Papers by rachawan suksathien
Orthopaedic Proceedings, Feb 21, 2018
Navigated THA is a new procedure in Thailand that has been performed since 2012. The previous stu... more Navigated THA is a new procedure in Thailand that has been performed since 2012. The previous studies have reported that navigated THA was a safe and reliable procedure that resulted in a more consistent cup placement compared to the conventional free hand technique. Furthermore, it decreased complications of THA, especially dislocation. Perioperative protocols are based on the surgeon's concern about stability of the prosthesis and the patient's health condition. Assuming that the navigator can improve the alignment and stability of THA, the time to start rehabilitation and the post-operative length of stay should be reduced in the hospital that does not implement any perioperative protocols. The purpose of the present study was to compare the time to start rehabilitation and the length of stay between navigated and non-navigated THA. This retrospective study of patients underwent THA using short stem by a single surgeon between March 2011 and November 2012. Seventy-six patients were classified into navigated and non-navigated groups. The patient's characteristic data that were recorded included age, sex, BMI, comorbid illness, diagnosis, ASA classification, preoperative hematocrit, operative time, type of anesthesia, intraoperative blood transfusion, postoperative length of stay, postoperative complication, and time to start rehabilitation. The data were compared between two groups by t-test and Chi-square test. There were 41 patients in the navigated THA and 35 patients in the non-navigated THA. There were 35 male patients (85.37%) in the navigated group and 27 (77.14%) in the non-navigated group. The mean age was 44.17 +/- 11.39 years in the navigated group and 44.51 +/- 8.17 years in the non-navigated group. The mean BMI was 21.77 +/- 3.09 kg/m2 in the navigated group and 22.44 +/- 4.3 kg/m2 in the non-navigated group. Most of the patients were diagnosed with osteonecrosis (more than 85% in both groups). There were no significant differences between the demographic data of the two groups except the cup abduction and anteversion angle. The mean cup abduction angle in the navigated group was 41.37 +/- 2.01 degrees and 43.97 +/- 4.44 degrees in the non-navigated group (p-value < 0.01). The mean cup anteversion angle in the navigated group was 13.57 +/- 3.28 degrees and 22.58 +/- 10.68 degrees in the non-navigated group (p-value < 0.01). The mean number of days from operation to rehabilitation in the navigated group was 3.27 +/- 1.83 days and 4.34 +/- 1.33 days in the non-navigated group (p-value < 0.01), which was significantly shorter. The postoperative length of stay was 5.37 +/- 2.42 days in the navigated group and 5.89 +/- 1.98 days in the non-navigated group. There were two patients with minor complications after operation. There was no dislocation or infection in both groups. The navigated THA procedure resulted in a significantly shorter time to start rehabilitation. The postoperative length of stay was lower in the navigated group; however it was not significant. The navigated THA technique increased the surgeon's confidence to provide early mobilization and rehabilitation program.
Background: The accuracy of cup placement in navigated total hip arthroplasty (THA) depends on th... more Background: The accuracy of cup placement in navigated total hip arthroplasty (THA) depends on the bony landmark registration intraoperatively. We created a semilateral decubitus position that combined the advantage of supine position for registration and lateral decubitus position for better femoral canal visualization. Objective: To evaluate the accuracy of cup placement within the “safe zone” and of imageless navigation measurement by comparing the intraoperative values of acetabular cup abduction and anteversion to postoperative CT values. Material and Method: All cases were performed in semilateral decubitus position with OrthoPilot THA plus 3.2 (cup only) software (Aesculap AG). Postoperatively, a multislice computed tomographic (CT) scan was obtained at two months or later for abduction and anteversion angle measurement. The abduction and anteversion angle measured on postoperative CT were compared to the intraoperative measurement with a paired t-test and a correlation test ...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2016
Background Spinal gnathostomiasis results in serious multiorgan impairments. Magnetic resonance i... more Background Spinal gnathostomiasis results in serious multiorgan impairments. Magnetic resonance imaging (MRI) and serology help in diagnosis, and assessing the severity and extent of the disease. However, the physiology of neural pathway could not be demonstrated. Electrodiagnosis may have a role in demonstrating the functions of the central and peripheral neural pathways and prognostic assessment of the disease. Material and Method An 18-year-old man presented with radicular pain and rapid progressive weakness of lower extremities, leading to paraplegia in three days. A clinical evaluation and laboratory tests, including serology, MRI, and electrodiagnosis, were performed. Results The investigation showed L1 paraplegia with urinary retention. The serial MRI of T-spine showed longitudinal T2 hypointense lesion along the lower thoracic spinal cord, representing track-like hemorrhage with spinal cord edema at the onset of symptoms, nodular enhancement of T11-T12 spinal cord, and enhan...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2015
BACKGROUND Stroke is one of the most common cause of disabilities in Thailand. Full-course compre... more BACKGROUND Stroke is one of the most common cause of disabilities in Thailand. Full-course comprehensive rehabilitation to achieve maximum goalfor each patient was uncommon in secondary and tertiary hospitals because of limited resources and budget, so short-course inpatient stroke rehabilitation program was developed for service in these circumstances. OBJECTIVE To evaluate the efficiency and cost of the short-course inpatient stroke rehabilitation in Maharat Nakhon Ratchasima Hospital. MATERIAL AND METHOD This prospective study included stroke patients with aged over 18 years old, able tofollow one-step command and admitted in rehabilitation ward for short-course rehabilitation program between January 1 and December 31, 2014. Patient's characteristic data, Barthel Index (BI) scores, BI effectiveness, BI efficiency, length of stay (LOS), Thai HospitalAnxiety and Depression Scale (THAI HADS), WHOQOL-BREF-THAI, cost, and details oftraining were recorded RESULTS Fifty stroke patie...
