<p class="abstract"><strong>Background:</strong> The LRS is an excellent option treating the failed osteosynthesis in long bone fractures, because of failure in healing due to loosening of implant, infection, nonunion, poor bone quality and bone loss associated with deformities, limb length discrepancy, soft tissue problems, functional and financial issues.</p><p class="abstract"><strong>Methods:</strong> we prospectively treated 30 cases of failed osteosynthesis of long bones (7 plating, 22 nailing & 1 k-wire with plaster) between April 2009 to October 2015 with LRS. Initially we managed by implant removal, freshening of fracture site or radical debridement followed by LRS application.<strong></strong></p><p class="abstract"><strong>Results:</strong> Union occurred in 93% cases. The eradication of infection was seen in 96.5% cases. Average lengthening done was 4.2 cms. We had 93% excellent and 7 % poor bony result. Functional result was excellent in 45%, good in 48% and failure in 7% cases using ASAMI scoring system.</p><p class="abstract"><strong>Conclusions:</strong> LRS is an excellent option in the management of failed osteosynthesis especially associated with infection, nonunion, deformities, limb length discrepancy, soft tissue problems, functional and financial issues and also where re-osteosynthesis is challenging with poor bone quality and bone stock. It is simpler technically, patient friendly and short learning curve.</p>
Posterior column fractures of the tibial plateau are relatively rare, as described by Duparc in his revised classification as less as 5% of the tibial plateau fractures although Barie et al has shown upto 30% incidence among tibial plateau fractures [1] . This posteromedial fragment can exist as a solitary fragment or a part of bicondylar tibia plateau fracture is usually not straightforward to diagnose, usually necessitating a CT scan to establish it's presence and morphology. Study was conducted in department of orthopaedics, at Institute of Medical Science & Research Centre, from march 2017 to January 2019.All cases presenting to the outpatient and emergency department fulfilling the below mentioned criteria were taken up for study. Of 15 patients, Functional outcome was assessed using Oxford knee score 12 patients i.e. 85.7% had excellent outcome, 2 patient's i.e. 10.7% had good and 1 patient i.e. 3.6% had fair results. The mean OKS score was 40 (range 36 to 44) at the end of one year ange of motion > 130 degrees was achieve in 12 patients with rest of the three between 110 to 130 degrees. The commonest cause of tibial plateau fracture was Road Traffic Accident, which accounted to 12 patients i.e. 79% and domestic fall accounted for 3 patients i.e. 21%.Amongst the Road Traffic Accident group, 10 had excellent outcome and 2 had good outcome. Amongst the domestic fall group, 2 had excellent outcome and 1 had fair outcome.
The aesthetic appearance of the thumb hasn't been analysed to a similar extent as thumb function which would aid during reconstructive surgeries of the thumb and first web space and analyse its outcome. The purpose of this study is to determine the relative length, girth, nail width of thumb with respect to the index finger and intermetacarpal distance. Measurement of the 1 st web space arc radius has been done to tackle the problem of webbing which is not addressed by IMD and palmar abduction angles. A total of 482 hands in 241 subjects were studied to measure the relative length of the thumb with respect to the index finger, the relative nail width of thumb with respect to index finger, the relative girth of IP joint of thumb with respect to PIP joint of index finger and Intermetacarpal distance was calculated. The 1 st web space arc radius was calculated by the "best arc fit" with the thumb in maximum radial abduction using a radius gauge. The data collected was analysed by age, gender, laterality of the hand and the height and weight of the child. Hands of subjects of which with a mean age of years were analysed. The relative Thumb length, girth and nail width remained independent of age. It has been observed that the reliability of the measurements between the right and left web space arc radius measurement is significant . The provided would help reconstructive surgeons analyse aesthetic outcomes of reconstructive surgeries intraoperatively and post operatively. A correlation between the 1 st web space arc radius of right and left hands would help predict the expected post-operative outcome.
Background: Forearm fractures are one of the most common injuries sustained by children and both bone forearm fractures are estimated around 40% of all pediatric fractures. Pediatric forearm fractures occur in approximately 1 in 100 children per year. Forearm shaft fractures in children are usually treated with closed reduction and cast immobilization and a good functional outcome is obtained, but few patients with gross displacement, angulations, soft tissue swelling due to edema, children nearing skeletal maturity, proximal third fractures, open fractures and displacement after closed manipulation and cast immobilization require surgical intervention. Greater controversy exists regarding the optimal method of fixation in children. Fractures in this age group that cannot be maintained in acceptable alignment with closed reduction can be treated with either intramedullary nails or open reduction and internal fixation with plates. The purpose of this study was to investigate the indications, techniques, clinical results, functional outcomes, possible complications and means of avoiding them in unstable forearm fractures in children treated with titanium elastic nails (TENs). Methods: Our prospective interventional study included Forty five children after application of inclusion and exclusion criteria, consent for study was taken from the parents.
<p class="abstract"><strong>Background:</strong> The Milch and Spaso methods are used for reduction of anterior shoulder dislocation of the shoulder. This study was undertaken to compare the efficacy of these two methods<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Sixty patients with anterior glenohumeral dislocation were included in this study. 30 patients were reduced by each of the 2 methods and the efficacy and the pain experienced by the patient was studied.<strong></strong></p><p class="abstract"><strong>Results:</strong> Both methods were found to be equally efficacious. The pain felt by the patient was lower in the Milch method but this was not statistically significant<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Both the Milch and the Spaso methods are equally effective methods for reduction of anterior dislocation of the shoulder<span lang="EN-IN">.</span></p>
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