Background: Supracondylar fractures of humerus are one of the most common fractures in paediatric age group. Closed reduction and percutaneous K-wire fixation is one of the most commonly used treatment modality in Gartland type 3 fractures. A prospective randomized controlled study was undertaken to compare whether parallel k wires are better in terms of the stability, functional outcome and iatrogenic ulnar nerve as compared to cross k wire (medial and lateral). Material and methods: This is a prospective comparative randomized controlled trial. A total of 30 patients of displaced supracondylar fracture aged between 5-13 years, without any compound injury or comminution were enrolled for the study and randomly divided into two groups, each of 15 patients. One group was assigned treatment of crossed pinning and other group with lateral pinning respectively and outcome was evaluated on basis of pain, motion, stability and function according to Mayo's elbow score and follow-up was maintained for a period of 45 days and statistical significance was calculated. Results: After assessment of 15 patients in each group we found out that mean mayo score was 98 in cross pinning group and 96.83 in lateral pinning group. This difference is statistically not significant. Conclusion: In our study we conclude that, lateral pinning is an equally good treatment choice in these fractures and especially for grossly swollen elbows. Also, risk of ulnar nerve injury during placement of medial pin is eliminated in lateral parallel k wires. Both the methods offer consistently satisfactory functional and cosmetic results.
Medial collateral ligament (MCL) is the most commonly injured ligament of the knee. Acute Grade III MCL injuries can be managed conservatively except bony avulsion, intra-articular entrapment and Stener lesion, which requires surgical treatment by repair with or without augmentation. Chronic MCL injuries are treated surgically with various reconstruction techniques that are well established in the literature, which requires use of autograft or allograft and multiple tunnel placement with multiple implants for graft fixation. These techniques possess higher chances of tunnel convergence and hardware-related complications, further increasing surgery cost, especially for multi ligament injuries. Finally, all these MCL reconstruction surgeries are technically challenging. Here, we propose our technique of single-row repair in cases of chronic femoral side MCL insufficiency with grade III valgus laxity. This technique reattaches the torn ligament at its near anatomical attachment site using a single, double-loaded 5.5-mm suture anchor. This technique preserves and uses the native MCL, requiring no separate graft and no tunnel preparation. Hence, no graft site morbidity and tunnel-related complications, along with maintenance of proprioception. It is a cost-effective, reproducible, and technically simple procedure with good functional outcome. Level I: knee Level II: collateral ligaments
Background: The locking compression plate (LCP) is a newer modality for fracture fixation of both bone forearm fractures. The aim of the study is to compare this modality with the conventional Limited contact dynamic compression plate for Diaphyseal fractures of both bone forearm. Materials and methods:It is a prospective type of comparative study involving 40 patients, 20 in each group. The functional outcome was assessed using the criteria of Anderson et al. The quality of reduction of the fractures was assessed using the criteria of Leung et al. The patient rated outcome was assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Results: The mean duration of surgery and the time for union were discovered to be less in LCP group as compared to LC-DCP though statistically insignificant. No significant differences were found between two groups with respect to functional outcomes (Anderson's criteria and DASH score) Conclusion: LCP is an effective alternative treatment over LC-DCP in the management of these fracture but their superiority could not be certified. We conclude that surgical planning and technique for plate fixation is more important than the choice of implant.
Background: This study evaluated the functional outcome of ipsilateral fracture of femur and tibia. Materials and Methods: 30 cases were studied. Fracture types were classified according to Fraser classification into Type1-22, Type2A-4, Type2B-2, Type2C-2 cases. Different modalities of treatment were used. Functional assessment was done according to Karlstrom and Olerud criteria. Results: Most common mode of injury was road traffic accidents. Average time period for bony union was 20.43 weeks for femur and 24.26 weeks for tibia in Type-1, 38.28 weeks for femur and 29.42 weeks for tibia in type 2. Compound, comminuted, intra articular fractures took more time to unite. Complications like knee stiffness, infection, delayed and non union were encountered which required additional procedures. Average knee range of motion was 0-108.67 o , functional outcome was excellent in 12, good in 11, acceptable in 2 and poor in 5 patients. Conclusion: Functional outcome was better in Type-1 fractures treated with intramedullary interlock nailing which allowed early mobilization and weight bearing than in Type-2 intra articular fracture treated with plating.
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