Keywords : Reconstruction
An Evaluation of the Clinic Radiological Effects of Single-Versus Double-Bundle Arthroscopic Anterior Cruciate Ligament Reconstruction
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 3, Pages 889-894
The research objective was to compare the clinical and radiological results of single-bundle versus double-bundle arthroscopic anterior cruciate ligament (ACL) replacement.
Method: 80 patients with isolated ACL injuries had surgery between July 2020 and July 2021, with groups for single bundle (SB) and double bundle (DB) reconstructions each consisting of 40 individuals. The GNRB arthrometer, the International Knee Documentation Committee, and the Lysholm scale were used to evaluate the results. The lateral pivot-shift test was used to evaluate rotational stability. To compare the repaired ACL graft orientation, postoperative magnetic resonance imaging (MRI) was done.
Result: The average follow-up was 18.2 months for the DB group and 14.8 months for the SB group. The mean Lysholm score was 94.12±2.66 in the SB group and 93.12±3.30 in the DB group at the time of the final follow-up (P value = 0.201, statistically insignificant). According to the objective IKDC scores, all of the patients in both groups were in grade A or B. The mean differential anterior tibial translation in the SB group was 1.44 ± 0.5 mm and in the DB group it was 1.16 ± 0.7 mm (P = 0.104, NS). In the DB group, all of the pivot shift tests were negative, whereas in the SB group, three patients showed positive results. According to an MRI of surgically repaired knees, both groups' mean sagittal and mean coronal ACL graft-tibial angles were equivalent (P value > 0.04, NS).
Conclusion: At an average of 15 months of follow-up, there was no statistically significant difference between the single-bundle and double-bundle ACL repair groups in terms of knee stability, knee ratings, subjective assessments, or MRI examination of graft inclination angles.
Reconstructions Of Length Of Ulna From Its Fragments-A Pilot Study In Eastern Indian Population
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 13-30
Background: In a densely populate, demographically diverse and vast country like India, the identity establishment of a dead person assumes great medico-legal importance. It also poses a true challenge to the forensic pathologist working in an environment where decomposition and taphonomic process are highly rapid and variable. One of the important pillars for identification is the stature. The estimation of age, sex and stature are vital for skeletal samples, when found from sites in mixed lot. So, a technique is urgently needed for reconstruction of total length of long bones from their fragments. This investigation was designed to estimate the total length of ulnas using its fragmentary bone length in a population specific study. In addition to this, the goal was to deploy them in stature formulae for population specific cases and lastly to estimate the stature of the individual.
Materials and Methods: After getting institutional ethical committee clearance, the study over 50 Ulna Bone revealed linear equation where total length of ulna was used as dependent variable and the different fragmentary length being the independent variables.
Results: The measurements of both sides (left and right) were grouped and noted separately but the results were pooled to obtain the regression equation. This was done because no significant difference in measurement between the left and right side in the sample of 50 ulna bones. The following Regression Equation was obtained:-
TOTAL LENGTH OF ULNA = 3.85+ 4.53QR +0.71ST +1.81PQ+0.32 TU
R SQUARED VALUE = 0.97.
Conclusion: This study was a preliminary work and a pilot project for estimating the regression equation to reconstruct the total length of ulna from its fragmentary lengths in a population specific sample (Eastern Indian population). Being population specific, it can be applied in disputed cases of identification of mutilated and fragmentary human remains of that geographic region and can be of immense help in future, especially for the law enforcement agencies in the case of mass disasters.
Reconstruction Of Anterior Cruciate Ligament With Autologous Peroneus Longus Tendon Graft: A Prospective Study In Tertiary Care Hospital, Rajahmundry, Andhra Pradesh
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 1, Pages 4755-4759
Background: ACL injuries are commonly associated with sports injuries and road traffic accidents. Incidence of ACL ruptures is estimated to range from 38-78 % per 100000 person years. The primary aim of ACL reconstruction is to restore the function of the ACL and native kinematics of the knee. ACL reconstruction restores the stability of the knee joint and protects the menisci and joint surfaces from further damage. The most preferred graft tissues for ACL reconstruction are hamstrings in view of better cosmesis, satisfactory results and to minimize postoperative mobility. However, use of peroneus tendon graft is increasing in view of simplicity of the technique. Peroneus longus graft harvest is possible due to synergistic action of peroneus longus and peroneus brevis. Even some studies suggest that peroneus brevis is more effective evertor than peroneus longus, justifying harvest of peroneus longus tendon.
