Browsing by Author "Dalal, Bhavik"
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Item Analysis And Outcomes Of Plating Versus Nailing In Humerus Shaft Fractures A Prospective Comparative Study(Society Of Medical Sciences, 2019-01) Parikh, Gaurav; Vala, Pathik; Dalal, Bhavik; Devda, AjayFractures of the humeral shaft are commonly encountered by orthopaedic surgeons, accounting for approximately 3% of all fractures [20]. Treatment methods for these injuries continue to evolve as advances are made in both non-operative and operative management. It is generally agreed that most fractures of humeral shaft are treated best non-operatively, although there are indications for primary or secondary operative treatment in some situations [8,18,19]. The encouraging results that have been reported with recent advances in internal fixation techniques and instrumentation have led to an expansion of surgical indications for such fractures and a dilemma about the procedure of choice.Item Effect of proximal femoral nailing in proximal third femur fracture.(2013-10) Goswami, Ashutosh; Chaudhari, Umesh; Dalal, Bhavik; Gandhi, Archit; Rathod, SandipBackground: Proximal third femur fractures are common fractures seen in community. Till date large numbers of intramedullary and extramedullary implant were used in the treatment of these fractures. These fractures differ significantly from femoral shaft fractures and more proximal femoral fractures in mechanisms, treatment and complications. In 1996 AO group has introduced proximal femoral nail (PFN) for treatment of these fractures. The use of PFN in both these fractures resulted in rotational stability along with union in more anatomic position. Aims & Objective: To prove the advantages of PFN like (1) close reduction of fracture which decreases the blood loss and chance of infection; (2) controlled impaction of the fracture; (3) rotational stability; and (4) load bearing capacity of the implant. Material and Methods: We have done a retrospective study of proximal femur fractures operated with proximal femoral nailing at our institute with follow up of 5 – 36 months. Our study included 30 patients with 8 patients having intertrochanteric fracture and 22 patients having subtrochanteric fracture. Patient was asked to come for follow up on 1, 2, 3 and 6 months from the date of surgery. At each follow up patient was assessed clinically as per Harris Hip score12 and x ray AP/LAT view of hip with femur is taken. Results: It concludes that according to Boyd and Griffith classification type II is the most common variety. In our study excellent to good results noted in 74% patients. All of them performing their routine normal activity well. 5 patients had poor results. Complication rate in our study was much lower. There was only one infection which was known case of diabetes mellitus. Conclusion: The procedure takes less time and the patient can be mobilized fast postoperatively as well after fixation with PFN. PFN should always be considered for management of subtrochanteric fractures in young as well as elderly patients who have multiple pre-existing illnesses. PFN is a closed nailing procedure which achieves a Biological Fracture fixation with minimal blood loss, preserving the fracture hematoma and helping easy healing of the unstable subtrochanteric femoral fracture as well as intertrochanteric fracture.Item Individualization of antiretroviral therapy - Pharmacogenomic aspect.(2015-12) Dalal, Bhavik; Shankarkumar, Aruna; Ghosh, KCombination therapy with three drug regimens for human immunodeficiency virus (HIV) infection significantly suppresses the viral replication. However, this therapeutic impact is restricted by adverse drug events and response in terms of short and long term efficacy. There are multiple factors involved in different responses to antiretrovirals (ARVs) such as age, body weight, disease status, diet and heredity. Pharmacogenomics deals with individual genetic make-up and its role in drug efficacy and toxicity. In depth genetic research has provided evidence to predict the risk of developing certain toxicities for which personalized screening and surveillance protocols may be developed to prevent side effects. Here we describe the use of pharmacogenomics for optimal use of HAART (highly active antiretroviral therapy).Item Results And Functional Outcomes In Lower End Radius Fractures With Conventional Bridging External Fixator_ Tips And Tricks(Society Of Medical Sciences, 2019-07) Parikh, Gaurav; Vala, Pathik; Dalal, Bhavik; Devda, Ajay; shah, RutvikItem Study of operative management for complex fracture of upper end of Humerus.(2013-10) Gandhi, Archit; Patel, Parimal; Dalal, Bhavik; Shah, RohitBackground: Proximal humerus fractures are very common fractures occurring in the skeleton. They account for approximately 4 – 5% of the fracture attendance at the hospital. It is the most common fracture of shoulder girdle. It is the 3rd most common fracture in elderly. Till date various methods are used including percutaneous and open reduction & fixation according to fracture type. Aims & Objective: To study the occurrence, mechanism of injury and displacement of various types of fractures and different modalities of the fixations in proximal humerus fractures. Come to conclusion about preferred modality of treatment of proximal humerus fractures according to the pattern of fracture. Material and Methods: In present study 44 patients of complex fracture of proximal humerus treated with either open reduction internal fixation or percutaneous fixation from 2009 to 2012. Follow up assessment was done by Constant score. Results: Radiological union occur at about 8 to 12 weeks. Closed reduction and percutaneous k wire or cancellous screws fixation showed excellent results in majority cases of 3 -part fracture. All 4 part fractures are treated with ORIF. Open reduction and internal fixation with locking compression plates showed good results among all implants used. Conclusion: Principle of fixation is reconstruction of the articular surface, including the restoration of the anatomy, stable fixation, with minimal injury to the soft tissues preserving the vascular supply, should be applied. Majority of poor results are due to poor surgical techniques and lack early physiotherapy.Item Study of results of ender nailing and cannulated cancellous screw in the treatment of intertrochanteric fracture femur.(2013-04) Dalal, Bhavik; Amin, Tarkik; Gandhi, Archit; Shah, RohitBackground: Intertrochanteric fracture of femur is one of the most common fractures seen in general population. Till date various fixation devices are used for fixation of this fracture that includes both extra medullary and intramedullary implants. Ender and Simon Weidner popularised the condylocephelic intramedullary nailing for this fracture. But it is seen that fracture treated by ender nailing alone resulted in varus malunion. Aims & Objective: Along with ender nail we added the cannulated cancellous screw which results in controlled collapse of the fracture with union in anatomic position. Material and Methods: We studied 50 patients of intertrochanteric fracture treated by ender nail and cannulated cancellous screw between year 2009 to 2011. Follow up assessment was done by Harris hip score. Results: The union achieved in mean time of 7 weeks. In study of 50 patients we obtained 86% excellent to good results. 14% patient had fair to poor results. Conclusion: We found that use of Ender nail and cannulated cancellous screw results in fracture union in more anatomical position with better patient compliance and early mobilization.