Background: Unstable inter-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to compare the proximal femoral nail and proximal femoral locking plate for the management of unstable inter-trochanteric fractures and their postoperative complications. Material and methods: This was a prospective study of 40 patients with unstable inter-trochanteric fractures of femur who were treated with PFN (20 cases) and PFLP (20 cases). The fractures were classified according to Boyds and Griffin classification. All patients were assessed functionally by Harris Hip Score. Results: Average duration of union was 14.75±3.52 weeks (range 14 to 16 weeks) in PFN cases and 17.70±2.00weeks (range 14 to 21 weeks) in PFLP cases, union was achieved in 100% cases except one case of PFN which goes to non union due to Z effect. Various complications were seen in both cases. As per Harris Hip score, excellent results were noted in 75%PFN and 40%PFLP cases, good in 15%PFN and 25%PFLP cases and fair in 5% PFN and 35% PFLP cases and poor in 5%PFN and 0%PFLP cases. Conclusion:Harris hip score comparison of study suggests that functional results were better in PFN than PFLP. Less Blood loss, less operative time, early weight bearing were other favouring factors in PFN. Though blood loss and operative time was more, rigidity of fixation was better in unstable fractures in PFLP group. We conclude that PFN is the better implant for unstable intertrochanteric fractures with lesser operative time and lesser blood loss. While PFLP can be a good alternative for unstable intertrochanteric fractures with better results with slightly longer operative time and more blood loss when compared with PFN.
Background: Osteoarthritis (OA) is the most common form of arthritis in the world. Proximal fibular osteotomy (PFO) is an alternative treatment to high tibial osteotomy (HTO). It is a surgical procedure for medial compartment knee osteoarthritis (KOA). Hence; the present study was undertaken for assessing the functional outcomes of proximal fibular osteotomy in osteoarthritis knee. Materials & Methods: A total of 30 patients were assessed. The patients were placed in the supine position after administration of spinal anaesthesia. An approximately 5-cm longitudinal incision was made over the lateral aspect of the proximal fibula, and the fibula exposed between the peroneus muscle and soleus muscle. Knee pain was assessed using a Visual analogue scale. Medical joint space and the hip knee-ankle angle was measured. based on the whole lower extremity radiograph. Results: Significant improvement was observed in the mean VAS improved from preoperative value of 8.23 to 2.1 at 9 months postoperative follow-up. Significant improvement was observed in the Mean knee joint space from preoperative value of 0.35 to 0.58 at 9 months postoperative follow-up. Significant improvement was observed in the mean hip knee ankle angle from preoperative value of 184.2 to 177.3 at 9 months postoperative follow-up. Conclusion: PFO is a novel alternative method in the management of medial compartment arthritis of the knee.
Oncologic treatments, such as Radio- therapy and Chemo-radiation, for head and neck cancer can cause long-term swallowing impairments (dysphagia) that negatively impact the Quality of life. Radiation-induced dysphagia consists of a broad spectrum of structural, mechanical, and neurologic deficits. The goal of this study is to understand the importance of Onco Rehabilitation during Radiation and Chemo-Radiation to minimize the incidence of Dysphagia during the Treatment, which ultimately causes delay in Overall Treatment Time (OTT).
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