Maharat Nakhon Ratchasima Hospital Medical Bulletin เวชสารโรงพยาบาลมหาราชนครราชสีมา, Oct 25, 2011
Background: Sexual adjustment and couple relationship seem to be a big problem after spinal cord ... more Background: Sexual adjustment and couple relationship seem to be a big problem after spinal cord injury. Medical staffs still have low consideration in this problem that may lead to couple relationship problem, low quality of life and high divorce or separation rate among patients with spinal cord injury. Objective: To assess the sexual adjustment, couple relationship and factors that related to sexual activity and satisfaction in spinal cord injured persons. Patients & Methods: Twenty eight spinal cord injured patients for more than 6 months with stable partner relationship (22 male, 6 female, mean age 42 years with range of 22-58) were included in the study. The questionnaires including socio-dermographic data, sexual activity, sexual function and satisfaction, sexual behavior, psychosocial aspect, relationship and information that patients want to know about sex were completed. Results: Of 28 patients, 12 (42.9%) reported having no sexual activity after injury, 16 (59.3%) had low sexual relationship satisfaction, 7 (33.3%) engaged in intercourse, 14 (66.7%) expressed their affection in other ways, 24 (85.7%) reported lower sexual desire than before injury, 16 (57.1%) never experienced orgasm, 19 (70.4%) reported markedly decreased genital sensation and 15 (55.6%) had problems about erection and vaginal lubricant. The complications disturbed the sexual activity were bladder and bowel problems, spastic and back pain. Most of them, 22 (78.6%) reported their overall relationship to be satisfactory and could easily talk about sex with their partners. 16 (57.2%) considered sex an important part of their lives and concerned their partner sexual enjoyment. 27 (96.4%) considered themselves had lower sexually attractive and 17 (60.7%) percept that their partners enjoyed their sexual relationships in low level. Only 5 (17.85%) had an idea of getting divorced or separation. Physical and psychosocial factors that correlated with sexual activity and satisfaction after spinal cord injuries were duration after spinal cord injury, type of bladder care, erectile function and vaginal lubricant problems, orgasm, type of sexual activity, consideration that they had sexually attractive and percept that their partners enjoyed their sexual relationship, overall couple relationship and social part of quality of life. Conclusion: Physical and psychosocial factors were important in sexual adjustment and relationship after spinal cord injury. More than half of spinal cord injured persons had low sexual relationship satisfaction but overall relationship was satisfied. The idea of getting divorced or separation was low. Key words: Sexual behavior, spinal cord injuries, quality of life, marriage
12 Region Medical Journal วารสารวิชาการเขต 12, Nov 26, 2014
Background : Medical studentus attitude about assessment system helped to choose appropriate asse... more Background : Medical studentus attitude about assessment system helped to choose appropriate assessment tools and improve assessment system. Objective : To describe medical studentsu attitude toward fairness of assessment methods in medical education centre, Maharat Nakhon Ratchasima hospital. Methodology : Mixed method study with focus group interview and questionnaires were used in 5th and 6th year medical students, between February and July 2014. The qualitative study with focus group interview in six 5th year medical students about opinions toward each assessment tools was performed. The data was analyzed with Steps for Coding And Theorization (SCAT). The quantitative study with questionnaires about opinions toward overall assessment system and each assessment tools were collected. Respondents were asked to score the agreement using 4-point Likert scale. There were free spaces for comments. Results : From the qualitative study, medical students showed their opinions toward each assessment tools, the reasons and problems about each assessment methods. From the quantitative study, ninetythree clinical medical students completed the questionnaires. More than 90 percent agreed that overall assessment was fair. Ninety-eight percent agreed that MEQ and OSCE were fair. The logbook was perceived as the least fair. Seventy-four percent thought that logbook was an unfair assessment and 53 percent wrote the negative comments about it. Fifty-nine percent disagreed with fairness of attitude assessment and nearly 50 percent wrote the negative comments about it. Thirty-eight percent expressed that there were some problems in assessment in some rotations. Conclusions : Logbook and attitude assessments were the least fair assessment tools in clinical medical studentsu opinions. Standardized assessment tools and assessors should be developed to improve validity, reliability and acceptability of the assessment system.
