Outcome Analysis of Neglected Musculoskeletal Injuries

Sivaprasad, K M (2017) Outcome Analysis of Neglected Musculoskeletal Injuries. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Musculoskeletal injuries, as a non-communicable disease has become a major epidemic. Neglect of such injuries has become a major burden in our society due to the preference for native treatment. Especially in injuries involving the joints, this neglect has lead to severe disability and is affecting the productivity of our population. AIMS AND OBJECTIVES: To analyse the outcome of neglected periarticular injuries and to calculate the sample proportion of these injuries. MATERIALS AND METHODS: Out of 615 patients admitted in Rajiv Gandhi Government General Hospital in the age group of 14-60 years with injuries involving the major joints, 160 were neglected cases, 11 cases in shoulder, 13 cases in elbow, 7 cases in wrist, 96 cases in hip, 17 cases in knee, 13 cases in ankle were studied. Pre op X rays were taken, CT scan in selected cases were taken. The cases were evaluated for pre-procedure Visual Analogue Scale, Functional capacity. Patient tailored procedure was done based on findings during pre-interventional and interventional period. All patients were followed up for maximum 1 year. Protocol based physical therapy was done. Functional evaluation scoring was done exclusive for each joint. RESULTS: Sample proportion of neglected cases in our study was 26%. In 80% of the cases the neglect was due to native treatment. In rural areas 18% of the cases in our study presented untreated due to poor accessibility. The Sample proportion for neglected upper extremity cases was 19% and the sample proportion for neglected lower extremity cases was 28%. The sample proportion of shoulder, elbow, wrist, hip, knee and ankle cases were, 15%, 25%, 16%, 36%, 17%, and 16% respectively. The average outcomes were good in shoulder, elbow, hip, and knee cases and Excellent in wrist and ankle cases. CONCLUSION: The complications and outcome in all the cases depended on many factors as even in some cases with longer neglect duration excellent outcome was possible but in some cases with shorter neglect duration also fair outcome was only possible. Hence the commonly found factors that can influence the outcome of the neglected musculoskeletal injuries in pre intervention stage were: Age of patient, Type of native treatment availed, Duration of native treatment methods, Quality of native treatment methods, Associated co morbidities, Associated fractures. The factors which influence the outcome in intervention and post intervention stage were: Intraoperative findings of soft tissue distortion and loss of anatomical configuration; Type of procedure selected; Aseptic precautions taken; Patients’ will for functional betterment; Expertise of the surgeons; Regularity in visiting the hospital for physiotherapy. In our study all the patients had a common will for betterment and they cooperated in all the steps and thereby had a successful outcome at the end of follow up. Hence patients’ cooperation and perseverance is the foremost quality that defined success for them.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Neglected musculoskeletal injuries, Native treatment, sample proportion, functional evaluation.
Subjects: MEDICAL > Orthopaedics
Depositing User: Devi S
Date Deposited: 19 Mar 2020 07:57
Last Modified: 19 Mar 2020 07:57
URI: http://repository-tnmgrmu.ac.in/id/eprint/12352

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