Browsing by Author "Uprety, Suresh"
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Publication Outcome of Elastic Stable Intramedullary Nail in Length Unstable Diaphyseal Femur Fractures in Children: A Case Series(Institute of Medicine, 2020) Bhandari, Prawesh S; Uprety, SureshABSTRACT Introduction: Elastic stable intramedullary nailing (ESIN) has been a common method of treatment of diaphyseal femur fracture in children. Though they are used in length stable fracture with favourable results, their use is debated in case of length unstable variants. The objective of the study was to evaluate outcome of these nails in length unstable diaphyseal femur fracture in children. Methods: We retrospectively reviewed seven fractures in seven children treated with ESIN for functional outcome. Results: Total of seven patients with seven unstable femur fractures were studied. There was male predominance with 71.4%. The fracture united at a mean duration of 12 wks. The overall Flynn scoring showed 71.4 % excellent and 28.6 % satisfactory result. Conclusion: Elastic stable intramedullary nailing can be safely used in length unstable variant of femur fracture in children. Keywords: Elastic stable nailing, length unstable, pediatric femur fracturePublication Prevalence of Surgical Glove Perforation in Orthopedic Surgery at Tribhuvan University Teaching Hospital: An Observational Study(Nepal Medical Association, 2025) Bhandari, Prawesh Singh; Adhikari, Shirish; Deo, Nitish Bikram; Uprety, Suresh; Bastola, PriskaAbstract Introduction: Gloves provide a physical barrier preventing cross-infection between the operating team members and the patient. However, there is always a chance of the gloves perforating and breaching this barrier. This study attempts to understand the prevalence of perforation of surgical gloves in orthopedic surgery at Tribhuvan University Teaching Hospital. Methods: This was an observational cross-sectional study carried out over three months. Gloves from the chief and first assistant surgeons were checked for visible perforation and occult perforation by water leak test. The type of surgery, hand dominance, duration of surgery, time during surgery when perforation occurred, and area of glove perforation were noted. Operative perforation rate, Overall glove perforation, and Operative perforation based on type of surgery, and duration of surgery were calculated. The categorical variables obtained were summarized with frequency and percentage. Results: A total of 166 cases were included in the study. The operative perforation rate was 79 (47.59%; 95% CI: 39.80-55.47%) and the overall glove perforation was 117 (8.81%). Trauma surgery was the most common surgery performed during this study 111 (66.86%) and 56 (50.45%) of trauma surgery cases had glove perforation. Glove perforation was noticed by 25 (43.85%) of chief surgeon during surgery, out of which 11 (44%) of it was between 0.5 to 1 hour. Similarly, 20 (50%) of assistant surgeon noticed glove perforation during surgery, out of which 9 (45%) of it was between 1 to 1.5 hour after starting the surgery. Conclusions: Perforations of the surgical gloves was comparable to other published literature. Trauma surgery was the most commonPublication Role of Ultrasonography in Early Diagnosis of Acute Osteomyelitis(Institute of Medicine, 2018) Sigdel, Bhim; Uprety, Suresh; Bhandari, Prawesh Singh; Paudel, SharmaAbstract Background: Osteomyelitis is the inflammation involving bone and bone marrow caused by a pathogenic organism. Acute osteomyelitis is one of the commonest bone infection in childhood and is a significant cause of morbidity. Timely diagnosis and intervention is critical for outcome. Imaging studies play an important role in diagnosis of osteomyelitis. Various modalities, including conventional radiography, bone scintigraphy, ultrasonography, computed tomography (CT) and magnetic resonance (MR) imaging have all been used. The purpose of this study is to evaluate the diagnostic value of ultrasonography in early diagnosis of acute osteomyelitis Methods: A prospective non-randomised analytical study in 30 children with sign and symptoms suggesting acute osteomyelitis presenting in Emergency Room(ER) and Out-patient department(OPD) of Tribhuvan University Teaching Hospital (TUTH) was carried out. Plain radiograph was done to each patient followed by Ultrasonography. Results: Twenty four patients (80%) were finally diagnosed to have osteomyelitis. Distal femur was most commonly involved site (33.33%). Sensitivity of USG was found to be 91.6% and specificity to be 83.3%. Conclusion: Ultrasonography was found to be highly sensitive and highly specific in early diagnosis of acute osteomyelitis in children with clinical suspicion of the disease and negative plain radiographs. Keywords: Acute hematogenous osteomyelitis, Cortical erosion, Deep soft tissue swelling, periosteal elevation, pericortical fluid, Ultrasonography.