Browsing by Author "Singh, Sumi"
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Publication Arthroscopic Debridement and Proximal Fibular Osteotomy in the management of knee Osteoarthritis: A Descriptive Longtudinal Study(Nepal Medical Association, 2024) Adhikari,Vijayendra; Sitaula, Prasamsha; Thapa, Ojas; Singh, Sumi; Shrestha, Praphulla; Chalise, Pralhad Kumar; Mishra, Anil Kumar; Singh, Ramesh PrasadAbstract Introduction: Knee osteoarthritis commonly occurs in the medial compartment. Arthroscopic debridement eases pain by irrigating debris and inflammatory cytokines. Proximal fibular osteotomy shifts the loading force more laterally from the medial compartment, eliminating pain and delaying degenerative progression. This study aims to evaluate pain relief by combining both procedures in knee osteoarthritis of the medial compartment. Methods: The study was conducted in Nepal Medical College Teaching Hospital from November 2021 to December 2022 after the ethical approval from institutional review committee (IRC Ref. No. 025-078/079). The outcome was assessed by visual analog score and knee society scores, who underwent a combined procedure of arthroscopic debridement and proximal fibular osteotomy during a study period of 12 months. Results: Diagnostic arthroscopy was done in 32 patients, out of which, 27 patients underwent combined procedure with arthroscopic debridement and proximal fibular osteotomy. The mean visual analog score in combined procedure was 6.89±0.93 initially and 3.11±0.69 at 12 months follow up. The mean knee society score in combined procedure was 46.85±6.1 preoperatively and 84.26±8.27 postoperatively at 12 months follow up. Common peroneal nerve neuropraxia was observed in 8 (29.62%) patients, which resolved spontaneously during 6 months of time period. Conclusions: Combined arthroscopic debridement and proximal fibular osteotomy procedure is effective in treating knee osteoarthritis of the medial compartment, as it decreases pain and improves knee society score.Publication Functional Outcome of Solid Interlocking Nail in Open Tibial Fracture at a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Adhikari, Vijayendra; Sitaula, Prasamsha; Thapa, Ojas; Singh, Sumi; Mishra, Anil Kumar; Singh, Ramesh Prasad; Chalise, Pralhad Kumar; Shrestha, PraphullaAbstract Introduction: There is a high incidence of open fractures accounting 23% of all tibial fractures. The minimal soft tissue and precarious blood supply of the shaft of tibia make these fractures vulnerable to complications. The treatment should be decided through thoughtful analysis for personality of injuries and the status of the soft tissue. Intramedullary nailing allows stable fixation with minimal soft tissues dissection and preserve the soft tissue and allows early joint motion with higher rate of union. The purpose of our study was to find the outcome of open tibial fractures lower than Gustilo type IIIb, that were treated by unreamed solid interlocking intramedullary nails. Methods: A descriptive cross-ectional study was conducted from December 2021 to June 2023 after taking approval from ethical committee. All 34 patients treated with solid interlocking intramedullary nail, without reaming for open tibial fracture during 18 months period were included in the study. Final follow up was done at one year and the outcome was assessed by Modified Ketenjian’s criteria. Results: The mean time of union rate was 15.82±3.95 weeks. Complications were: superficial infections in 4 (11.76%) patients and deep infection in 1 (2.94%) patient. Using Modified Ketenjian's Criteria, 26 (76.47%) patients had an excellent result followed by good in 7 (20.59%), fair in 1 (2.94%) and there was no case with poor outcome. Conclusions: Solid intramedullary interlocking nail is an effective treatment with minimal soft tissue dissection for open tibia fracture less than GA III B as it provides stable fixation with early mobilization and provides a high rate of union, less complication and early return to function.