Papers by Dr. Chowdhury Iqbal Mahmud
Mymensingh Medical Journal, Oct 1, 2021
Retrocalcaneal bursitis is one of the important causes of posterior heel pain which is due to rep... more Retrocalcaneal bursitis is one of the important causes of posterior heel pain which is due to repetitive friction of the retrocalcaneal bursa between the postero-superior calcaneal tuberosity (haglund deformity) and Achilles tendon. Most of the patients are treated by conservative methods. But when the condition becomes chronic and not responding to the conservative treatment, surgical treatment is an option of these cases. This prospective interventional study was conducted in the Department of Orthopaedic Surgery, BSMMU (Bangabandhu Sheikh Mujib Medical University), Dhaka, Bangladesh from September 2017 to August 2019. Within this period, total 40 cases of chronic retrocalcaneal bursitis were operated at BSMMU. The clinical and functional outcome was evaluated according to AOFAS (American Orthopedic Foot Ankle Society) scale. The results of this study showed significantly improvement of pain, functional status and deformity at the time of final follow-up period of 1 year, total mean score improved from 46/100 to 89/100. The outcome of the subjects was satisfactory 90% and unsatisfactory 10%. Surgical intervention is an effective option of treatment with satisfactory outcome, in the treatment of chronic retrocalcaneal bursitis.
PubMed, 2020
Giant cell tumors (GCT) are usually benign bone tumors with aggressive characteristics. Giant cel... more Giant cell tumors (GCT) are usually benign bone tumors with aggressive characteristics. Giant cell tumors have a benign indolent course in most patients, but tumors may recur locally in as many as 50% of cases depending on the type of treatment and initial presentation of the tumor. The aim in the management of long bone GCT is to eradicate the tumor and prevent local recurrences. In this study, we retrospectively assessed the functional outcomes in 5 patients having recurrent GCTs of the distal femur treated with custom made modular endoprosthesis following wide resection of the tumor from January 2017 to December 2018 in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Tumor Society functional score (MSTS) was used to assess the results of our patients. The mean follow-up period was 13.2 months. We achieved good to excellent results with our mean functional score of 80.66%. To the best of our knowledge, probably first started by us using customized modularendoprosthetic massive replacements for recurrent GCTs in our country. The use of custom made modular mega prosthesis is a simple and technically superior method of feeling the bone defects after wide resection in aggressive recurrent GCTs. In our opinion endoprosthesis replacement for recurrent GCTs had early good to excellent functional results 5.
International Journal of Orthopaedics Sciences, Oct 1, 2020
Introduction: Developmental dysplasia of the hip (DDH) is a term that encompasses a wide spectrum... more Introduction: Developmental dysplasia of the hip (DDH) is a term that encompasses a wide spectrum of pathology ranging from mild acetabular dysplasia with or without instability to a complete dislocation at birth which may or may not be reducible. The purpose of this study is to assess the results of one-stage combined operative management of developmental dysplasia of the hip in children of walking age. Methods: is a retrospective study involving 21 hips in 17 children with DDH, who underwent surgical operation at the department of orthopaedic surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2014 to December 2019.Tönnis and Severin grading systems were used to classify the radiographic status of the hip in pre-and postoperative period respectively. The operative procedure included open reduction, capsulorraphy, Salter's osteotomy and a femoral derotation osteotomy. Catteral's 'test of Stability' was used after open reduction as an indicator for need of pelvic and femoral osteotomy. The children were evaluated clinically on McKay's criteria and radiologically on Severin's criteria. Result: Among the 17 cases, 11(64.7%) were female and 6(35.3%) were male; 4(23.52%) children had bilateral involvement; 9(52.94%) had left-sided and 4(23.52%) had right-sided involvement. The average age was 3.3 years (range 18 months-8 yrs.) at the time of operation. Follow-up range between 1 to 3.8 years. At the time of last follow-up, 8(38.09%) children had excellent outcomes, 10(47.61%) had good, 2(9.52%) had fair, and 1(4.76%) had poor outcomes on McKay's criteria. Avascular necrosis of femoral head was noted in 2(9.52%) and hip re-dislocation was observed in 1(4.76%) hip. Conclusion: One-stage surgery which include open reduction, capsulorraphy, Salter's and femoral derotation osteotomy in walking age children with DDH is a safe and highly effective method. Complication rate and the need for repeat surgery is very low.
