Mid-term follow-up of superior pubic ramus osteotomy in locked symphysis pubis with urethral injury: A case report.

A locked pubic ramus body is an unusual variant of lateral compression injury. Till date, there have been only 25 cases reported in the published literature. We herein described a case where the right pubic ramus was entrapped within the opposite obturator foramen with an overlap of greater than 4 cm, with associated urethral injury. When all maneuvers of closed and instrumented reduction failed, we performed a superior pubic ramus osteotomy on the left side and unlocked the incarcerated right pubic ramus. The osteotomy site was stabilized with a 6-hole recon plate. The patient underwent delayed urethral repair 10 weeks after the index surgery. At 3-year follow-up, the patient has sexual dysfunction especially difficulty in maintaining erection, secondary urethral stricture, heterotopic ossification, and breakage of implants.

Efficacy of Caudal Epidural Steroid Injections in Chronic Low Backache Patients.

Background: Caudal epidural steroid injections are the popular treatment for patients with chronic low back aches (LBA) and radiculopathy, pain that radiates down the legs. These injections are typically given in the lower back, and their purpose is to reduce inflammation and pain caused by a herniated disc or other issues in the lumbosacral spine. Studies have generally found that caudal epidural steroid injections effectively manage chronic LBP, although they may not provide long-term relief in all cases. It is essential to remember that these injections should be combined with other forms of conservative management, such as physical therapy, before considering more invasive interventions. Materials and Methods: A prospective analysis is performed at the Orthopedics Department At The Hind Institute Of Medical Sciences In Sitapur, Uttar Pradesh, India, over two years. In the study, 80 patients with chronic low back pain and symptoms that did not improve with conservative therapies. The patients are clinically examined before and after receiving a cervical epidural steroid injection (CESI) based on their ability to perform daily activities and work using the Oswestry disability index (ODI) and visual analog scale (VAS). Results: The experiment was conducted with 165 CESI administered to 120 patients. A single injection is given to 85 patients; two injections are given to 25 patients, and 10 patients receive three injections. Of the 120 patients, 50 were male, and 70 were female, all of whom had chronic LBA. Of the 120 cases of LBA, 37 were diagnosed with lumbar disc herniation, 11 with lumbar canal stenosis, and 22 with degenerative disc disease. The remaining 50 cases were classified as non-specific LBA. Follow-up evaluations were conducted 1 week, 1 month, and 3 months after that, till 12 months of treatment. The mean pre-CESI VAS score was 7.11, and the mean post-CESI VAS score was 4.82 after one year of treatment. The mean ODI score before CESI treatment was 59.12; after CESI treatment for a full year, it was 44.64. We observed excellent outcomes in 27.5% of patients, good outcomes in 38.33%, fair outcomes in 21.67%, and bad outcomes in 12.5% of patients. Conclusion: Patients who experience chronic function aches can dramatically reduce their discomfort with the help of CESIs.