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Biomedical subjects

S S Sangwan

Publications and source records attributed to S S Sangwan.

At least 19 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↗
PubMed2005

Percutaneous bone marrow grafting for the treatment of tibial non-union.

This is a prospective study to evaluate the efficacy of percutanous bone marrow grafting in patients with established tibial non-union and minimal deformity, whilst on the waiting list for open surgical procedures. Twenty consecutive patients with established tibial non-union and minimal deformity were treated by percutanous bone marrow injection under local anaesthesia. Bone marrow was obtained from the iliac crest, 3-5 ml of marrow was aspirated and injected immediately into and about the non-union site. Subsequent aspirations were performed 1 cm posterior to the previous site until a maximum of 15 ml of marrow was injected. Our results revealed clinical and radiological bone union following percutanous injection in 15 out of 20 patients (75%), with an average time to union following the first injection of 14 weeks. Four patients (20%) showed no evidence of union and were considered a failure. There were no cases of infection following the injection, and no complications at the donor site. We conclude that percutanous bone marrow grafting is a safe, simple, and reliable method of treating tibial non-union with minimal deformity. It is a limited invasive technique with minimal complications. It can be performed under local anaesthesia, is cost effective and potentially can avoid major surgical reconstruction.

Adult↗
PubMed2005

Prolapsed intervertebral disc with sciatica: the role of common peroneal nerve block.

A total of 210 patients of Lumbar disc prolapse with sciatica were given common peroneal block by infiltrating 2% xylocaine around the common peroneal nerve 3 cm below the head of fibula on the affected side. After receiving the block the pain decreased on from grade 2.99 +/- 0.46 to 0.91 +/- 0.99, and straight leg raising increased from 32.1 +/- 12.55 to 59.66 +/- 12.11 degrees. The method, as an outpatient procedure, has been found to be simple and useful in the patients of sciatica with prolapsed lumbar intervertebral disc potentially appropriate for a low-resource setting.

Adolescent↗
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 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

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↗
PubMed2003

Evaluation of myelography and computed tomography in clinically diagnosed patients of lumbar disc herniation.

Forty patients with dinical diagnosis of lumbar disc herniation were evaluated with myelography and CT scan. Myelography diagnosed lumbar disc hemiation at 59 levels in 40 patients, while CT diagnosed disc hemiation at 64 levels. Lumbar disc hemiation was confirmed peroperatively in 30 out of 40 patients at 48 levels. Myelography correctly diagnosed 43 levels out of 48 levels and thus had a sensitivity of 89.6 per cent. CT diagnosed all the 48 levels correctly with a sensitivity of 100 per cent. Thus CT is super to conventional myelography in the diagnosis of lumbar disc herniation. However, conventional myelography supplements CT examination by limiting the number of scans to the level of interest and thus reduces radiation exposure.

Adult↗
PubMed2002

Functional restoration by excision arthroplasty in temporomandibular joint ankylosis--a report of 35 cases.

OBJECTIVE: To evaluate the long term functional results of excision arthroplasty in treatment of temporomandibular joint (TMJ) ankylosis. MATERIAL AND METHODS: This retrospective study includes 35 patients of TMJ ankylosis who were treated by excision arthroplasty and followed for a maximum period of eight years after surgery. Past trauma was documented as a major etiological factor in 63% cases. Fibrous ankylosis & unilateral involvement was found to be more common. Peroperatively a gap of 1 1/2 to 2 cm was created. The results were assessed according to a criteria based on inter-incial month opening, deviation of jaw and complications. They were satisfactory in 29 cases and there were 3 recurrences. CONCLUSION: Childhood trauma is a major cause of TMJ ankylosis in India. Long term results of excision arthroplasty are satisfactory & comparable to other surgical modalities that are in vogue, provided the patients are operated when young, the ankylosis is in early stage, gap created is adequate and post operative exercise regimen is followed diligently.

Adolescent↗
PubMed2002

External fixator in the management of trochanteric fractures in high risk geriatric patients--a friend to the elderly.

The best treatment option for trochanteric fracture in a geriatric high risk patient with all associated medical and surgical problems remains debatable. Conservative methods of treatment are associated with dangerous complications of prolonged recumbency while open reduction and internal fixation under anaesthesia significantly increases the mortality and morbidity rates. We treated 110 elderly patients who were unfit or high risk cases for anaesthesia and major surgery for internal fixation due to associated medical and surgical conditions, by external fixation under local anaesthesia. The average age was 65 years and mean follow up was 18 months. 83.3% were ambulatory with support and 97.2% were able to manage activities of daily living at the time of discharge. At 18 months post surgery, 74% were ambulatory with a stick or better. The fracture united in an average of 16.4 weeks. Overall satisfaction rate was 80% at end follow up. The mortality rates were comparable to series of open reduction and internal fixation. Pin tract infection and knee stiffness were the major complications. External fixation done under local anaesthesia offers advantages in the form of a quick, simple relatively inexpensive procedure with negligible blood loss, preserves fracture haematoma, can be easily removed as an out patient procedure, besides it provides earliest possible ambulation and day care to the elderly high risk patient.