Scholars journal of applied medical sciences, Aug 3, 2021
Original Research Article Objective: In this study our main goal is to compare the efficiency of ... more Original Research Article Objective: In this study our main goal is to compare the efficiency of posterior lumbar interbody fusion (FLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of spondylolisthesis. Method: This experimental observational type study was carried out at Bangabandhu Sheikh Mujib Medical University and different private hospital in Dhaka from July, 2006 to December 2019. A total number of 340(PLIF=150, TLIF=190) patients underwent lumbar interbody fusion with pedicle screw fixation for the treatment of adult lumbar spondylolisthesis were taken as a study sample. Results: During the study, surgical outcomes between PLIF and TLIF where there were significant differences between the groups in relation to VAS for back pain. These variables were significantly higher in the TLIF group compared to the PLIF group. There was no significant difference between the two groups with respect to VAS for leg pain at final follow-up. However prevalence of Nerve Root injury,Dural tearand blood loss is higher in FLIF groupe than TLIF group. Also, at the time of the last follow-up, both groups had similar slip reduction, and spinal fusion rates (P > .05). Conclusion: From our study we can say that, TLIF is superior to PLIF with respect to functional outcome and complication rate in grade I/II single-level lumbar spondylolisthesis.
International Journal of Orthopaedics Sciences, 2018
Angiomyolipoma is usually a solitary renal tumour and composed of adipose tissue, blood vessels, ... more Angiomyolipoma is usually a solitary renal tumour and composed of adipose tissue, blood vessels, and smooth muscles. Extrarenal angiomyolipoma is an uncommon disease and commonly found in liver. Angiomyolipoma in the musculoskeletal tissue particularly in the subcutaneous region of the knee is very rare. Histopathological section of angiomyolipoma shows an admixture of small to medium-sized thickwalled blood vessels, smooth muscle cells and adipose tissue which include different types of mature fat cells. The treatment of AML is wide resection, which is usually curative We describe a case of Angiomyolipoma (AML) in the subcutaneous tissue of the knee joint of a 70 years old male with MRI and histological features of the tumour. There is an only one previous report of this type of case in the literature. To the best of our knowledge, this is the second case of a solitary angiomyolipoma in the subcutaneous tissue of the knee joint area.
International Journal of Orthopaedics Sciences, 2022
Introduction: Cervical spine injuries represent 2 to 6% of adult blunt trauma, and one third of a... more Introduction: Cervical spine injuries represent 2 to 6% of adult blunt trauma, and one third of all spinal injuries. Anterior approach of operative management of cervical spinal injury with incomplete neurological lesion has least analyzed in our settings, the present study has been designed to evaluate the outcome of ACDF and stabilization by cervical plate and screw for managing traumatic cervical spine injury with incomplete neurological deficit. Methods: This study was conducted at NITOR, Dhaka, from July 2016 to June 2018.Twenty available patients meeting the inclusion & exclusion criteria were included. All cases were properly evaluated preoperatively and underwent ACDF & stabilization with cervical plate and screws. Follow up was done for 5 to 12 months. The final assessment was done by ASIA impairment scale, MRC grading, Bridewell fusion grade, Denis work & pain scale and modified Odom's criteria. Results: Highest number of patients 10 (50%) were in ASIA grade B, 7(35.0%) patients were in ASIA grade D and 3(15.0%) patients were in ASIA grade C on admission. But in last follow up, highest number of patients were in ASIA grade E (45%). The ASIA grade has improved 1 grade in 55% cases. Bridewell fusion grade showed anterior fusion grade I in 55% of cases, grade II in 45% cases. 60% of cases were in W2 group of Denis work scale after last follow up. Early post-operative complications were dysphagia (20%), respiratory distress (5%) and neck pain (20%). Late post-operative complications were neck pain (10%), donor site pain (5%) and bed sore (5%). According to modified Odom's criteria, 65% of the cases were found excellent. Conclusion: On the basis of the results in this study, it can be said that anterior cervical decompression, stabilization and fusion by bone graft of the patients who have traumatic unstable cervical spine injury with incomplete neurological lesion will provide effective benefit.
International Journal of Orthopaedics Sciences, Jul 1, 2022
Introduction: Atrophic nonunion of the humerus is rare and complex condition to treat. Several su... more Introduction: Atrophic nonunion of the humerus is rare and complex condition to treat. Several surgical techniques have been used for the treatment of non-union, which include compression plating, intramedullary nailing and use of external fixators, with or without bone grafts. Use of autogenous fibular as a strut graft is proposed to achieve good union and functional recovery. The aim of this study was to assess the clinical result of the intramedullary fibular graft adjunct to dynamic plate fixation in diaphyseal atrophic non-union of the humerus. Methods: The present prospective study was carried out within the period of January 2019 to December 2021 in the Department of Orthopedic Surgery of Bangabandhu Sheikh Mujib Medical University. Fifteen patient (09 male and 06 female) with atrophic non-union of the humerus midshaft fracture within the age range of 41-60 years were selected. All the case had non-union of the fracture of the middle third of humerus with a delay in commencement of specific treatment. The clinical and radiological outcome of Surgery has been assessed using definite recommendation. Statistical results were obtained by using the SPSS program. Result: The mean union time was 5.65 months. Post-operative complications were noticed in 3 patients, infection in 01 patient and 02 patients had persistent pain due to failure of union. Regarding the final outcome, satisfactory results were found in 86.66% case and unsatisfactory result in 13.33% case. Conclusion: The intramedullary fibular auto graft with dynamic plating results in satisfactory clinical outcome in atrophic osteoporotic diaphyseal non-unions of the humerus.
