<p class="abstract"><strong>Background:</strong> Hip fractures in older patients are associated with impaired mobility, excess morbidity, mortality and loss of independence. To avoid the drawbacks of internal fixation and for early mobilization, hemiarthroplasty is performed in elderly. The bipolar prosthesis was developed to overcome the shortcomings of the unipolar fixed-head prosthesis. An additional site of motion would be expected to decrease the amount of loosening, dislocation, and head migration. The aim of the study is to assess the functional outcome of the patients with fracture neck of femur treated with bipolar hemiarthroplasty.</p><p class="abstract"><strong>Methods:</strong> In this study, 20 patients above the age of 60 years with acute displaced fracture neck of femur underwent hemireplacement arthroplasty with bipolar prosthesis in Department of Orthopaedics, KIMS, Bangalore. The patients were followed up on 6th, 12th, 18th, 24th week post operatively. Functional outcome was assessed with Harris hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, mean average age was 72.3 years with predominantly female patients with 75% of the patients with left sided fracture. 95% of the patients had slight or no pain, 85% of patients had slight or no limp. 50% of the patients could walk without support, 65% of the patients could walk a distance of 6 blocks or more. Average Harris hip score was 82%.</p><p class="abstract"><strong>Conclusions:</strong> These results suggest functional outcome following bipolar hemiarthroplasty is good. Early mobilisation, pain free hip and with good level of activity is obtained following bipolar hemiarthroplasty.</p>
<p class="abstract"><strong>Background:</strong> Proximal humerus fracture accounts for about 5% of all fractures in recent advances proximal humerus fractures are often managed operatively with PHILOS plate which provides greater angular stability and study was aimed at to assess functional outcome of PHILOS plate fixation in proximal humerus fractures.</p><p class="abstract"><strong>Methods:</strong> Prospective study of 31 cases of proximal humerus fractures admitted and operated in Kempegowda Institute of Medical Sciences Hospital November 2017 to May 2019 of which 4 patients died due to medical comorbidities so 27 patients were studied. Follow-up of these patients was done at 6 weeks, 12 weeks and 24 weeks with functional evaluation was done using Constant and Murley (CM) scoring and disabilities of the arm, shoulder and hand (DASH) scoring.<strong></strong></p><p class="abstract"><strong>Results:</strong> CM scoring and DASH scoring was applied to analyze the functional outcome among the cases. Most of the patients had excellent outcome (52%) followed by good (26%), fair (8%) and poor (15%) outcome according to CM scoring and according to DASH scoring 20.21 was mean score and mean CM score was 77.62. Complications observed were impingement in 1 patient, avascular necrosis in 2 patient and non union in 1 case.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that the use of PHILOS plate for the fixation of proximal humerus fractures is a good device as it provides rigid fixation and early mobilisation and prevented complications. Precontoured locking plates work on the principle of angular stability, divergent screws, less disruption of vascularity and less chances of plate failure.</p>
<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures are common in old age group, but uncommon in younger age group. The goal of treatment of intertrochanteric fractures is restoration to pre-injury status at the earliest. The purpose of this study is to compare the functional outcome of the two fixation devices proximal femur nail (PFN) and dynamic hip screw available for intertrochanteric fractures in terms of the eventual functional outcome of the patient.</p><p class="abstract"><strong>Methods:</strong> Prospective study of 30 cases of Intertrochanteric fractures admitted and operated in KIMS hospital from November 2017 to May 2019. Follow-up of these patients was done at 6 weeks, 12 weeks and 24 weeks with functional evaluation was done using Harris hip score at the 24th week.<strong></strong></p><p class="abstract"><strong>Results:</strong> The results at the end of 24 weeks follow-up were calculated by the Harris hip score were better with the PFN. 66.7% of the patients operated with PFN gave excellent results as compared to 60% of patients operated with dynamic hip screw (DHS).</p><p class="abstract"><strong>Conclusions:</strong> We conclude that the use of PFN for the fixation of trochanteric fractures against the proven DHS offered better results along with a few advantages. PFN required smaller incision, shorter duration of surgery, less blood loss and faster recovery and better functional outcome at the end of 24 weeks. But still PFN is technically more demanding than the DHS and was found to have longer fluoroscopy exposure.</p><p class="abstract"> </p><p> </p>
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