Narendra Kumar; Syed Sahil Ali; Deepak Kumar Sharma; Anmol Kankane
Abstract
Introduction: Routinely used inflammatory markers such as ESR and CRP are suggested to suspect post-operative infection at an early stage. Therefore their normal trend after arthroplasty surgeries need to be known and their variation from that trend need to be understood.Methods: A prospective observational ...
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Introduction: Routinely used inflammatory markers such as ESR and CRP are suggested to suspect post-operative infection at an early stage. Therefore their normal trend after arthroplasty surgeries need to be known and their variation from that trend need to be understood.Methods: A prospective observational study was conducted. 75 patients undergoing THR or HRA surgeries of hip or TKR surgeries fulfilling the inclusion and exclusion criteria were considered for the study. Blood samples were collected preoperatively and postoperatively on day 1, 3, 5, 7 and 15 after surgery and sent to measure ESR and CRP values. Surgical site was assessed for presence of any discharge, which was sent for culture. Presence of any growth after 48 hours of incubation was diagnosed as infection.Result: Values of both ESR and CRP raised after surgery. ESR reached its peak value on POD 5 while CRP reached its peak value on POD 3. Both ESR and CRP declined thereafter. On correlating these trends with infected cases, we reported a statistically significant correlation of CRP with infection on POD 15. However, ESR values did not show any significant correlation with infection in starting 15 days post-operatively.Conclusion: There is a significant variation in levels of ESR and CRP after arthroplasty surgeries of lower limb. In infected cases, there is a deviation from this normal trend, that can be used to suspect post-operative infection. However, none of these parameters can be used to suspect it in starting 7 days after surgery.
Narendra Kumar; Binay Kumar Sahu; Deepak Kumar Sharma
Abstract
Introduction: Tibial plateau fractures represent the fractures involving the articular surface of proximal part of the tibia bone i.e. lateral or medial condyle or both, and with varying degrees of articular depression and displacement.Fixation by locking plates has led to dramatic improvement in the ...
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Introduction: Tibial plateau fractures represent the fractures involving the articular surface of proximal part of the tibia bone i.e. lateral or medial condyle or both, and with varying degrees of articular depression and displacement.Fixation by locking plates has led to dramatic improvement in the treatment of tibial plateau fractures.Method: It was a prospective study conducted on 30 patients with tibial plateau fractures at a tertiary care hospital in New Delhi, India. Patients were operated with locking compression plates and followed up for 18 months. Union was checked with serial radiographs and functional outcome was assessed with Rasmussen Functional Knee Score.Result: Twentynine patients achieved union at a mean time of 13.65 weeks, one patient had infective nonunion. Overall mean Rasmussen Functional Knee Score was 27 which is graded as excellent.Conclusion: Treatment of tibial plateau fractures with open reduction and plating with locking compression plates provides anatomical reduction and desirable functional outcome. Union is earlier and functional results are better for Schatzker type 1-3 when compared to type 4-6. Return to work with greater capacity largely depends on motivation.