Background: Pain in the lower lumbar spine is a socioeconomically serious medical illness. The main reason from physiological perspective was micro and macro instability of spine. Posterior lumbar interbody fusion (PLIF) is a reliable treatment option for patients with spondylolisthesis; providing spinal stabilization in a balanced alignment with the disc space height being restored and with the neural elements being decompressed mechanically. Aims: To study clinical and radiological outcomes of Posterior lumbar interbody fusion with cage and local bone graft from laminectomy bone chips in lumbar spondylolisthesis. Material and Method: Our study includes 4 males and 8 females, aging 35-64 years. As per the Meyerding-evaluating system, 11 cases were classified as degree I, 1 cases as degree II, and 0 cases as degree III. The average follow-up duration was 18 months. The clinical outcomes were evaluated using the Oswestry Disability Index preoperatively and at 4th, 8th 12th, 18th month and the Kim & Kim criteria at last follow up. The radiological outcomes were evaluated as per the Modified Lee's criteria for fusion. Results: There were 7 cases of definitive fusion, 4 cases of probable fusion and 1 case of pseudoarthrosis, with a fusion rate of 91.67% (definitive 58.3 % + probable 33.3 %). The mean time for fusion was 16 months. There were no implant failures. According to Kim & Kim clinical criteria for scoring, the results were excellent in 9 cases, good in 2 cases, and fair in 1 case. The excellent and good rate was 91.66 %. Conclusion: PLIF with cage and bone graft from local laminectomy chips serves as a solid internal fixation and has the advantages of shorter operative time and less blood loss. This technique also provides excellent outcomes according to the clinical and radiological evaluation.
Scaphoid fractures are common, but present unique challenges because of the particular geometry of the fractures and the tenuous vascular pattern of the scaphoid. Delays in diagnosis and inadequate treatment for acute scaphoid fractures can lead to nonunions and subsequent degenerative wrist arthritis. Scaphoid nonunions can present with or without avascular necrosis of the proximal pole, and may show a humpback deformity on the radiograph. If left untreated, scaphoid nonunions can progress to carpal collapse and degenerative arthritis. Surgical treatment is directed at correcting the deformity with open reduction and internal fixation with bone grafting. Recently, vascularized bone grafts have gained popularity in the treatment of scaphoid nonunions, particularly in cases with avascular necrosis. This study gives us a radiological and functional outcome of 10 cases operated by pronator quadratus based muscle pedicle bone graft for scaphoid non unions at waist level.
BACKGROUND Postoperative patients of ankle fracture patients can be made weightbearing as tolerated immediately following surgery. Immediate Weightbearing As Tolerated (IWBAT) allows patients to return to ambulation and activities of daily living faster and may facilitate rehabilitation. MATERIALS AND METHODS Retrospectively, patients were identified who have ORIF after unstable ankle injuries had treated by the senior author. Patients were excluded if they were not IWBAT based on specific criteria or if they did meet followup requirement. RESULTS After the study, it was seen that only 1/26 patients was noted to have loss of fixation. This was found at the 6-week followup and was attributed to a missed syndesmotic injury. At 2-weeks follow up, 2 patients had peri-incisional erythema that resolved with a short course of oral antibiotics. At 6-week follow up, 20 patients were wearing normal shoes and 6 patients continued to wear the Cam Boot for comfort. CONCLUSION It was seen that IWBAT in a certain subset of patients with stable osteosynthesis following an ankle fracture were at a safe alternative to a period of protected weightbearing.
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