Introduction: Ulnar hemimelia is a congenital ulnar deficiency of the forearm characterized by complete or partial absence of the ulna bone. History and Examination: 18 years female presented to us with deformed left upper limb. Cosmetically, the forearm looked curved with concavity towards the ulnar side. Materials and Method:The correction was carried out in 2 stages. In first stage, the wedge shaped bone was osteotomised and correction was then fixed with dynamic compression plate. The ulna was fixed with ilizarov frame. In second stage, the corticotomy of proximal ulna was done and rush nail was passed intra medullary before distraction to prevent translation. The ulna was lengthened until it reached the distal radio ulnar joint. Result and Conclusion: In our case report, the girl with ulnar hemimelia was not able to do routine activities of daily living before the operation. Hence treatment was necessitated to improve cosmetic and functional outcomes. Management of such cases is highly individualised and mainly involves improvement of function.
Background: For extracapsular proximal femur fractures, the treatment options are innumerous, though the implant choice is debatable. In our institute we use proximal femoral nail for the treatment of extracapsular proximal femur fractures. Choosing most suitable implant for such fractures specially in old aged osteoporotic patients till date puts the surgeons in great dilemma. Aim & Objective: To study the clinical results and functional outcome of proximal femoral nail in extracapsular proximal femur fractures routinely used in our institute and to review the available literature. Material & Methods: This study consists of 60 patients who had undergone treatment of proximal femur fractures. Males constituted 70% of the study and 43.6% of the patients were more than 60 years old. Clinical outcome and functional results were evaluated by using Harris Hip scoring system. Results: Mean duration of surgery was 93 min.Post-operative complication rate was 6.7% which was superficial infection. Average time of union is 11.7 weeks. One patient had shortening of 2 cms and 2 patients had shortening of 1 cm. According to the Harris Hip Score we got excellent result in 70% and good result in 20%. Conclusion: Proximal femur fracture is common in elderly due to osteoporosis and mostly occurs due to trivial fall. PFN being a closed procedure, the amount of blood loss and duration of surgery was lesser. PFN is technically easier, with least complications even on follow up. PFN achieved the best clinical results and highest functional scores. Hence we conclude that PFN is the treatment of choice in proximal femur fracture.
Introduction: It is the study of mid shaft clavicle fracture treated with anatomical locking plates. We wanted to study to study the surgical management and to assess its functional outcome in displaced midshaft clavicular fractures. To study the duration of union, complications and compare the results of operated cases with other operative study and conservative study. Materials and Method: The study consist of 100 patients with mid shaft clavicle fracture. We have treated patient with anatomical locking plates. Clinical outcome and function results were evaluated by Constant and Murley scoring system. Result: We have operated total 100 cases with anatomical plate in mid-shaft clavicle fractures. Average union time was 11.7 week. We have achieved 80% of excellent result. Conclusion: Anatomical plate for mid-shaft clavicle fracture are as per shape of the bone. Anatomical reduction is possible and axial alignment and rotational stability is provided. As plates have groove on inner surface so it preserves the periosteal blood supply which will help in faster healing of the bone. Rigid fixation with plate and screws for fresh displaced or comminuted middle third clavicle fracture gives immediate pain relief and prevents the development of shoulder stiffness and non union.Keywords: Operated fracture, axial alignment, shoulder stiffness Introduction Clavicle links the thorax and shoulder girdle and plays important part in movements at shoulder girdle. Clavicle fracture is a common traumatic injury due to its superficial position. It is caused by low velocity or high velocity impact clavicle fracture is about 5-10% of all fractures and 44% of injuries to the shoulder girdle. About 70%to 80% of these fractures are in the mid-shaft of and less in the lateral third (12% -15%) and medial third (5% -8%). A weak area in the clavicle is present at the mid clavicular region, which causes for most fractures occurring in this region. Several muscular and ligamentous forces act on the clavicle, and familiarity of these various forces is essential to know the displacements of clavicle fractures and why some of the fracture patterns lead to cause problems if not reduced and surgically stabilized. Embryologically clavicle develops from 2 ossification centers separately and then unites so the junction is weakest point. Anatomically it has two curves which make the bone vulnerable for fracture at its middle. Distribution of ligament attachment as well as muscular attachment is as such that medial portion is less mobile than lateral which common to fracture from middle. "The incidence of mid clavicular fracture is 64 per 100 000 population. Breaks of the shaft form 70% to 80% of all clavicular fractures; lateral fractures contribute 15% to 30%, and medial fractures, at 3%, are rare. Open fracture is an absolute rarity, found in only 0.1% to 1% of cases. The rate of mid clavicular fractures is more than twice as high in men as in women. The peak incidence occurs in the third decade of life. Mid shaft fractures have traditional...
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