Materials & Methods: We have done 26 cases of ACL injuries treated with arthroscopic ACL reconstruction using peroneus longus autograft at GSL medical college between Jan 2020 to Dec 2020. Cases were followed up for a period of 1 year and have been evaluated based on Lysholm, AOFAS and FADI score systems.
Results: In our study, all 26 patients have completed follow up for 1 year (19 male, 7 female). At final follow up anterior drawer test showed normal findings in 80percent, while 20 percent of all examined patients had 1+ anterior laxity.
Conclusion: Peroneus longus tendon is a promising autograft for ACL reconstruction with advantage of simplicity of harvesting technique, larger graft diameter, minimal graft complications.
A Study on Submental Island Pedicle Flap (Sipf) in Oral Cavity Reconstruction – A First Hand Experience
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 3737-3741
The aim of this study is to study on submental island pedicle flap (sipf) in oral cavity reconstruction – a first hand experience.Functional results such as deglutition and speech were not affected post-surgery. This study has been carried out on 20 oral carcinoma patients admitted in surgical oncology ward of Index Medical College Hospital & Research Centre, Indore (M.P) and underwent oral reconstruction. Prior to admission, proper screening along with detailed clinical evaluation with detailed history of each patient was done.
Duration of surgery and duration of hospital stay were significantly less. Small to medium sized defects of oral cavity. Colour and texture of donor and recipient site matches perfectly in SIPF. Donor site defect can be closed primarily. Donor site scar is acceptable and not visible as it is in continuation with upper neck dissection scar. In male patients growth of hair at the recipient site was a significant problem. SIPF is well suited for small defects and is good alternative for oral reconstruction.
THE PES ANSERINUS: THE ANATOMY AND PATHOLOGY OF NATURALLY OCCURRING AND EXTRACTED TENDONS
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 2312-2320
The goal of this article is to have a comprehensive review of the anatomy of the pes anserinus (PA) and the spectrum of pathologic conditions that can affect this structure. After the insertion site of the PA tendons was fully exposed, careful dissection was performed to determine the exact shape of the PA. Insertions were made into the gracilis and superficial layers of the sartorius and the deep layers of the semitendinosus on the medial side of the tibia. Sixty-six percent of specimens had one semitendinosus tendon at the insertion site, while 31 percent had two, and 3 percent had three. A connection was made between the deep fascia of the leg and the tendons of the gracilis and semitendinosus. The anserine bursa was a somewhat asymmetrical, roughly circular shape. Some of the anserine bursa specimens even extended beyond the proximal line of the tibia. The anserine bursa, as seen from the medial side of the tibia, was situated posteriorly & superiorly from the tibial midline, paralleling the sartorius muscle. Anserine bursa injections should be given at an angle of 20 degrees medially and inferiorly from the vertical line, 15 or 20 millimetres deep, and roughly 20 millimetres medially and 12 millimetres superior from the inferomedial point of the tibial tuberosity.
RESULTS OF SURGICAL TREATMENT OF CONGENITAL HIP DISLOCATION
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 3, Pages 939-947
Relevance. At present, although significant progress has been made in the field of early detection of congenital malformations and conservative treatment, a large number of patients with this pathology remain untreated in a timely manner. In 10-15% of patients treated conservatively with congenital malformations of the thighs, the need for surgical treatment arises. Purpose of the study. It consists of studying the causes of complications observed during long periods of treatment of patients treated surgically on congenital malformations of the thighs and looking for measures to prevent them. In such cases, depending on the age of the patients and the severity of the discharge, surgical procedures are performed, ranging from simple open placement to repair and opening of the proximal part of the femur and the roof of the joint.This article presents the results of surgical treatment performed for 111 children with congenital hip dislocation. After 30 years, the long term results of the intervention were studied in 76 (68.5%) patients. According to observation, 22(28.9%) patients and 31(40.8%) patients demonstrated good and satisfactory long term results respectively. While results of surgical treatment for 23(30.3%) patients estimated as unsatisfactory. Identified the causes of unsatisfactory results and preventive measures were recommended.
