Introduction: Supracondylar humerus fractures are one of the commonest fractures in the paediatric age group. Displaced fractures of these kind, that is, Gartland type III are treated by closed or open reduction and k wire fixation. Cross k wire and lateral wires are the commonest configurations used for fixation. The present study aims to evaluate the difference between the two configurations in terms of surgical technique, functional outcome and complications. Materials and methods: A prospective study of 30 paediatric patients with displaced Supracondylar humerus fractures was carried out between September 2016 to September 2017. 15 patients were treated with cross k wire fixation (Group A) while the rest with 2 lateral k wires (Group B). The functional outcome of the 2 groups was measured by Flynn's criteria. Also, the intra operative difficulties and iatrogenic ulnar nerve palsy were noted. Statistical analysis between the two groups was done by Student's t-test to find any statistical significant difference. Results: As per Flynn's criteria, 66.67 % patients treated with cross k wire fixation and 60.00 % patients treated with lateral k wires had excellent functional outcome. This difference was not statistically significant. 3 patients in group A had ulnar nerve palsy which resolved within 3 weeks after surgery. No incidence of ulnar nerve palsy was found in patients of group B. Conclusions: There is no statistical difference between the two techniques with respect to functional outcome indicating that both methods are equally efficient. However, there is a risk of ulnar nerve palsy during insertion of the medial wire of the cross k wire fixation.
Objectives: The COVID-19 pandemic is a public health emergency causing a deleterious effect on the health system. It affected all the specialties and subspecialties in the medical field causing havoc in the health institutions. This pandemic affected both orthopaedic consultants and the residents who are under training. Our purpose was to study the impact of COVID-19 on orthopaedic residents in their professional life.Method: The study design was a computer-based digital online survey of the orthopaedic residents in India. The survey had 15 questions with multiple options related to the effect of COVID-19 on their orthopedic department, effect on teaching, surgical exposure, hands-on surgeries, the effect on workload, effect on mental stress, exposure to arthroplasty, arthroscopic surgeries, spine surgeries, and deformity correction surgeries.Results: Elective surgeries stopped in 91% of the hospitals, academic teaching stopped in 98% of the institutions. Eighty-six percent of the residents are not getting adequate surgical exposure, 73% of the residents are getting negligible hands-on surgical training. Residents are mentally stressed related to academic examinations, academic training, and also because of COVID 19 duties. Residents are getting the least exposure in subspecialties like arthroplasty, arthroscopy, and spine. Conclusion:The COVID-19 pandemic not only affected the orthopaedic consultants but also the orthopaedic residents to a great extent as residents are the backbone of any department/institution. The pandemic affected significantly resident's academic teaching, surgical exposure, hands-on training and mental stress related to COVID duties, academic training disturbance, and also academic examinations.
<p class="abstract"><strong>Background:</strong> Gap non-union is one of the most perplexing problems facing the orthopedic surgeon today. Fibula is the preferred site of non-vascularized bone graft due to its easy accessibility to surgical resection and minimal donor site complications.</p><p class="abstract"><strong>Methods:</strong> The study comprised 11 patients of gap non-union between 13 to 80 years (mean=34.9 years). The fibular graft was harvested from the mid shaft and cortico-cancellous bone graft taken from the iliac crest was applied at both ends of the fibular graft to aid in union.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average bone gap was 7 cm (4-13 cm). 64% of the patients achieved bone union after the first procedure, of the remaining 4 patients, 1 patient showed union after secondary cortico-cancellous bone grafting, while two are planned for the same. The remaining one patient has only completed 16 weeks follow-up at present and is not showing signs of union at present. Functional range of motion was achieved in both the proximal and distal joints in all cases.</p><p class="abstract"><strong>Conclusions:</strong> Non-vascularized fibular bone grafting is a simple and effective treatment option which does not require any special skill, has a very low complication rate and has very high patient compliance.</p>
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