55y male patient had history of fall from bike and had fracture of proximal tibia which was managed conservatively by cast application outside. After 1 day of cast application pt had blisters over the entire tibia and patient came to us. We had taken care of blisters and got x-ray of knee done. By looking at the x-ray it is not possible to managed this fracture conservatively and CT scan also done which shows depression of more than 10mm of articular surface. We first taken care of blisters and let the skin condition become good for surgery and after 3 weeks we did open reduction of tibia by bicondylar approach and platting with elevation of depressed fragment. Knee rom was started early and in follow up fracture is uniting with full range of motion of knee.
52y male had grade 4
avascular necrosis of rt hip with restricted range of motion and shortening.
we did uncemented total hip replacement for that by posterior approach. At 3
month follow up pt. had full ROM with stable and painless hip without any
shortning.pt able to do cross leg sitting on floor.
32 yr.old young active
male had history of fall having communited radial head racture with essex
lopersetti type of injury.
we did radial head replacement for him by lateral approach.
Pt had full range of motion at elbow after the surgery .
62y old male had history
of fall having supracondylar femur fracture. we did distal femur platting
through lat approach.pt gain full rom and fracture united at end of 3 months.
35yr old female had history of fall from height and had fracture of L1 vertebra with affected neurology and unstable spine. we did pedicle screw fixation through posterior approach at 2 level to stabilise the spine.
60yr old female had
history of fall at home having IT with subtrochenteric femur fracture. We did
ong PFN for her.
Fracture has united at end of 3 months and pt had full range of motion.
55 yr male having shaft
humerus fracture by fall from bike.
We did bridge platting of humerus by minimal invasive tech.
A 9 year old female child referred to Zydus Medical College & Hospital from private hospital with blunt chest trauma due to fall from tree. Patient was attended and managed by Dr Mahesh M. Pukar and Dr. Gunjan vadwala. Patient came with pain and difficulty in breathing had SpO2 68%. On examination had cut lacerated wound over chest on right side with opened thoracic cavity. Patient was shifted to operation theatre, where debridement and closure of the wound with Intercostal chest tube insertion done. Post operative period was uneventful and oxygen saturation was maintained 98%. Intercostal chest tube was removed on 5th post operative day after confirming the full expansion of lung on X-ray chest. A patient was discharged on 10th day after suture removal.
A 10 year old male child came to Zydus Medical College & Hospital with cough with expectoration and had difficulty in breathing. Patient was examined and managed by Dr Mahesh M. Pukar and Dr Gunjan Vadwala. Patient was investigated, CT scan shows lung hydatid cyst on left side ruptured into the left broncus. After confirming diagnosis Dr M.M.Pukar and Dr Gunjan had decided to do thoracotomy. On Opening thoracic cavity large hydatid cyst in lung was seen. De-roughing with aspiration of the cyst was done. There was a communication of the cyst with left broncus was seen where air leak was found. Rent was sutured with vicryl 3-0. Thoracotomy wound was closed by approximating ribs after insertion of Intercostal Chest drainage tube. Post operative period was uneventful; oxygen saturation was maintained more than 97 % during post operative period. Chest drainage tube was removed on 7th day after confirming full expansion of lung on X-ray chest. Patient was discharged on 10th day after suture removal.
Two patients
from urban health centre were referred to Zydus Medical College &
Hospital, Dahod with history of passing faecal matter from vagina
after delivery. Patient was seen by gynaecologist and referred to
general surgery. Both the patients were operated by Dr Mahesh M
Pukar, Dr.Deepak Rathwa, Dr. Gunjan Wadwala. Debridement with
margins freshening and suturing in layers done. Patient was observed
for 14 days in ward, post operative period was uneventful. Fistula
was healed. Patient was discharged on 15th day after suture
removal.
Motaliben Nabhalabhai Bhabhor 75 year old female residing Ta-Garbada, Dahod came to Zydus Medical College & Hospital with history of lamb in abdominal and pain in abdominal seen 3 years patient belong to low social economic class. Patient consulted many hospitals in Dahod but everybody referred her to higher centre. Such case was operated in Zydus Medical College & Hospital by Dr Mahesh M Pukar, Dr.Shailesh Rathod and Dr. Deepak Rathwa. Patient was suffering from huge gastric GIST involving whole abdominal cavity arising from anterior wall of stomach, superiorly attach to left lobe of liver laterally up to paracolic gutter inferiorly up to pelvis. Partial gastrectomy with complete removal of mass done. Post operative period was uneventful. Patient was discharged after suture removal on 14th day of surgery.
Ditabhai, 82 year old male patient came to Zydus Medical College & Hospital, Dahod with history of assault over his head with wooden road by known person. Patient had lost his voice and developed weakness in right upper and lower limb. Patient was drowsy and disoriented. CT scan shows depressed skull fracture in parito – temporal region on left side with extra dual hematoma with size of more than 17mm in width midline shift. Relatives were informed about the prognosis of the patient due to the injury and suggested to take neurosurgery at higher centre but relatives refused to go any other hospital. So surgeons in Zydus Medical College & Hospital, Dahod decided to operate on that patient. After taking written and informed consent surgery done. Depressed fracture segment was removed, clot evacuated good haemostasis achieved. Post operative period was uneventful patient regained his voice and improved weakness in both upper and lower limb. Patient was started on full diet after 48hours and discharged after 12days.
A young male of 32 years Age developed a cancer of buccal mucosa involving part of mandible due to addiction to Guthka 10-15 packets a day. Successfully operated in rural hospital Zydus Medical College & Hospital, Dahod.Patient was seen by various consultants in private hospitals at Dahod and advised to go to higher centre at Baroda/Ahmedabad for further management like oncosurgery. Patient belongs to low socioeconomics class could not afford treatment in higher centre due to cost and travelling factor. Patientcame to surgery department Zydus Medical College & Hospital on 25th December 2017 seen by Dr Mahesh Pukar HOD Surgery department. He decided to do surgery on that patient and after thorough examination and investigations. Patient was taken to surgery on 30th December 2017. Right side hemimandibulectomy with wide excision of buccal mucosa growth was done. Reconstruction of the defect was done with titanium mandibular plate and forehead flap. Surgery was done by Dr.Mahesh Pukar, Dr.Shailesh Ratod, Dr.Dipak Rathva, Dr.Rahul Yadav, Dr.Gunjan Vadwala. Post operative period was uneventful; patient was started on oral diet after a week. Refashioning of flap and suture removal was done after three weeks. One month after surgery patient was referred to Ahmedabad cancer hospital for radiotherapy.This was a first onco–surgery done for oral cancer in Zydus Medical College & Hospital, Civil Hospital, and Dahod.