Browsing by Author "Thapa, Shrawan Kumar"
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Publication Demography of Total Joint Replacement Surgeries Performed in a Tertiary Care Hospital: A Cross-sectional Survey Authors(Nepal Medical Association, 2021) Thapa, Shrawan Kumar; Kandel, Manoj; Panta, Sunil; Adhikari, Bishwa RajAbstract: Introduction: Total joint replacement of hip and knee is considered as one of the most successful orthopedic surgeries in the twenty-first century because of the only solution to end-stage arthritis of these joints. The real burden of the problem is yet to be established in developing countries like Nepal. This study aims to describe the demographic findings of the joint replacement surgeries among total lower limb surgeries in a tertiary care hospital. Methods: This cross-sectional survey was conducted using the hospital records of 73 total joint replacement surgeries of the lower limb in the Department of Orthopedics of a tertiary care hospital from November 2016 to November 2020. Ethical approval was taken from the Institutional Review Committee (reference number: 077/78-011). Convenience sampling was done. Data analysis was done using the Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: There were 73 total joint replacement of hips and knees. Of which, 32 (43.84%) total hip replacements were done in which one (3.13%) patient had a simultaneous bilateral hip replacement in single-stage and the other one (3.13%) had two-stage bilateral hip replacement. Forty one (56.16%) total knee replacements were done in which 18 (24.65%) had a simultaneous bilateral knee replacement and five (6.85%) had a unilateral knee replacement. Conclusions: Total joint replacements of the hip were more common among the lower limb surgeries.Publication Hoffa’s Osteochondroma - Para-articular Extrasynovial Infrapatellar Fat Pad Osteochondroma: A Case Report(Nepal Medical Association, 2021) Panta, Sunil; Thapa, Shrawan Kumar; Paudel, Krishna Prasad; Kandel, Manoj; Adhikari, Bishwa RajAbstract: Osteochondroma usually arises from the metaphyseal region of growing bones. The occurrence of extraskeletal osteochondroma is rare with very few case reports. Para-articular osteochondroma is a type of extraskeletal osteochondroma. It frequently occurs around the knee, usually at infrapatellar Hoffa’s fat pad. It is usually intracapsular but extrasynovial and arises from the capsule and connective tissues due to osteocartilaginous metaplasia. We present a case of 19-years male with anterior knee pain for 3 years, swelling, and deformity of the knee with flexion limitation for one year. Radiography revealed ovoid, corticated lesion free from adjoining bones. Mass interpreted as benign, so planned for excision. Well circumscribed nodule excised from the medial parapatellar approach. Histology revealed cartilaginous tissues surrounded by fibrous tissues with scattered enchondral ossification. Postoperatively and subsequent follow-up resulted in pain-free joint, complete recovery of range of motion with no clinicoradiological evidence of recurrence.Publication Osteoporosis among Postmenopausal Women Attending the Orthopedics Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Panta, Sunil; Neupane, Madhu; Thapa, Shrawan Kumar; Sapkota, KalyanAbstract: Introduction: Osteoporosis and resulting fracture is a major public health concern worldwide. With increase in life expectancy, osteoporosis and fragility fracture is expected to be more prevalent. It is associated with high patient morbidity, while hip and vertebral fractures have high mortality. The real burden of the problem is yet to be established in developing countries like Nepal. This study aims to find out the prevalence of osteoporosis among postmenopausal women visiting a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted among 89 postmenopausal women attending at Orthopedic Outpatient Department of Bharatpur Hospital from 1st January 2019 to 30th December 2019 with postmenopausal status. The ethical clearance was taken from the Institutional Review Committee of Bharatpur Hospital. Convenience sampling technique was used. Bone Mineral Density was estimated with dual energy x-ray absorptiometry scan Statistical Package for Social Science was used for analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 89 postmenopausal women, 29 (32.58%) (Confidence Interval = 32.48-32.68) women had osteoporosis. The mean age and Bone Mineral Density were 62.16±8.17 years and 0.968±0.14 g/cm² respectively. The women with history of fragility fracture had low bone mineral density. Conclusions: Prevalence of osteoporosis was high. Women with history of fragility fracture are at increased risk of another fragility fracture. It is hence necessary to have awareness programs and early screening to minimize the magnitude of morbidity and mortality associated with osteoporosis.Publication Radial Head Arthroplasty among Patients with Radial Head