Aged↗
PubMed2002

Leeds procedure--a treatment modality for scoliosis.

The present study comprises of forty patients of scoliosis in growing age group (10-25 years) with Cobbs angles ranging from 52"-98". They were treated with Leeds procedure which is by anterior loosening followed by Posterior Harrington fixation + Luque derotation + Fusion and Costoplasty. Majority of the curves were thoracic (60%), and right sided (72%). Average correction of the deformity after surgery was 45%. Satisfaction level of patients and parents was good in 60% of the cases. The modality of treatment was decided on the basis of personality of each case, its demand and requirement, time of presentation and the potential for increasing severity. Anterior spinal surgery for scoliosis is an effective procedure in hands of experienced surgeons and it reduces stiffness of the curve, shorten the anterior column, decreases thoracic lordosis which leads to some improvement of pulmonary function. But there is greater risk of damage to vital structures with higher risks of cardiorespiratory failure. The potential risks have to be balanced with the expected rewards. The optimum method of correction has to be decided by careful preoperative evaluation. Combined procedure of anterior and posterior surgery causes lesser decrease in pulmonary functions than costoplasty alone, and achieving better cosmetic correction. This study reaffirms the role of anterior spinal surgery in India as the patients due to lower levels of health awareness present late and with severe deformities.

Adolescent↗
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↗
PubMed2001

Role of percutaneous bone marrow grafting in delayed unions, non-unions and poor regenerates.

The present study comprises of 72 patients of post traumatic delayed unions, established non-unions, poor regenerate in segmental bone transportation and limb lengthening procedure treated by percutaneous injections of autogenous bone marrow at the site of failed healing. The average follow up was 4 years. Bone union was achieved in 68 patients. Overall, 72.2% of the patients had an excellent result, 11.1% a good result, 11.1% a fair result and 5.5% a poor result or failure. These results with only 4 failures (5.5%) are encouraging and suggest that percutaneous autogenous bone marrow grafting is a simple, safe and useful technique in the treatment of delayed unions and non-unions. We believe that this technique of percutaneous autogenous bone marrow grafting can be a procedure of choice in those patients where Phemister or Forbes methods of bone grafting alone is required, especially in limbs with scarred and poor soft tissue coverage. This procedure can also be useful in iatrogenic delayed or non-unions which is the commonest cause of non-union in present era of enthusiastic fracture fixation.

Bone Marrow Transplantation↗
PubMed2001

Synovial hemangioma--a case report.

True synovial based hemangiomas are rare lesions and should be differentiated from mass lesions especially pigmented villonodular synovitis. A case of 4 years old male child, presenting with recurrent painful swelling, is described in the present article. The differential diagnosis is also discussed.

Child, Preschool↗
PubMed2000

Unicompartmental osteoarthritis of the knee: an innovative osteotomy.

Thirty patients with unicompartmental osteoarthritis of the knee and genu varum deformity ranging from 2 degrees to 15 degrees were treated with high tibial osteotomy by using a medial open wedge, stabilized and distracted with our fixator. Pain relief and correction of deformity were achieved in all except two cases.

Aged↗
PubMed1999

Role of pin traction in wound closure.

This study examined the role of pin traction in wound closure. Forty patients comprised the study population. Wounds treated were on legs, thighs, and forearms. Kirschner wires were passed around margins of the wound and interconnected with stainless steel wires, which were gradually tightened to approximate the wound edges to healing. Final results were excellent in 18 (45%), good in 13 (32.%), fair in 5 (12.%), and poor in 4 (1%) patients. The main complication was cutting through the wires. The results were unsatisfactory in old, scarred, and large wounds.

Adolescent↗
PubMed1996

Gluteus maximus island flap for the repair of sacral pressure sores.

Surgical management of decubitus ulcers in spinal cord injured patients (SCI) has been considerably improved by the application of muscle, myocutaneous and fasciocutaneous flaps. The goal of the present study was to do a critical analysis of the use of a gluteus maximus island flap for sacral pressure sores in paralysed as well as nonparalysed patients. In a prospective study, 34 patients with sacral pressure sores from grade V to VII were treated by gluteus maximus myocutaneous island flaps. Follow up ranged from 1.8 years to 6.2 years. Results were evaluated according to criteria based on (i) extent of wound dehiscence (ii) flap necrosis (iii) recurrence. Final results were excellent to good in 30 cases (88.3%). Poor results occurred in two patients (5.8%) and recurrence in one (2.9%) due to a major flap necrosis. Postoperative infection and wound dehiscence occurred in two cases each. No systemic complications occurred except for one patient who died from uraemia. The rehabilitation of these patients was improved. The postoperative duration of stay in hospital was from 18 to 32 days (mean: 22.5 days). The majority of the patients were quite pleased with the operation.

Anesthesia↗