Scholars Journal of Applied Medical Sciences
Objective: In this study our main goal is to compare the efficiency of posterior lumbar interbody... more Objective: In this study our main goal is to compare the efficiency of posterior lumbar interbody fusion (FLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of spondylolisthesis. Method: This experimental observational type study was carried out at Bangabandhu Sheikh Mujib Medical University and different private hospital in Dhaka from July, 2006 to December 2019. A total number of 340(PLIF=150, TLIF=190) patients underwent lumbar interbody fusion with pedicle screw fixation for the treatment of adult lumbar spondylolisthesis were taken as a study sample. Results: During the study, surgical outcomes between PLIF and TLIF where there were significant differences between the groups in relation to VAS for back pain. These variables were significantly higher in the TLIF group compared to the PLIF group. There was no significant difference between the two groups with respect to VAS for leg pain at final follow-up. However prevalence of Nerve Root injury,Dural tearan...
Introduction: Discoid meniscus is a broad disc like congenital anatomical abnormality of the meni... more Introduction: Discoid meniscus is a broad disc like congenital anatomical abnormality of the meniscus. Discoid meniscus is often revealed clinically during childhood. However, many patients with discoid meniscus remain asymptomatic and presents late. Surgery is needed only for symptomatic discoid meniscus. There has been considerable debate about the best treatment options for symptomatic discoid meniscus. The purpose of this study was to evaluate the effectiveness of the arthroscopic procedures for the symptomatic discoid meniscus. Methods: Twenty patients with symptomatic lateral discoid meniscus were reviewed retrospectively after arthroscopic surgery with a minimum follow up period of 12 months. There were 8 males and 12 females with a mean age of 20.7 years (range, 7-42 years). Symptoms included pain in 80%, popping and snapping in 50%, locking in 50%, giving way in 60% cases; and objective signs included loss of extension in 40% and positive McMurry test in 60% cases. Arthrosc...
International Journal of Orthopaedics Sciences, 2018
Angiomyolipoma is usually a solitary renal tumour and composed of adipose tissue, blood vessels, ... more Angiomyolipoma is usually a solitary renal tumour and composed of adipose tissue, blood vessels, and smooth muscles. Extrarenal angiomyolipoma is an uncommon disease and commonly found in liver. Angiomyolipoma in the musculoskeletal tissue particularly in the subcutaneous region of the knee is very rare. Histopathological section of angiomyolipoma shows an admixture of small to medium-sized thickwalled blood vessels, smooth muscle cells and adipose tissue which include different types of mature fat cells. The treatment of AML is wide resection, which is usually curative We describe a case of Angiomyolipoma (AML) in the subcutaneous tissue of the knee joint of a 70 years old male with MRI and histological features of the tumour. There is an only one previous report of this type of case in the literature. To the best of our knowledge, this is the second case of a solitary angiomyolipoma in the subcutaneous tissue of the knee joint area.
International Journal of Orthopaedics Sciences, 2019
Introduction: Appropriate treatment method for osteoporotic trochanteric fracture in elderly peop... more Introduction: Appropriate treatment method for osteoporotic trochanteric fracture in elderly people is rather controversial because of the poor quality of bone mass, difficult anatomical reduction and accompanying systemic disorders. Internal fixation in these cases usually involves prolonged bed rest, limited ambulation and implant failure secondary to osteoporosis. This might result in higher chances of complications like pulmonary embolism, deep vein thrombosis, pneumonia, and decubitus ulcer. The purpose of this study is to analyse the role of primary cemented hemiarthroplasty in cases of osteoporotic intertrochanteric femur fractures in elderly patients with co-morbities. Materials and Methods: In this study, 120 cases of primary cemented hemiarthroplasty performed for osteoporotic intertrochanteric fractures were analysed retrospectively. There were 85 female and 35 male. Mean age of the patients were 65.2 years (range, 60-85 years). Harris hip score (HHS) was used to assess the outcome. Result: The mean Harris hip score at the two-year follow-up was 83.10 ± 10.90. A total of 25 patients were graded as excellent, 60 patients as good, 30 as fair and 5 as poor. It was observed that, patients with stable variety of intertrochanteric fractures had better outcome than the unstable variety in our study. Conclusion: Hemiarthroplasty for osteoporotic intertrochanteric fractures in the elderly patient results in early ambulation and good functional results, although further prospective randomised trials are required before reaching to conclusion.
