Background: The incidence of femoral neck fractures, one of the most common traumatic injuries in the elderly increases continuously due to the ageing of population on the planet and urbanization. Aims and Objective of the Study: To study the incidence of intracapsular femoral neck fractures in the elderly population with respect to age, sex, occupation, fracture type and laterality of injury. Materials and Methods: The prospective study included 30 patients with intracapsular femoral neck fractures referred to the Department of Orthopaedics, Ashwini Hospital, Gulbarga were selected for this study. Patients with intracapsular femoral neck fractures and aged above 55 years were considered. Patients were briefed about the nature of the study, the interventions used and written, informed consent was obtained. Further, descriptive data of the participants like name, age, sex, detailed history, were obtained by interviewing the participants and clinical examination and necessary investigations were recorded on predesigned and pretested proforma. Results: Majority of the patients (seven patients, 23.33%) were in the age group between 71 to 75 years and five patients, (16.67%) each were in the age groups of 55 to 60 years, 76 to 80 years and above 80 years. In the present study, out of the 30 patients there 18 were female accounting to 60% and 12 male patients making up the remaining 40%. The average interval between admission to the hospital and surgery was 3.6 days with a range of 01 to 17days. The average duration of hospital stay was 13.3 days with a range of 7 to 26 days. The duration of hospital stay is less in our series as the patients were mobilized early. Out of 18 female patients 14 females were house wives. Three were retired from job, and one was self-employed. Among the males, seven were retired from their jobs, four males were businessman and one male patient was self-employed. Majority of the fractures occurred due to fall in bathroom (56.67%) and fall in living room (30%). Right side involvement was more commonly seen than the Left in this study group. Right side was involved in twenty patients making up for 66.67% of the fractures and the left was involved in ten patients accounting for 33.33% of the fractures. Out of the 30 fractures, majority were type IV fractures (23 patients) accounting for 76.7%. Remaining 23.3% (07 patients) were type III fractures. Conclusion: In conclusion, hip fractures are a serious injury in the elderly population. There is a very mortality rate and morbidity rate following hip fractures in the elderly. Once diagnosis has been made, appropriate stabilization of the patient from a medical standpoint and rapid operative fixation of the fracture or prosthetic replacement helps patients obtain a better functional result. Adequate rehabilitation in an inpatient setting, as well as at the patient's home with home health is an important adjunct to an overall successful outcome.
Background: Most of lower leg external fixation are bulky and cumbersome and provides only temporary bony stabilization. Anatomically pre-contoured supracutaneous LCP has been utilized by many authors as an external fixator in patients with metaphyseal and diaphyseal fractures of tibia. Aim: The aim of this study is to analyse the end result of Supracutaneous LCP as a definitive external fixation and its effect on rate of union in metaphyseal and diaphyseal fractures. Materials and methods: A complete of 30 patients of compound fractures of tibia underwent "supracutaneous plating" of the tibia using an LCP. Average age was 44 years. Regular screw tract dressings were done. Average period of follow-up was 13 months. Results: The plate was kept ex situ for a period of 24-30 weeks. Proximal metaphysis, diaphysis and distal metaphysis united in 14 weeks, 20 weeks and 16 weeks respectively. Total of 30 patients were operated for Supracutaneous LCP of which one complicated with Infected Non-union resulting in implant removal and other complicated with Non-union which later underwent internal fixation. Conclusion: In compound fractures of tibia supracutaneous LCP are often used as a definitive external fixator because it gives good results especially for metaphyseal fractures and fewer complication rates, with Adequate stability. Advantageous effect of LCP in facilitating wound healing, cosmetic surgery procedure. Because it does not strike the contralateral leg therefore cosmetically acceptable and functional while ambulation. Because of nonoverlapping of implants fracture healing is easily assessed on x rays.
Tibial plateau fractures are the common injuries that may be associated with poor outcomes and a high rate of complications. The problem rise significantly in high energy trauma and severe soft tissue injuries. Early technique of osteosysnthesis were based on extensive surgical approach. Introduction of minimally invasive plate osteosynthesis using locking compression plate conserves the vascularity of the bone but also leads to the overall improvement in the values of bone healing. MATERIALS AND METHODS: Inclusion criteria for this study were patients of either sex, tibial plateau fractures Schatzker's Type V and VI, age group 15 to 60 years and compounding upto Gustilo and Anderson's Grade II and excluded the patients where the compounding was grade III and displacement <2mm. The fractures were treated applying LCP percutaneously either medially or laterally depending on the side of comminution. RESULTS: In our study conducted on 45 patients 4 lost to follow up in first 6 months with displaced tibial plateau overall the functional result using Rasmussen's criteria was acceptable in all of the cases with an average score of 26.38. All the patients in our series showed union with average time for union being 13.3 weeks. DISCUSSION: Our study confirms that minimally invasive locking compression plate osteosynthesis is a viable alternative as a treatment for open tibial plateau fractures Gustilo and Anderson's type I and II. The incidence of infection in our study wad 10% which is comparable with most of the series in literature that select the high energy tibial plateau fractures. None of the patients had nonunion only one had delayed union and does not required bone grafting as the metaphyseal area has a good blood supply. There were superficial infection in 4 cases which resolved to the dressing and antibiotic treatment within 3 weeks. The mean range motion at knee joint was 5 degree to 130 degree.
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