دكتور. إيهاب عباس

Flexible unreamed locked nailing

A modified implant using unreamed locked intramedullary nailing of the humerus allows a stable fixation of humeral shaft fractures and immediate postoperative functional recovery. The type of nail used has angulations at its two ends: between them there is a long cleaved flexible shaft. The implant has two forms: the thicker form is cannulated and the thinner one is solid. This type of nail was used to stabilize fractures 2 cm below the surgical neck and 4 cm proximal to the olecranon fossa. This nail was used on 74 patients who had suffered humeral shaft fractures. This type of nail can be inserted by either antegrade or retrograde methods. All of the fractures operated on, healed in an average of 6 months with excellent postoperative shoulder and elbow function. In cases of pathological fractures, stability was maintained up to the end of the patient's life. There were no occurrences of vascular and nerve iatrogenic injury, septic complications, or implant failure. Postoperative radial nerve palsy was temporarily displayed in 3 patients, all of whom showed spontaneous recovery.

Snake bites article | Dr.Ihab Abbas

It was my pleasure to be part of this article presenting my cases with animal bites.

Management of Animal Bites: A Global Perspective

The relationship between for humans, animals, and environment is balanced since human existence. Animal bites humans is a major neglected global health problem. Dog and cat bites are most common in USA and Europe, snake bites in east Asia, and crocodile and camel bites in Africa. We aim to lay the principles of managing these animal bites. Bites located on the hands, arms, and legs comprise 70–80% of animal bites. The head and neck are involved in 10–30%. The occurrence of wound infection depends on the nature and location of the wound, the patient’s immunity, and the type of attacking animal. Principles of managing animal bites include addressing immediate life-threatening injuries; taking a detailed history of the animal bite; evaluating tetanus and rabies risk; administering antibiotics and antivenom (when needed); wound debridement and revision; addressing the risk of necrotizing fasciitis and compartment syndrome, and finally delayed closure/skin graft and fracture management when the wound becomes clean. Using the Haddon matrix is very useful for injury prevention. It includes preventing the animal bite before it occurs, reducing its impact if it occurs, and treating it properly after it occurs.