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Biomedical subjects

K M Marya

Publications and source records attributed to K M Marya.

11 recordsLinked to original sources
PubMed2006

Unusual K-wire migration.

The authors report a case of intra-abdominal migration of a Kirschner wire from the left hip to the right lobe of the liver in a 5-year-old child. The wire was used for stabilization of the left hip after open reduction for neglected unreduced congenital dislocation of the left hip. The migrated wire was removed by laparotomy. Surprisingly, no injury was noted to any intervening abdominal structure intra-operatively. This unusual migration of a Kirschner wire into a child's liver has not been reported previously.

Bone Wires↗
PubMed2004

Compressive peroneal neuropathy during harvesting season in Indian farmers.

Thirty patients (34 limbs) with compressive peroneal neuropathy induced by prolonged squatting of more than 5 h during harvesting season were treated conservatively and followed-up to an average of 28.2 months. A marked preponderance of involvement of the left side was noticed. We attribute this to the intermittent extension of the right lower limb habitually used by Indian farmers to propel themselves forwards while squatting during harvesting. All but two lesions recovered fully within 3 to 9 weeks: one patient took 16 and another 20 weeks. We recommend non-operative treatment for this benign lesion.

Adolescent↗
PubMed2003

An innovative compression-clamp for open contaminated fractures of patella: a short report of five cases.

Five patients with open contaminated fractures of the patella were managed using an indigenously designed external clamp cum compressor. All had an infected lacerated wound at the fracture site, and one had open exposed knee joint (Gustilo grade IIIB open fracture). These patients reported after 3-7 days of injury. The wounds were thoroughly washed and débrided and the clamp cum compressor was applied. They were encouraged to do active knee movements immediately post-operatively. The wounds healed within 3-4 weeks, and the fractures united within 10-16 weeks. Good functional results were achieved in four of the five.

Adult↗
PubMed2003

Critical evaluation of mangled extremity severity scoring system in Indian patients.

Amputation of a mangled extremity is repugnant to the patient and the surgeon. However, prolonged unsuccessful attempts at salvage are costly, highly morbid and sometimes lethal. Much discussion has taken place regarding which criteria predict successful salvage, and predictive indices have been proposed in an attempt to identify limbs for which attempted salvage is unlikely to succeed. The mangled extremity severity score, or MESS system is the most thoroughly validated of the various classification systems, but at present there is no predictive scale that can be used with confidence to determine whether to amputate or attempt to salvage a mangled lower extremity. MESS system based on four significant criteria (with increasing points with worsening prognosis) i.e. skeletal injury, limb ischaemia, shock and patient age, has become a standard method to determine which one of the mangled extremities will eventually undergo amputation or salvage. Keeping in view the paucity of studies on Indian patients, a prospective trial of MESS was done in 50 patients who had 56 mangled extremities during the last 3 years. A significant difference between the MESS value of salvaged limbs (4.7) and amputated limbs (8.6) was found. MESS value of more than 7 was most specific and was found to have a positive predictive value of 100%. The results have been compared with Western literature and authors suggest that nerve injuries and irreparable soft tissue loss should be given an extra point each. In bilateral cases, the MESS value of each limb should be properly assessed (especially when patient is in shock), as the score may increase because of the other injured limb.

Adult↗
PubMed2003

Critical evaluation of compartment pressure measurement by saline manometer in peripheral hospital setup.

A hundred limbs of patients suffering limb trauma were assessed by at least two different reviewers for symptoms of compartment syndrome, both clinically, and by a simple, locally devised apparatus for pressure measurement. We have found the apparatus to be very effective, safe, reproducible and simple. Orthopaedic surgeons working in peripheral hospitals in the developing world can make use of this apparatus which costs less than 5 dollars to assemble. This technique may assist an early decision regarding surgical decompression at a peripheral hospital or referral to specialist unit, thus saving valuable time and expense.

Adult↗
PubMed2003

A technique to prevent Ender nail back-out.

Ender nails are advantageous in the treatment of certain fractures; however, inadequate fixation and back-out are frequent complications. This article presents a simple looping technique that prevents Ender nail back-out.

Bone Nails↗
PubMed2003

Painful bilateral bipartite patellae--case report.

Bipartite patella is usually asymptomatic. Painful bipartite patella is either non-surgically managed by immobilization, anti-inflammatory drugs and physical therapy or treated by excision. We report a case in whom locally injected bupivacaine and steroid (methylprednisolone acetate) injection relieved the symptoms completely in a case of bilateral painful bipartite patellae.

Adult↗
PubMed2003

Medial opening wedge high tibial osteotomy for osteoarthritis of knee: long-term results in 50 knees.

To retrospectively study the long term results of high tibial valgus osteotomy in management of primary medial compartment osteoarthritis, with special reference to patient satisfaction and functional assessment, we conducted this study in radiologically established 50 knees of patients with primary osteoarthrosis of knee. In these patients with medial compartment disease (varus knee), medial open wedge osteotomy was performed using full thickness iliac crest grafts. These were called for follow-up after average 7.5 years and clinico-radiological assessment was done. Although many surgeons of the west do not favour this osteotomy, we found the procedure to be quite acceptable to our patients in whom the primary concerns of cost and squatting habits are well taken care of. The authors feel that this osteotomy is still relevant in the third world. Results do deteriorate with time but most patients consider the surgery satisfactory.

Adult↗
PubMed2002

Cubitus varus--correction by distraction osteogenesis.

Cubitus varus deformity in thirty children was corrected by gradual medial opening wedge osteotomy. The osteotomy was stabilized and distracted by simple external fixator-cum-distractor. The patients of both sexes and age from 6 to 14 years, had varus deformity from 17 degrees to 43 degrees. We achieved good to excellent results in 28 cases as regards to correction of deformity and range of motion at elbow joint. None of the cases had neurological deficit or permanent stiffness. One case had fair result due to under-correction and another case had a poor result as osteotomy united before correction. The main complication faced was superficial pin-site infection particularly in summer season and a in fatty children but was managed by good pinsite dressing and care. The technique has been found to be quite effective, technically simple, cosmetically acceptable and with little, if any, lazy S deformity.

Adolescent↗