish Prasad; Banskota, Bibek; Pandey, Nitesh Raj; Rijal, Saroj; Rajbhandari, Tarun; Regmi, Subhash; Banskota, Ashok KumarAbstract Introduction: Lower extremity long bone, femoral and tibial shaft, fractures often have associated injuries. Patients with lower extremity long bone fractures in the Department of Orthopaedics can land up in high dependency unit admissions, mostly due to underlying complications. The study aimed to find out the prevalence of high dependency unit admissions among patients with lower extremity long bone fractures visiting the Department of Orthopaedics in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with lower extremity long bone fractures in a tertiary care centre. The data from 1 March 2017 to 31 January 2020 was collected from the medical records from 1 August 2020 to 30 September 2020. All patients with femoral or tibial shaft fractures in isolation or a part of a multi-system injury were included. Patients with inadequate data were excluded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 507 patients with lower extremity long bone fractures, 137 (27.55%) (23.66-31.44, 95% Confidence Interval) required high dependency unit admission. Among them, 119 (86.86%) were males. A total of 71 (51.82%) cases involved 2-wheelers. Conclusions: The prevalence of high dependency unit admission among patients with lower extremity long bone fractures was high and majority of them required multidisciplinary approach.Publication High Dependency Unit Admissions among Patients with Lower Extremity Long Bone Fracture Visiting the Department of Orthopaedics in a Tertiary Care Centre(Nepal Medical Association, 2024) Barnawal, Satish Prasad; Banskota, Bibek; Pandey, Nitesh Raj; Rijal, Saroj; Rajbhandari, Tarun; Regmi, Subhash; Banskota, Ashok KumarAbstract Introduction: Lower extremity long bone, femoral and tibial shaft, fractures often have associated injuries. Patients with lower extremity long bone fractures in the Department of Orthopaedics can land up in high dependency unit admissions, mostly due to underlying complications. The study aimed to find out the prevalence of high dependency unit admissions among patients with lower extremity long bone fractures visiting the Department of Orthopaedics in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with lower extremity long bone fractures in a tertiary care centre. The data from 1 March 2017 to 31 January 2020 was collected from the medical records from 1 August 2020 to 30 September 2020. All patients with femoral or tibial shaft fractures in isolation or a part of a multi-system injury were included. Patients with inadequate data were excluded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 507 patients with lower extremity long bone fractures, 137 (27.55%) (23.66-31.44, 95% Confidence Interval) required high dependency unit admission. Among them, 119 (86.86%) were males. A total of 71 (51.82%) cases involved 2-wheelers. Conclusions: The prevalence of high dependency unit admission among patients with lower extremity long bone fractures was high and majority of them required multidisciplinary approach.Publication Hip-Spine Discordance in Bone Mineral Densities in Patients Undergoing Dual Energy X-Ray Absorptiometry Scan in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Chaudhary, Rajesh Kumar; Regmi, Subhash; Shah, Niraj; Banskota, Bibek; Barakoti, Ram Krishna; Banskota, Ashok KumarAbstract Introduction: The discordance in the diagnosis of osteoporosis is characterized by the variation in bone mineral density measurements at different skeletal sites. The presence of discordance significantly alters the treatment plan as different treatment is required for different skeletal sites. The aim of this study was to find out the prevalence of hip-spine discordance in bone mineral densities in patients undergoing dual-energy x-ray absorptiometry scans for suspected osteoporosis. Methods: A descriptive cross-sectional study was conducted among patients undergoing dual-energy x-ray absorptiometry scans from 1 December 2020 to 30 October 2022. Ethical approval was taken from the Institutional Review Committee (Reference number: IRC-2020-11-18-08). Patients undergoing dual-energy x-ray absorptiometry scans for suspected osteoporosis were included. Patients aged less than 50 years, already diagnosed and under treatment for osteoporosis, and incomplete information about T-scores of hips and spine were excluded. