Khaled Elawady

By Saqeb Beig Mirza, Khaled Elawady, Syed Kashif Abbas, Shafat A. Gangoo and Sukhmeet S. Panesar

Trauma and orthopedics is a specialty in which significant blood loss can be incurred both in terms of traumatic injuries and operative management. This chapter starts with a brief review of the biology of hemostasis followed by the importance of hemostasis in surgery. This is followed by a discussion on the ideal hemostatic agent. Various strategies of achieving hemostasis will be discussed including mechanical, thermal, pharmacological and topical agents in both elective orthopedic and spine surgery as well as in trauma. Specifically, we will look at synthetic agents such as cyanoacrylate, polyethylene glycol hydrogel and glutaraldehyde cross-linked albumin and absorbable agents such as gelatin foams and oxidized cellulose. We will also look at biological agents such as topical thrombin, sealants and platelet gels. Hemostatic dressings will be discussed in detail.

Part of the book: Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 1 [Working title]

By Khaled Elawady and Saqeb Beig Mirza

Compartment syndrome is a painful condition, caused by increased pressure in a closed muscular compartment. A compartment is a group of muscles enclosed in fascia and septa of connective tissue, which separates different muscle groups. The chambers created receive their blood supply through the arteries. As the pressure builds in the closed space, the blood supply to muscles enclosed decreases. Normal compartment pressure allows blood to flow in and then venous outflow to exit the compartment. However, with increased pressure in the compartment, the arterial flow is impaired. Subsequently, venous outflow stops, adding to the volume of the closed chamber, and hence, pressure builds to the point when the arterial flow stops as well. This chapter provides a general overview of the compartment syndrome in orthopaedic surgical practice. It includes definitions, causes, microscopic anatomy and pathophysiology, as well as the management of this condition.

Part of the book: A Comprehensive Review of Compartment Syndrome

By Sedeek M. Mosaid, Ahmed Khalil, Khaled Elawady, Munier Hossain and Nijil Vasukutty

The combination of neuropathy, vasculopathy, and impaired bone repair makes ankle fractures in people with diabetes mellitus a serious clinical concern. Complications, including infection, nonunion, Charcot neuroarthropathy, and even amputation, are more likely to occur in these individuals. This chapter analyses the biochemical and physiological impacts of diabetes on bone health and recovery, reviews specific assessment and evaluation methods for affected patients, and delineates both nonsurgical and surgical treatment alternatives. This study evaluates various surgical techniques, including standard, trans-syndesmotic, transarticular, hybrid fixation, and primary arthrodesis, within the framework of diabetic conditions. The significance of selecting a suitable fixation technique, evaluating vascular health, and utilising a multidisciplinary approach is highlighted. In addition, this chapter discusses complications such as Charcot arthropathy, fixation failure, and infection. The objective is to provide orthopaedic surgeons and clinicians with a practical, evidence-based guide for the effective management of diabetic ankle fractures.

Part of the book: Comprehensive Overview of Foot and Ankle Trauma

By Sedeek M. Mosaid, Khaled Elawady, Ashok Marudanayagam and Rohit Rambani

Talus fractures are rare but one of the most complex and challenging injuries in orthopedic trauma due to their anatomy, weight-bearing and limited blood supply. These fractures are often high-energy injuries and can lead to complications. This chapter will cover the anatomy, vascular supply, classification systems, mechanism of injury and clinical evaluation of talar fractures. Radiological imaging, especially computed tomography (CT), is crucial for diagnosis and surgical planning in these cases. The chapter will discuss various fracture patterns, head, neck, body and lateral processes, and modern operative techniques. The fracture type, soft tissue condition and the need for anatomical reduction will determine the surgical approach. The chapter will discuss complications and their management to guide clinicians in providing the best care and improving the outcomes for these patients.

Part of the book: Comprehensive Overview of Foot and Ankle Trauma