International Journal of Orthopaedics Sciences, 2018
Background: Extensor tendon injuries are very common injuries in hand & forearm, which inappropri... more Background: Extensor tendon injuries are very common injuries in hand & forearm, which inappropriately treated can cause severe lasting impairment of hand function of the patient. After the extensor tendons repair whether to immobilization or to early active mobilization is debatable. Objectives: Compare the two common protocols, immobilization vs. early active mobilization by using a simple static splint after surgical repair of extensor tendon. Method: This prospective randomized study was conducted in the Department of Orthopaedic Surgery, BSMMU, Dhaka for duration of January 2014 to December 2017. Forty (40) patients of extensor tendon injuries in zone V-VIII were selected. The patients were divided into two groups by sealed envelope technique, Group A-immobilization group & Group B-early active mobilization group. Extensor tendon was repaired by Doyle proposed technique. Mayo Wrist Score and Dargan criteria were used for evaluation of final result at 12 th months. Results: Most of the patients were in 3 rd decade. Male and right hand injury were predominant in both groups. More than one third, (35.0%) patients were factory worker in immobilization group and 8(40.0%) in EAM group. Majority 17(85%) patients had glass cut injury in both groups. Nine (45.0%) patients had Zone VI injury in immobilization group and 10(50.0%) in EAM group. In immobilization group out of 72 tendon injury EDC injury was 37(51.38%) and in EAM group out of 69 tendon injury EDC injury was 37(53.62%). Complications developed 6(30.0%) in immobilization group and 4(20.0%) in EAM group. Satisfactory outcome was 85% in immobilization group and 95% in EAM group at 12 th months. Assessment at 12 th weeks and 6 th months were statistically significant (p<0.05) but not at 12 th months between two groups. Conclusion: EAM by using simple static splint following extensor tendon repair shown faster recovery, gain complete range of motion and improved grip strength at early post-operative period.
The American Journal of Sports Medicine, 2005
Anterior cruciate ligament tears, common among athletes, are functionally disabling; they predisp... more Anterior cruciate ligament tears, common among athletes, are functionally disabling; they predispose the knee to subsequent injuries and the early onset of osteoarthritis. A total of 3810 studies published between January 1994 and the present were identified and reviewed to determine the current state of knowledge regarding the treatment of anterior cruciate ligament injuries. Part 1 of this article focused on studies pertaining to the biomechanical behavior of the anterior cruciate ligament, the prevalence of and risk factors for injuries related to it, the natural history of the ligament-deficient knee, injuries associated with anterior cruciate ligament disruption, indications for the treatment of anterior cruciate ligament injuries, as well as nonoperative and operative treatments. Part 2 includes technical aspects of anterior cruciate ligament surgery, bone tunnel widening, graft healing, rehabilitation after anterior cruciate ligament reconstruction, and the effects of sex, ag...
Ibrahim Medical College Journal, 2010
Permanent deformity and disability can occur in diabetic Charcot arthropathy (neuropathic arthrop... more Permanent deformity and disability can occur in diabetic Charcot arthropathy (neuropathic arthropathy) if not diagnosed and treated promptly. We report two patients with uncontrolled diabetes mellitus in whom the diagnosis of ankle neuro-arthropathy was delayed by up to six months, with misdiagnoses including ankle arthritis, osteomyelitis and cellulitis. The clinical scenario and appearances of the ankle and foot were typical of Charcot arthropathy. Unfortunately, both of them sustained ankle fracture-dislocation without a history of significant trauma. Both the patients were treated by ankle arthrodesis (fusion of joint). Prevention and early diagnosis of diabetic foot is the key to avoid the development of complications. In diabetic patients, a higher index of suspicion for the possibility of Charcot's disease is needed.
Acta Ortopédica Brasileira
Rotura em "alça de balde" de ambos os meniscos do mesmo joelho é um fenômeno raro. Apre... more Rotura em "alça de balde" de ambos os meniscos do mesmo joelho é um fenômeno raro. Apresentamos o caso de um paciente em que a ressonância magnética demonstrou rotura em "alça de balde" dos meniscos medial e lateral do mesmo joelho, associada a rotura do ligamento cruzado anterior, confirmado por videoartroscopia. A ressonância magnética demonstra sinais que permitem o diagnóstico preciso.
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Papers by Dr. Chowdhury Iqbal Mahmud