Anterior cruciate ligament reconstruction: single-bundle hamstring versus double-bundle reconstruction with lavsan (polyethylene terephtalate)
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 2, Pages 951-959
Anterior cruciate ligament is one of the main stabilizateur of the knee joint. Many methods were suggested for its reconstruction with different allo- and autografts, as well as synthetic materials. The aim of study is to compare of two methods of ACL reconstruction. Material and metods. The study included 110 patients who underwent ACL reconstruction. I group (54 patients) underwent single-bundle ACL reconstruction with hamstring tendons, II group (56 patients) underwent double-bundle reconstruction with lavsan (polyethylene terephtalate) tape. Patients were evaluated with Lachman, anterior drawer and pivot-shift tests and Lysholm score. Results. Our results showed better results in double-bundle group, especially rotational stability was significant better. Conclusion. Independing of the method of ACL reconstructions these surgeries must be perform taking into account anatomic features and changes of the knee. Double-bundle technique of ACL reconstruction with lavsan provides better stability than single-bundle technique with hamstring tendons.
Reconstruction of Guarantee for Legal Protection of Communities Affected by Land Procurement For Railway Construction In Indonesia
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 8, Pages 296-30
This study aims to analyze the concept of regulation that guarantees adequate legal protection in the event of problems in fulfilling the rights of compensation for entitled parties. This research uses normative or doctrinal standard research methods. Primary data sources were obtained through field studies, while secondary data used literature studies data collection techniques using surveys, interviews, and literature study. The data analysis technique used a qualitative approach with an interactive model. The sampling method used was purposive and snowball sampling. In terms of its nature, this dissertation is explanatory research, and from the point of view of its form, it is a prescriptive study. In this legal research, the researcher uses 2 (two) approaches, the statute approach, and the conceptual approach. The results show, in terms of the validity theory of Gustav Radbruch's law, the guarantee of the legal protection of Law Number 2 of 2012 on the process and mechanism for providing compensation for entitled parties have valid validity from a juridical review but does not yet have valid validity from philosophical thought. And sociological. This study also concludes that it is necessary to reconstruct the land acquisition law, mainly concerning the provisions governing the process and mechanism for providing compensation or compensation to entitled parties. To guarantee legal protection in drafted regulations to fulfill the fundamental values of justice and benefits for the community, reconstruction is directed at a. There is the involvement of parties entitled as the subject of land acquisition rights with appraisal in the assessment of land acquisition objects, b. the presence of a dispute resolution institution with a non-litigation paradigm (PnLg) in the form of mediation, c. there is a change in the term "compensation" to "compensation," and d. there are additional rights for entitled parties, namely: "the right to get adequate compensation." Based on the above conclusions, it is recommended that the government revise Law Number 2 of 2012.
EVALUATION OF SUBMENTAL ISLAND FLAP FOR RECONSTRUCTION OF INTRAORAL DEFECTS
European Journal of Molecular & Clinical Medicine,
2017, Volume 4, Issue 1, Pages 309-316
Diverse flaps are used for the reconstruction of various intraoral lining defects in patients with oral cancer. If flaps are properly selected according to each patient’s need, it gives satisfactory functional and cosmetic results with minimal or no morbidity. Here we are to evaluate the usefulness of submental island flap for the reconstruction of tongue and other intraoral soft tissue defects.
Methods: Patients who underwent intraoral reconstruction using submental island flaps were selected.Postoperatively the patients were assessed for the functional status in terms of Ryle’s tube feeding, speech intelligibility, swallowing and tongue mobility. They were also assessed for flap loss and donor site scars. Usefulness of submental island flap was assessed with these criteria.
Results: Over two years submental flaps were used for 17 oral cancer patients in the departments. Except for one case of partial flap loss, and one case of epithelial loss, all flaps survived. Venous congestion of the flap was observed in 4 cases for a few days. All patients had good functional and cosmetic results.
Conclusion: Submental island flap is a simple and reliable reconstructive option for intraoral lining defects after resection for oral cancers. It leaves a well-hidden donor site without much morbidity. It is ideal for reconstruction of moderate defects of tongue, buccal mucosa, lip, and after marginal mandibulectomy. It is less time consuming, less tedious, and more cost effective than microsurgical reconstruction.