Maharat Nakhon Ratchasima Hospital Medical Bulletin เวชสารโรงพยาบาลมหาราชนครราชสีมา, May 24, 2012
Korat Dynamic External Fixator System (KDEFS) has been used since 2003 for definite treatment of ... more Korat Dynamic External Fixator System (KDEFS) has been used since 2003 for definite treatment of opened fracture which had the good result. Then the authors developed KDEFS accessories for treatment of many complications from opened fracture in one system. Objective: To evaluate the result of KDEFS in 6 functions 1. Bone transportation 2. Bone lengthening 3. Infected nonunion treatment 4. Bone gap closure 5. Hybrid external fixator and 6. Correction of malunion. Patients & Methods: Preliminary study in patients with 6 conditions in Maharat Nakhon Ratchasima Hospital during May 2006 – April 2007. Results: 1. Bone transportations were dome in 3 patient with segmental bone loss. The transportation length was 4.4- 6.1 cm. (average 5.1 cm.). The union time was 22-28 weeks (average 24 weeks) 2. Bone lengthening was performed in one patient. The lengthening length was 3.5 cm. in 8 weeks and the union time was 20 weeks. 3. Infected nonunion in 2 tibias and 2 femurs were treated. The union time of tibias were 12, 15 weeks and femurs were 18, 20 weeks.4. Bone gap of 19 patients were successfully closed intraoperatively. 5. Hybrid external fixators were applied in 1 tibial plateau fracture and 1 tibial plafond fracture. The union time were 14 and 16 weeks. 6. Correction of tibial malunion was done with successful correction in 3 weeks and the union time was 12 weeks. Conclusion: KDEFS was the new generation external fixator that has multi-function propose.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2014
The accuracy of cup placement in navigated total hip arthroplasty (THA) depends on the bony landm... more The accuracy of cup placement in navigated total hip arthroplasty (THA) depends on the bony landmark registration intraoperatively. We created a semilateral decubitus position that combined the advantage of supine position for registration and lateral decubitus position for better femoral canal visualization. To evaluate the accuracy of cup placement within the "safe zone" and of imageless navigation measurement by comparing the intraoperative values of acetabular cup abduction and anteversion to postoperative CT values. All cases were performed in semilateral decubitus position with OrthoPilot THA plus 3.2 (cup only) software (Aesculap AG). Postoperatively, a multislice computed tomographic (CT) scan was obtained at two months or later for abduction and anteversion angle measurement. The abduction and anteversion angle measured on postoperative CTwere compared to the intraoperative measurement with apaired t-test anda correlation test at a 0.05 level ofsignificance. Sixty...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2014
Acetabular component malposition has been linked to increased rates of dislocation, impingement, ... more Acetabular component malposition has been linked to increased rates of dislocation, impingement, pelvic osteolysis, cup migration, leg length discrepancy and polyethylene wear in patients undergoing total hip arthroplasty (THA). Compare the acetabular component positioning and the operative time in two consecutive short-stem cementless THA series without and with using an imageless navigation. The retrospective study consisted of 31 cases of short-stem cementless THA without navigation (NNAV) and 30 cases with navigation (NAV). CT scans were performed in all cases at two-month or later postoperatively. The abduction and anteversion angles measured on postoperative CT were compared between two groups using t-test. The percentage of cup placement (abduction, anteversion and combined) within the safe zone for each group was compared using Chi-square test at a 0.05 level of significance. The operative time was compared between two groups using t-test. The mean abduction was 43.97 (range...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2013
Navigated THA is a new procedure in Thailand that has been performed since 2012. The previous stu... more Navigated THA is a new procedure in Thailand that has been performed since 2012. The previous studies have reported that navigated THA was a safe and reliable procedure that resulted in a more consistent cup placement compared to the conventional free hand technique. Furthermore, it decreased complications of THA, especially dislocation. Perioperative protocols are based on the surgeon's concern about stability of the prosthesis and the patient's health condition. Assuming that the navigator can improve the alignment and stability of THA, the time to start rehabilitation and the post-operative length of stay should be reduced in the hospital that does not implement any perioperative protocols. The purpose of the present study was to compare the time to start rehabilitation and the length of stay between navigated and non-navigated THA. This retrospective study of patients underwent THA using short stem by a single surgeon between March 2011 and November 2012. Seventy-six pat...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011
