Browsing by Author "Subedi, Ram Sharma"
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Publication Clinical and Radiological Outcome of Anterior only Stabilization for AO Type B And C Subaxial Cervical Spine Injury: An Observational Study(Nepal Medical Association, 2025) Subedi, Ram Sharma; Hamal, Bhadra; Baral, Kabita Devi; Rijal, Badri; Karmacharya, Mahesh; Sah, Prem Kumar; Dhakal, Gaurav RajAbstract Introduction: AO type B and C subaxial cervical spine injuries are highly unstable and require surgical fixation for the stabilization. This study aims to determine their outcome after anterior stabilization clinically and radiologically. Methods: This was an observational longitudinal study conducted at tertiary level trauma center, from March 2021 to April 2022 after ethical approval from Institutional Review Board (Reference Number: 665/2077/78). Based on inclusion criteria total sampling was done. Cervical spine injuries AO type B and C operated with anterior cervical stabilization were included. Descriptive statistics were used to analyze data. Results: Among 21 total cases, 14 (66.67%) were male and 7 (33.33%) were female with the median age of 40 (IQR 32-51) years. Eleven (52.38%) patients sustained AO type B injury and 10 (47.61%) patients sustained AO type C injury. The commonest mode of injury was fall from height 14 (66.66%) followed by RTA 6 (28.57%) and physical assault 1 (4.76%). Postoperatively there was 33% improvement in incomplete neurology by one grade on ASIA neurology. Pain was evaluated using Visual Analogue Score and disability was evaluated using Neck disability Index scoring with the median value of 2 (IQR 0.4-3) and 10 (IQR 3-13) respectively. Radiographic failure was present in 2 (9.52%) patients. Forteen (66.66%) patients showed Grade 1 fusion, six (28.57%) showed Grade 2 fusion, and one (4.76%) showed Grade 3 fusion.. Conclusions: Most of the patients experienced mild pain and disability, stable fusion and low rate of radiographic failure with no new neurological deterioration. Almost half of the injuries occurred at the level of C5-C6.Publication LIMP Score and Anterior Cruciate Ligament Injury in Patient Undergoing Arthoscopy for Acute Knee Injury: An Observational Study(Nepal Medical Association, 2025) Karmacharya, Mahesh; Sherchan, Binod; KC, Bikash; Subedi, Ram Sharma; Rijal, Badri; Koju, Saphalata DeviAbstract Introduction: Globally, anterior cruciate ligament injury is common but difficult clinical diagnosis in acute setting because of pain during examination and difficult availability of investigations and diagnostic arthroscopy. Legs giving way, Inability to continue the task, Massive effusion and pop sound heard at the time of injury or LIMP score is a history based scoring which can be aid to diagnose anterior cruciate ligament injury. This study is designed to find out the proportion of patient with LIMP score of >2 having anterior cruciate ligament injury. Methods: An observational cross-section study was done among the patients visiting emergencies and out patient department of respective hospitals after approval from Institutional review Committee (Reference number: 23/2078/79). The LIMP score was assessed during the presentation and patients were followed up at arthoscopy for the final diagnosis. Results: There were 126 patients enrolled in the study among which 68 (54%) had LIMP score of >2. Out of the total, 74 (59%) had anterior cruciate ligament inury among which 67 (90.5%) had LIMP score >2. Among the patient who did not have anterior cruciate ligament injury, 51 (98%) had LIMP score <2. Conclusions: The proportion of patients having anterior cruciate ligament injury were higher in the category with LIMP score >2.