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Day Care Surgery in Orthopaedics

CG Pradhan, JA Pachore

Day Care surgery is gaining popularity today due to obvious advantages like reduced hospital stay and economical advantages.

Following are the surgeries which can be done in the day care, in orthopaedics:

1) Non Surgical Day Care Cases
i. Closed reduction and immobilisation (with or without G.A.), of fractures and dislocations (Supracondylar Humerus)
ii. Manipulation of: knee, shoulder, cervical or lumbar spine, Congenital Talipus Equino Varus (CTEV)

2) Surgical Day Care Cases
i. Minimally Invasive:
a. Local Hydrocortisone injection
b. Joint aspiration
c. Needle biopsy
d. Skeletal traction
ii. Endoscopic procedures
a. Discectomy
b. Arthroscopy: Diagnostic / Therapeutic.
c. Epidural injection
iii. Open procedure
a. Trauma: - Fracture fixation (radius-Ulna)
- External fixator application
- Implant removal
b. Infective: - Incision and drainage
- Wound wash
c. Open Biopsy: Infection, tumour
d. Excision biopsy: Bursa, ganglion, lipoma
e. Contracture release: Polio, Cerebral palsy
f. Soft tissue release: Carpal tunnel syndrome, Trigger finger, Tenosinovitis, Transfer of ulnar nerve

A lot has been written about day care surgery, its benefits and disadvantages. The criteria’s for patient selection, discharge, with follow up, remain common to most of the specialities. Most importantly, keeping the principles of surgery in mind, making maximum utilisation of the available resources, for the ultimate benefit of the patient, should be the bottom line of Day Care surgery.

As our knowledge increases day by day, more and more cases will be included as day care, which will be the need of the future.

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