Dr. Karun Singla

Urologist, General surgery, Genitourinary surgery, Robotic Surgery

  • A urologist may suggest ureteroscopy if they suspect a polyp, tumor, stone or abnormal tissue somewhere in the urinary tract. It is a procedure done to treat stones and tumors of the ureter.

  • This procedure is performed under general anesthesia. The urologist inserts a thin scope (ureteroscope) into the bladder and ureter to check for kidney stones. Once the ureteroscope is into the bladder, a sterile solution is released through the tip of the scope.

  • Urethrotomy is a surgical procedure done to remove obstruction to urine flow because of urethral stricture. Optical Internal Urethrotomy procedure is done with the use of endoscopic device called a urethrotome and a sharp knife for the incision in the urethra.

FRACTURE : Unicortical Plate With Nail in Tibia

A fracture, or break, in the shinbone just below the knee is called a proximal tibia fracture. The proximal tibia is the upper portion of the bone where it widens to help form the knee joint.In addition to the broken bone, soft tissues (skin, muscle, nerves, blood vessels, and ligaments) may be injured at the time of the fracture. Both the broken bone and any soft - tissue injuries must be treated together. In many cases, surgery is required to restore strength, motion, and stability to the leg, and reduce the risk for arthritis.

Anatomy

The knee is the largest weight-bearing joint of the body. Three bones meet to form the knee joint: the femur (thighbone), tibia (shinbone), and patella (kneecap). Ligaments and tendons act like strong ropes to hold the bones together. They also work as restraints - allowing some types of knee movements, and not others. In addition, the way the ends of the bones are shaped help to keep the knee properly aligned.

Description

There are several types of proximal tibia fractures. The bone can break straight across (transverse fracture) or into many pieces (comminuted fracture).ometimes these fractures extend into the knee joint and separate the surface of the bone into a few (or many) parts. These types of fractures are called intra-articular or tibial plateau fractures.

The top surface of the tibia (the tibial plateau) is made of cancellous bone, which has a "honeycombed" appearance and is softer than the thicker bone lower in the tibia. Fractures that involve the tibial plateau occur when a force drives the lower end of the thighbone (femur) into the soft bone of the tibial plateau, similar to a die punch. The impact often causes the cancellous bone to compress and remain sunken, as if it were a piece of styrofoam that has been stepped on.

This damage to the surface of the bone may result in improper limb alignment, and over time may contribute to arthritis, instability, and loss of motion.

Symptoms

  • Pain that is worse when weight is placed on the affected leg
  • Swelling around the knee and limited bending of the joint
  • Deformity - The knee may look "out of place"
  • Pale, cool foot - A pale appearance or cool feeling to the foot may suggest that the blood supply is in some way impaired.
  • Numbness around the foot - Numbness, or "pins and needles," around the foot raises concern about nerve injury or excessive swelling within the leg.

If you have these symptoms after an injury, go to the nearest hospital emergency room for an evaluation.

Treatment

A proximal tibia fracture can be treated nonsurgically or surgically. There are benefits and risks associated with both forms of treatment.Whether to have surgery is a combined decision made by the patient, the family, and the doctor. The preferred treatment is accordingly based on the type of injury and the general needs of the patient.

When planning treatment, your doctor will consider several things, including your expectations, lifestyle, and medical condition.In an active individual, restoring the joint through surgery is often appropriate because this will maximize the joint's stability and motion, and minimize the risk of arthritis.

In other individuals, however, surgery may be of limited benefit. Medical concerns or pre-existing limb problems might make it unlikely that the individual will benefit from surgery. In such cases, surgical treatment may only expose these individuals to its risks (anesthesia and infection, for example).