Introduction: Open distal femoral fractures are not rare and are difficult to manage. In open grade III injuries, according to Gustilo-Anderson's classification of Open fractures, due to massive trauma to the soft tissue and loss of bone, chaotic mindset of treating doctor compels him to fall prey to petty methods of fixation leading to inferior results. Method: We studied a group of 24 patients with open distal femur fractures with or without bone loss, classified them and treated according to the steps described in our treatment flow chart. We have tried to formulate a standard, reproducible method of treating such fractures according to priority and need. Results: We achieved 79.2% good to excellent results according to Knee Society Scoring system on treatment of open distal femoral fractures with author's preferred treatment. This is comparable with many other similar studies pointing towards the fact that our treatment protocol and scoring system for these fractures are worthwhile. Conclusion:We conclude that immediate management in emergency department, early shifting of patient to the operating room and stabilizing the fracture and carrying out proper debridement of wound and depot antibiotics are important steps in management. Vacuum assisted dressings, sequential debridement, autologous bone grafts, double plate fixation and staged wound management can give good results in the hands of any surgeon.
Introduction: Encouraged by the distinct advantages of minimally invasive plate osteosynthesis technique for treatment of peri-articular fractures of long bones, we have extended the concept for treatment of distal radius fractures. The aim of our study was to evaluate the clinical and functional outcome of MIPO technique for distal radius fractures. Method: Thirty patients with isolated Frkyman's type I to IV fractures of distal radius were treated using minimally invasive approach of proximal vertical and distal transverse incision and fixed with volar locking plate and followed till six months post operatively. Final assessment was done using Mayo wrist scoring system at the end of six months. Results: Based on Mayo wrist scoring system 73% had excellent results and 27% had good results. All patients could return to pre-injury work status by 8 weeks. There were no cases of neuro-vascular injury or joint stiffness and cosmetic acceptance of barely visible scar was very satisfactory. Conclusion: Fixation of extra-articular distal radius fractures and minimally displaced, stable intraarticular fractures by using minimally invasive approach appears to be encouraging, reliable and easily reproducible by all.
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