Fracture in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Kandel, Manoj; Banjade, Deepak; Thapa, Shrawan Kumar; Kandel, Prakash; Adhikari, Bishwa Raj; Neupane, KabinAbstract Introduction: Proximal radial fractures are a common type of fracture around the elbow joint. Among these comminuted radial head fractures are commonly associated with secondary injuries and instability of the elbow joint. Management of the radial head in such cases is very important in restoring the stability of the elbow joint and starting early mobilization. The aim of this study was to find out the prevalence of radial head arthroplasty among patients with radial head fracture in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 25 January 2019 to 25 December 2020 among patients with a radial head fracture at the Department of Orthopaedics of a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee (Reference number: 076/77-08A). A convenience sampling method was used. The study group consisted of patients between 20 to 60 years of age with isolated radial head fractures. Radial head arthroplasty was done for Mason types III and IV fractures and functional outcome was calculated postoperatively with Mayo elbow score on follow-up at 3-, 6- and 12-month intervals. Point estimate and 95% Confidence Interval were calculated. Results: Out of 96 patients with radial head fracture, 22 (22.92%) (17.59-28.25, 95% Confidence Interval) underwent radial head arthroplasty. The mean Mayo elbow score was 96.33±7.74 at 12 months of follow-up. Conclusions: The prevalence of radial head arthroplasty among irreparable radial head fractures was similar compared to other studies done in a similar setting.Publication Traumatic Spinal Injury among Patients with Spinal Injuries Admitted to the Spine Unit of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Paudel, Krishna Prasad; Panta, Sunil; Thapa, Shrawan Kumar; Thapa, SushilAbstract Introduction: Traumatic spinal injury is a major source of morbidity and mortality throughout the world. The number of spinal injuries is growing annually but epidemiological and demographic features may be different in different regions. This study aims to find out the prevalence of traumatic spinal injury among patients with spinal injuries admitted to the spine unit of a tertiary care centre. Methods: This was a descriptive cross-sectional study was done on a total of 102 traumatic spinal injury patients admitted to the spine unit of a tertiary care centre from 1st June, 2019 to 31st May, 2021 after receiving ethical approval from the Institutional Review Committee (Reference number: 077/78-09). Demographic details, mode of injury, morphology, patterns of fractures, neurological level, and management methods in the hospital were recorded. Convenience sampling was done. Data were analysed using the Statistical Package for the Social Science version 24.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentages for binary data. Results: Among 130 spinal injury patients, the prevalence of traumatic spinal injury was found to be 102 (78.46%) (71.39-85.53 at 95% Confidence Interval). The most common mode of spinal injury was due to falls in 80 (78.43%) cases. Conclusions: The prevalence of traumatic spinal injury was higher when compared to the other studies done in similar settings.Publication Traumatic Spinal Injury among Patients with Spinal Injuries Admitted to the Spine Unit of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Paudel, Krishna Prasad; Panta, Sunil; Thapa, Shrawan Kumar; Thapa, SushilAbstract: Introduction: Traumatic spinal injury is a major source of morbidity and mortality throughout the world. The number of spinal injuries is growing annually but epidemiological and demographic features may be different in different regions. This study aims to find out the prevalence of traumatic spinal injury among patients with spinal injuries admitted to the spine unit of a tertiary care centre. Methods: This was a descriptive cross-sectional study was done on a total of 102 traumatic spinal injury patients admitted to the spine unit of a tertiary care centre from 1st June, 2019 to 31st May, 2021 after receiving ethical approval from the Institutional Review Committee (Reference number: 077/78-09). Demographic details, mode of injury, morphology, patterns of fractures, neurological level, and management methods in the hospital were recorded. Convenience sampling was done. Data were analysed using the Statistical Package for the Social Science version 24.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentages for binary data. Results: Among 130 spinal injury patients, the prevalence of traumatic spinal injury was found to be 102 (78.46%) (71.39-85.53 at 95% Confidence Interval). The most common mode of spinal injury was due to falls in 80 (78.43%) cases. Conclusions: The prevalence of traumatic spinal injury was higher when compared to the other studies done in similar settings.