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 1028 patients, 602 (58.56%) (55.55-61.57, 95% Confidence Interval) had discordance in hip and spine bone mineral densities. The majority of them, 570 (94.68%) were female and 32 (5.71%) were male. Major discordance was observed in 101 (16.77%) patients and minor discordance was observed in 501 (83.22%) patients. Conclusions: The prevalence of discordance in hip and spine bone mineral densities in patients undergoing dual-energy x-ray absorptiometry scans was higher than that reported in other similar studies done in similar settings.Publication Positive Pivot Shift Test among Patients with Displaced Anterior Tibial Spine Fractures Undergoing Arthroscopic Fixation in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Joshi, Amit; Shrestha, Sabin; Regmi, Subhash; Basukala, Bibek; Sharma, Rajiv; Bista, Rohit; Singh, Nagmani; Pradhan, IshorAbstract Introduction: Understanding of displaced anterior tibial spine fractures has evolved over the years and is now considered to be anterior cruciate ligament avulsion injuries rather than intra-articular fractures. However, there are very few studies available evaluating the presence or absence of a pivot shift test, which is specific in diagnosing anterior cruciate ligament insufficiency, in patients with anterior tibial spine fractures. This study aimed to find out the prevalence of the positive pivot shift test among patients with displaced anterior tibial spine fractures undergoing arthroscopic fixation in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients presented with displaced anterior tibial spine fractures undergoing arthroscopic fixation. The data were collected between 1 January 2020 and 30 May 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: IRC_2019_11_09_1). All patients who presented with displaced anterior tibial spine fractures undergoing arthroscopic fixation were included in the study and those who did not provide consent were excluded. The pivot test was performed under anaesthesia. Point estimate and 90% Confidence Interval were calculated. Results: Among 48 patients, pivot shift was positive in 36 (75%) (64.75-85.25, 90% Confidence Interval). The mean age of the participants was 28.97±11.16 years, 21 (58.33%) were males and 15 (41.66%) were females. Conclusions: The prevalence of positive pivot shift test under anaesthesia in patients with displaced anterior tibial spine fractures undergoing arthroscopic fixation was higher than other studies done in similar settings.Publication Ramp Tear among Patients Undergoing Arthroscopic Anterior Cruciate Ligament Reconstruction in a Tertiary Care Centre(Nepal Medical Association, 2023) Joshi, Amit; Nepal, Santosh; Regmi, Subhash; Pradhan, Ishor; Singh, Nagmani; Basukala, Bibek; Bista, Rohit; Rajiv SharmaAbstract Introduction: Ramp tear is a specific injury that affects the posterior horn of the medial meniscus and its meniscosynovial or meniscocapsular attachments. The actual prevalence of ramp lesion is unknown due to the high probability of misdiagnosis or underdiagnosis caused by the low sensitivity of imaging modalities and poor visualization during arthroscopy. This study aimed to find out the prevalence of ramp tear among patients undergoing arthroscopic anterior cruciate ligament reconstruction in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients undergoing arthroscopic anterior cruciate ligament reconstruction after getting ethical approval from the Institutional Review Committee. Data from 1 March 2019 to 31 December 2022 was collected between 1 May 2023 to 30 May 2023 from medical records. The study included all patients who underwent arthroscopic anterior cruciate ligament reconstruction. Patients with a previous history of medial meniscus injury or repair and undergoing revision anterior cruciate ligament reconstruction were excluded. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 412 patients who underwent arthroscopic anterior cruciate ligament reconstruction, 53 (12.86%) (9.63-16.09, 95% Confidence Interval) had ramp tears. The mean age of patients with ramp tears was 28.64±7.57 years. Among 53 patients, 42 (79.24%) were male and 11 (20.75%) were female. Conclusions: The prevalence of ramp tears in patients undergoing arthroscopic anterior cruciate ligament reconstruction in a tertiary care centre was found to be lower than other studies done in other international studies.