The tibial shaft is one of the most common sites of open fracture. External fixators emerged as t... more The tibial shaft is one of the most common sites of open fracture. External fixators emerged as the treatment of choice for high energy open tibial fractures because they were easy to apply, allow sufficient access for wound care and provide sufficient mechanical fixation for patient mobilization and bone healing. Based on the advantages of dynamization in increased union rate and the simplicity of monolateral frame, a new design dynamic external fixator system was developed for definite treatment in open tibial fracture. To evaluate the clinical results of open tibial fractures treated with a new design dynamic external fixator system until healing. The case series of 60 patients with open tibial fracture treated with the new design dynamic external fixator system for acute and definitive-treatment frame between 2005 and 2009. According to the system of Gustilo and Anderson, 14 fractures were classified as type II, 43 as type IIIA, and three as type IIIB. Partial weight bearing wit...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2007
To investigate which hand muscles were used for interphalangeal joint (IP) extension when holding... more To investigate which hand muscles were used for interphalangeal joint (IP) extension when holding the metacarpophalangeal joint (MCP) in 90 degrees flexion, 0 degrees, and full hyperextension. Fifteen volunteers extended IP when MCP was manually maintained in 90 degrees flexion, 0 degrees, and full hyperextension for 5 seconds with and without maximal manual resistance twice each. Maximal resistance was ensured and maintained manually by the actions of both researcher and subject. By using needle electromyography, the root mean square (RMS) * values representing the muscle function of the extensor digitorum communis (EDC), lumbrical, and interosseous muscles of the middle fingers of the dominant hands were recorded and averaged from the two tests conducted on each subject. In 87% of the subjects, EDC had the highest RMS value in 90 degrees MCP flexion without resistance, and in 100% of them, it had the highest value in both 90 degrees MCP flexion and 0 degrees with resistance. There...
Background: Knee and elbow flexion contractures are a frequent cause of ambulation and function p... more Background: Knee and elbow flexion contractures are a frequent cause of ambulation and function problems that often require extensive rehabilitation. Traditional methods are of limited benefit in severe and fixed contracture. A new static progressive splint was developed from daily-use knee and elbow orthosis and a newly invented gradual telescopic rod, which is designed to provide low load, and gradual and prolonged stretching.
Background: Idiopathic fibrosis of the quadriceps muscle can be defined as progressive loss of kn... more Background: Idiopathic fibrosis of the quadriceps muscle can be defined as progressive loss of knee flexion due to fibrosis within the muscle developed in early childhood. A few cases have been reported, but these did not detail the MRI and pathological findings. Material and Method: A 28-year-old woman presented with difficulty in sitting and inability to bend both knees completely. The clinical evaluation, radiological examination, MRI, treatment and muscle pathology were demonstrated.
Background: Idiopathic fibrosis of the quadriceps muscle can be defined as progressive loss of kn... more Background: Idiopathic fibrosis of the quadriceps muscle can be defined as progressive loss of knee flexion due to fibrosis within the muscle developed in early childhood. A few cases have been reported, but these did not detail the MRI and pathological findings. Material and Method: A 28-year-old woman presented with difficulty in sitting and inability to bend both knees completely. The clinical evaluation, radiological examination, MRI, treatment and muscle pathology were demonstrated.
Background: Knee and elbow flexion contractures are a frequent cause of ambulation and function p... more Background: Knee and elbow flexion contractures are a frequent cause of ambulation and function problems that often require extensive rehabilitation. Traditional methods are of limited benefit in severe and fixed contracture. A new static progressive splint was developed from daily-use knee and elbow orthosis and a newly invented gradual telescopic rod, which is designed to provide low load, and gradual and prolonged stretching.
Uploads
Papers by rachawan suksathien