Background: Inter-condylar fracture distal humerus in adults often pose a challenge to orthopaedic surgeons because of the complex anatomy, fracture pattern and limited bone stock of this region. Adequate exposure of the articular surface of the distal humerus and elbow joint is essential for operative stabilisation of complex distal humerus fracture. Various operative approaches have been recommended to access this difficult region which includes triceps splitting, triceps reflecting and trans-olecranon approaches though each approach has its own advantage & disadvantage. Olecranon osteotomy approach provides better visualization of complex intra-articular fractures, enabling accurate reduction and fixation.
Aim of this study:To assess the functional outcome of intercondylar humerus fracture with olecranon osteotomy approach. Study design: prospective study Material and methods: Sixty patients of inter-condylar fracture humerus fulfilling the inclusion criteria were treated with internal fixation with various implants with olecranon osteotomy via posterior approach. Preoperative and postoperative radiograph measurements were taken and fractures were classified according to the AO system. All patients were operated through posterior trans-olecranon approach. Elbow exercises were started at third postoperative week. Patients were followed at three weeks and thereafter monthly, with clinical examination and x-rays. Results: The average ROM on follow up after 6 weeks was flexion up to 140 o and extension upto 5 o of elbow flexion. No cases of olecranon or distal humerus non-union were reported. Conclusions: Posterior surgical approach with olecranon osteotomy provides optimal exposure of the intra articular aspect of distal part of humerus and among them olecranon osteotomy gives the best exposure of the articular surface and there by better reduction and internal fixation which in turn gives better stability and good range of motion as compared to other approaches.
Background: Calcaneum fracture is the most frequently injured tarsal bone of human body. It consists of 2% of all fractures, out of them 70% are intra-articular fracture.10% injuries are bilateral and 5% are open fractures which leads to high potential for disability. Best treatment option is always controversial. The aim of our study was the management and outcome of these fractures by maintaining angles like Bohler's angle and Gissane's angle by either conservative or surgical method. Objective: To compare and evaluate the outcome of calcaneum fracture by maintaining Bohler's angle and Gissane's angle of calcaneum by conservative or surgical procedure, taking into account, the post management outcome, complications, and the AOFAS questionnaire. Material & Methods: This is a Retrospective study design, where a retrospective study was carried out on 60 patients at SCB Medical College from 2015 to 2017 of which 20 patients were referred to SCB OPD from peripheral centres with old calcaneum fracture & who did not received any treatment for the same. Rest 40 pateints with calcaneum fracture were intervened of which 10 had bilateral calcaneum fracture. For statistical method: Chi-square test was used. P value was calculated to determine the level of significance. Results: We have achieved good functional outcome with AOFAS score of 78 as compared to 62 of control group by trying to restore the angles of calcaneum by interventions. (Conservatively or Surgical) Conclusion: Surgical or conservative management of calcaneum fractures according to types of fractures by maintaining angles like Bohler's angle and Gissane's angle gives good functional results.
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