Background: One of the most common injuries encountered in orthopedic practice are Distal Radius fractures. This comprises of 8%−15% of all fractures in adults 1 . The reason for comminuted DER fractures is high-energy trauma in young and low-energytrauma in elderly. They present as shear and impacted fractures involving the articular surface of the distal radius with displacement of the fragments 2-7 . External fixation for distal radius fracture relies on the principle of Ligamentotaxisin which, a distraction force applied to the carpus aligns the fragments by means of intact ligaments. The length and alignment of fracture fragment is guided by pull and counter pull which are otherwise difficult to control 8 . Objective: To study functional outcome of distal end radius fracture treated by ligamentotaxis with evaluation of functional results according to Disabilities of the Arm, Shoulder and Hand (DASH) score system. Material and Methods: We included 30 patients (Male 24 and Female 6) treated for distal end radius fracture during a period from 2015 to 2017. Patients were evaluated clinically by subjective assessment using DASH Scoring system. Result: After functional evaluation of patients according to the scheduled follow up with mean DASH Score of 76.08 at 1st month, 62.92 at 3rd month and 42.60 at 6th month, and was found to be Highly Significant (p<0.001) among all the compared groups. Conclusion: We concluded that external fixation and ligamentotaxis applied to complex distal radius fractures, when added with augmented K-wire fixation can provide direct augmentation of fracture stability and a good wrist function.
Osteochondral fractures of lateral femoral condyle are common in adolescents and young adults. They are usually caused by direct trauma or twisting injuries of the knee. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. Adequate exposure was achieved by doing Z-plasty of quadriceps apparatus. The fracture was treated with open reduction and internal fixation using Herbert's screws. Medical management in the form of vitamin D and calcium along with testosterone was given. After the surgery, full weight-bearing was allowed at three months. At one year followup, patient has good quadriceps function without any weakness of the muscle.
Background: Most commonly reconstructed ligament of knee is Anterior Cruciate Ligament that aims to halt or minimise the number of instability episodes 1. Testing with biomechanical parameters has shown that there is correlation between graft cross-sectional area and maximum load to failure 2. This study attempts to analyse the functional outcome of ACL reconstruction with 5 strands of hamstring autograft Aims and Objectives: This study is based on hypothesis that larger graft will be stronger, stiffer providing better functional outcome. Materials & Methods: 35 Patients having ACL injury were treated at a tertiary care hospital; using a 5-strand hamstring graft, fixed with suspensory fixation at femoral side and aperture fixation at the tibial side. Cases were diagnosed with ACL on clinical examination & MRI. Tegner-lyshom score and International Knee Documentation Committee -Orthopaedic Scores (IKDC) is used post-operatively to grade the functional outcome of an ACL reconstruction. Results: Male predominance was observed in study subjects than female with left side slightly more commonly involved than right. Laterality didn't influenced outcome. Graft diameter observed is 9mm in 68.6%, 8 mm and 10 mm was observed in 11.4% and 20% respectively. Lysholm score at baseline was 41.63 which increased progressively to 93.45 at the end of 9 months. The IKDC score at baseline was 32.5 which increased progressively to 83.45 at the end of 12 months. Superficial infections was seen in 8.6% while complaint of knee pain was given by 2.9% cases. Lachman test was positive in 2 (5.7%) cases. Conclusion: Five-strand graft offers very high strength and more length than the 4ST. It is useful in patients with ligamentous laxity, small tendons, or other stability risk factors.
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