Browsing by Author "Shrestha, K R"
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Publication Neurovascular injury in supracondylar fracture of Humerus(Institute of Medicine, 2012) Shrestha, K R; Sapkota, R; Rajbhandari, N; Thapa, B; Shrestha, U KAbstract Introduction: Supracondylar fractures of the humerus are the commonest upper limb fractures in children, accounting for up to 70% of all pediatric elbow fractures. Supracondylar fractures of the humerus can be managed in outpatient setting but are often complicated by neurovascular injury. Methods: Retrospective study including 187 patients who had presented with supracondylar fracture of humerus with 47 neurovascular injuries during the period of July 2007 to June 2011. Out of 142 patients with Gartland type III fracture 107 underwent immediate open reduction, exploration and internal fixation. Results: Vascular injury is commonly associated with type II supracondylar fracture with posterior displacement. Twenty-two patients had vascular injury and all of them had satisfactory outcome after surgery. Conclusion: A careful clinical evaluation, urgent surgical treatment and adequate fracture reduction can prevent lifelong handicap. Keywords: P ulseless hand, Supracondy lar fracture, Vascular injuriesPublication Popliteal artery injury in and about knee injury: An experience in Manmohan Cardiothoracic vascular and transplant center(Institute of Medicine, 2015) Baral, RK; Shrestha, K R; Sapkota, R; Shrestha, UKAbstract Introduction: Knee dislocation is a common knee injury leading to neurovascular insufficiency. Penetrating injury to the popliteal fossa is also associated with neurovascularv injuries. Amputation rate is high amongst popliteal artery injury associated with bone injury. Delayed detection and late interventions are the factors contributing for limb loss in these cases. We present our experience of the popliteal artery injury from a tertiary care center over the period of 3 years. Method: It is a retrospective analysis of prospectively collected data of cases of popliteal arterial injury over the period of three years (July 2011 till June 2014). Data were analyzed on their demographic, clinical, management and outcome parameters with SPSS 17. Result: There were total 35 popliteal artery injuries in 34 patients associated with injuries of knee. Twenty two (65%) patients were male and rests were female. Mean age of these patients was 23±12 years, with age ranging from 15 to 76 years. Twelve patients had amputation and were identified and treated late. Most of the patients reach our center late mean time 9±5 hours and as late as 7 days. Conclusion: High index of suspicion is required to identify the popliteal artery injury in patients with injuries in and about the knee. Early vascular surgical consultation and intervention is required to alleviate its poor outcome. Keywords: knee injury, popliteal artery injury