BACKGROUND: Supracondylar fracture is one of the commonest fracture in children account for 60% of all fractures around the elbow joint and represent approximately 3% of all fractures in children. ToAIM AND OBJECTIVES: evaluate clinico-radiological and functional outcome of early mobilization after closed reduction and percutaneous lateral k-wires xation in displaced fracture of Supracondylar humerus in children by using by Flynn's criteria. The present prospectiveMATERIAL AND METHODS: study was conducted on 34 patients from February 2020 to September 2021 who had displaced supracondylar humerus fracture. MeanResults: age of the study population was 6.8 years. A total of 20 were male patients and 14 were female. Majority of patients i.e. 26.4% got injuries due to fall from height. Maximum number of patients had type III Gartland fracture i.e. 20 followed by Type II i.e. 14 patients. Mean duration of trauma – surgery interval was 2.4 days. 50% of patients k-wire was removed at 3 weeks and rest 50% patients at 4 weeks. Final follow up at 6 months showed a total of 28 patients had loss of exion <5 degree followed by 6 patients who had loss of exion between 6-10 degree. Similarly, 31 patients had loss of extension<5 degree followed by 3 patients who had loss of extension 6-10 degree. After 6 months, we observed only 30 patients with <5 degree, 4 patients with 6-10 degree and none with >10 degree loss of carrying angle. In 2 patients, we found supercial pin site infection and in none of the patients we found any loss of reduction, delayed union, non-union, malunion and arthobrosis. A total of 28 patients had excellent results according to Flynn's criteria and 6 patients had good results. It is concluded that closed reduction andCONCLUSION: percutaneous lateral pinning is a sound and effective modality for the treatment of displaced supracondylar fractures of humerus.
Background: The subtrochanteric fractures accounts for 10-34% of hip fractures. Operative treatment is gold standard in adults in view of anatomical location, deforming forces & vascularity issues. Intramedullary device are less invasive, more biological & mechanically stable whereras extramedullary methods achieves better anatomical reduction but at the expense of vascularity. However, there is still no consensus over the methodology for being the best for these fractures. Objective: To evaluate clinical, functional and radiological outcomes of intramedullary osteosynthesis of subtrochanteric femur fractures in adults with long PFN. Methods: A prospective randomized control study was conducted on total 30 patients of subtrochanteric fractures and treated with long proximal femoral nail (PFN). All the patients were followed up for a maximum of 24 weeks. Outcomes were observed & analysed such as tip apex distance, duration of surgery, complications, functional and radiological outcomes. Results: The average age of patients was 43.6 years ±13.26. Left sided fracture were more than right sided fracture. The most common type of fracture as per AO-ASIF classication was 32-C3 (53.33%). In 21 patients compression screw used was 95mm or above. Derotation screw of size 85mm or above were inserted in 19 patients. Mean TAD of compression screw and derotation screw was 11.59 and 13.81 respectively. Closed reductions was achieved in 27 patients. Mean surgical time was 157 minutes. Mean radiological union time of fracture was 14.16 weeks. Mean Harris hip score at 24 weeks was 84.56. Conclusions: It is concluded that intramedullary xation by long PFN is a sound and effective modality for the subtrochanteric fractures. Subchondral xation of both proximal screws probably has led to better stable xation with hundred percent union rates and no implant failure.
<p class="abstract"><strong>Background:</strong> The trochanteric fractures are one of the commonest fractures in elderly population. Incidence of these fractures is increasing due to better life expectancy, growing number of population, industrialization and the road traffic accidents. Variety of implants are available but still there is no consensus for single implant.</p><p class="abstract"><strong>Methods:</strong> A prospective randomized control study was conducted on total 60 patients of intertrochanteric fractures which were randomized into 2 groups of 30 each, treated with dynamic hip screw (DHS) and proximal femoral nail (PFN). All the patients were followed up for a maximum of 6 months. Outcomes were reviewed and compared such as mode of injury, complications, functional and radiological outcomes.<strong></strong></p><p class="abstract"><strong>Results:</strong> There was no significant difference between two groups of patients as regards to mean age and sex. The mode of injury by slip and fall was main cause. The most common type of fracture as per AO-orthopaedic trauma association (OTA) classification was 31-A2 (65%) and 31-A3 (5%) being the least common type. Mean surgical time of DHS group and PFN group was 125.17 minutes and 89.93 minutes respectively. Mean blood loss in DHS group and PFN group was 251.67 ml and 158.67 ml respectively. Mean radiological union time of fracture in DHS group and PFN group was 12.3 and 9.5weeks respectively. Mean Harris hip score at six month in DHS group and PFN group was 80.77 and 85.47 respectively.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that though both the implants can achieve comparable union rates but PFN are better than DHS as of better Harris hip score, shorter surgical time and less intra operative blood loss.</p>
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