A Definitive Role of Antibiotic Impregnated Nailing in Compound Fractures of Tibia | Chapter 11 | Medical Research and Its Applications Vol. 9

 

Introduction: Antibiotic nails are currently the preferred treatment for Gustilo Type I, II, and IIIA fractures, replacing the conventional approach of fixing open tibia fractures. They not only expedite the one-step bone union process but also lessen the systemic adverse effects of parenteral antibiotics after surgery. These nails elute the antibiotic exactly in the right doses where it is needed to combat the infection and prevent a possible delayed union or hostile environment in Gustilo type I, II and IIIA compound tibial fractures.

 

Aim: The aim was to determine the definitive role of antibiotic-impregnated Intramedullary (IM) nailing in compound tibial fractures.

 

Materials and Methods: We treated twenty-five adults having compound tibial shaft fractures of Gustilo Type I and Type II and IIIA with antibiotic-impregnated IM nails to evaluate the outcome.

 

Results: Results were excellent to good in 92% (Lysholm’s scale). Partial weight bearing commenced at 5.44 weeks and full weight bearing after 10.48 weeks of operation on average. Radiological union achieved in 12 to 18 weeks (average 15.55 weeks) in all AO (Arbeitsgemeinschaft für Osteosynthesefragen, German for “Association for the Study of Internal Fixation”) group A, group B fractures with Gustilo type I injury. Complex (AO group C), while Gustilo type II took 12 to 22 weeks (average 16.69 weeks). One Gustilo type IIIA fracture showed delayed union (beyond 22 weeks). There was minimal incidence of infection [overall 24% (20% in type II- superficial in 12% and deep in 8% cases; 4% in type IIIA-deep)]. One Gustilo type IIIA fracture showed infection along the deeper tissue planes. In the present study, results were better when compared with the above-quoted studies as 100% union was achieved with an overall infection rate of 24% only. The infection did not hinder the union and resolved with a local antibiotic release through nail and concurrent administration of systemic antibiotics.

 

Conclusion: Antibiotic-impregnated nails can be a trustworthy alternative single-stage treatment modality, obviating the need for multiple procedures to achieve the bony union in open fractures of the tibia. Early range of motion exercises of joints and early weight bearing are permitted because breakage of the implant is very uncommon due to load sharing.

 

 

Author(s) Details

Kamal Kumar Arora
Government Medical College, Amritsar, Punjab, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mria/v9/1136

Comparison of Accuracy of Gender Identification between Regression Models Derived from Hand, Foot Measurements and Long Bone Measurements in a Sample of Kolhapur Population | Chapter 5 | New Visions in Medicine and Medical Science Vol. 6

 Introduction: Gender identification has been done using the measurements of various body parts such as trunk, vertebral column, limbs, long and short bones, hand, foot, frontal bone, etc.

Aim: The present study aims to compare the accuracy of the regression formula derived to predict gender using data on measurements of foot and hand with the formula derived to predict gender using the length measurements data of the long bones (tibia and ulna).

Methods: The samples are selected randomly from the patients attending outpatient services, the age range of the patients selected is 18-50 years.  (n=1000; 500 males and 500 females). Subjects suffering from any kind of bone deformity were excluded. Vallois method was used to estimate the measurements of hand, foot, tibia, and ulna. Regression formulas were obtained from the hand, foot-long bones measurements; to predict gender, using multiple logistic regression.

Results: Differences between male’s and female’s measurements of hand (P<0.001), long bones (P<0.001), and foot (P<0.001) were significant. The accuracy of the model used to predict gender, which was calculated from the dimensions of hand and foot was 81.5%. The accuracy of the model used to predict gender calculated from the long bone measurement was 78.3%. Surprisingly, dimensions of hand and foot seems to be a better predictor of gender, than long bones (tibia and ulna) length in the Kolhapur population. The major strength of this study is that it is one of the largest studies conducted to identify gender using data on the measurements of hand and foot.

Conclusions: Dimensions of hand and foot are a better predictor (81.5%) of gender vs the length of long bones (tibia and ulna) (78.3%) in the Kolhapur population. The applicability of the methods on populations from other geographic areas should be tested on skeletal samples in which the sex is known, either through documentation, other anthropological methods, or genetic analysis.

Author(s) Details:

Dr. Arun Karmalkar,
Department of Anatomy, D.Y. Patil Medical College, Kolhapur, India.

Dr. Vasudha Nikam
Department of Anatomy, D.Y. Patil Medical College, Kolhapur, India.

Please see the link here: https://stm.bookpi.org/NVMMS-V6/article/view/14281

A Case Report on Third Head of Biceps Femoris Muscle | Chapter 14 | New Frontiers in Medicine and Medical Research Vol. 6

 Variants of the biceps femoris, such as an auxiliary head of the biceps femoris, can be encountered on occasion. During regular cadaveric dissection at the department of anatomy, All India Institute of Medical Sciences, Jodhpur, we discovered a case with an accessory head of biceps femoris in both lower limbs.

The biceps femoris' long head fibres form the muscle belly, which runs down medially to the medial superior portion of the tibia's medial condyle. On the right side, the insertion point resembles a sheath and integrates halfway with the thigh's medial intermuscular septum. On the left side, the insertion seems to be a thin sheath at first, then a thin muscle belly. The muscle belly is slender in compared to the long and short heads of the basic muscle bellies. The left side has a thickness of roughly 3.7mm on the higher end and thinner on the lower end, whereas the right side has a thickness of around 3.75mm. The right side of the muscle belly is around 5cm long, whereas the left side is about 5.5cm long. After then, the muscular belly creates a sheath with a length of approximately.5mm before returning to its original length of around 3.5cm. A short head appears high above on the left side, whereas the right side is normal.

Author (S) Details

Surajit Ghatak
All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Sonali Adole
All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.             

Debajani Deka
All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Md Faizal
All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.             

View Book :- https://stm.bookpi.org/NFMMR-V6/article/view/2772

Morphological Variations of Nutrient Foramina in Lower Limb Long | Chapter 5 | Recent Research Advances in Biology Vol. 9

 Background: The nutrient arteries, which enter through the nutrient foramen, provide the majority of blood supply to the long bones. A nutrient foramen is a hole in the bone shaft that allows blood vessels in the medullary cavity of the bone to pass through. The nutrition foramen of all bones is directed away from the growing end and has a specific position for each bone. The goal of this study was to look at the topographic architecture and morphology of the nutrition foramina in adult human lower limb long bones. Materials and Methods: A total of 150 lower limb long bones, 50 femora, 50 tibiae, and 50 fibulae, were used in the study. The bones were taken from the Punjab Institute of Medical Sciences' department of anatomy in Jalandhar. The number and position of nutrient foramen in distinct lower limb long bones were observed to vary. Double and triple foramina were found in the femur. Nutrient foramen were not found in the femur or fibula. Conclusion: Knowing the topography of these foramina is useful in avoiding injury to the nutrition vessels during specific surgical procedures in orthopaedics, as well as in plastic and reconstructive surgery.

 
Author (s) Details

Dr. Mamta Sharma
Department of Anatomy, Punjab Institute of Medical Sciences Jalandhar, Punjab, India.

Dr. Rajeev Prashar
SMO I/C Fattudhinga, District Kapurthala, Punjab, India.

View Book :- https://stm.bookpi.org/RRAB-V9/article/view/2006