Objective: This study aims to observe the clinical outcomes associated with in situ single-stage suture repair for knee dislocation in patients suffering from multiple knee ligament injuries with the use of unabsorbable materials of the suture. Study design: A retrospective observational study Place and Duration this study was conducted in Gambat Medical College Pir Syed Abdul Qadir Shah Jellani Institute of Medical Science GIMS Gambat from May 2021 to May 2022. Methodology: In this study35 patients treated surgically with in situ suture repair were recruited. A retrospective analysis was done on 35 patients with a mean follow-up score of 3.8 ± 1.3 years. Patients were undergone in situ surgical procedures for all the ruptured ligaments followed by a proper rehabilitation protocol post-operatively. Outcome variables were assessed by Lysholm score, satisfactory score, Meyers functional rating score, VAS score, and Tegner score. Results: Results of the study states that the mean follow-up a score of VAS was recorded as 1.98 ± 0.4, Lysholm score was recorded as 82.5 ± 6.7, and the patient satisfaction score was recorded as 7.5 ± 0.9. Statistically, significant differences have been observed between the pre and post-scores of ranges of motion and Tegner activity scores with a p-value of < 0.001 for both activity and ROM scores. Final follow-up of these patients reported that patients were left with no ligament laxity except for two patients who were unable to restore back to work. Among 35 patients, 5 were unable to achieve full ROM and had stiffness whereas two had infections at the surgical site. Conclusion: In situ suture repair of multiple ligaments had shown significant improvement in terms of ligament repair and early rehabilitation and therefore can be considered an effective treatment approach for the management of multiple ligament injuries. Keywords: Multiple ligament injuries, in situ repair, knee dislocation, cruciate ligament injury, single-stage repair.
Volar Barton fracture is the fracture of distal radius bone associated with ventral displacement. It is an oblique intra-articular fracture. Objective: To investigate the results, both functional and radiological, of open reduction and internal fixation with locking compression plates of the volar Barton fracture. Methods: A total of fifteen patients were included in this study. All of the participants had volar fragment type B3 fractures of the wrist. All the patients underwent open reduction to treat the fracture. Internal fixation was done using a locking compression plate (LCP). Out of a total of 15 patients, 10 were male and 5 females. The most common cause, almost 67 %, of the fracture was a road traffic accident (RTA). The mean age of the patients was 33 years, ranging from 21 to 55 years. All the patients had their respective surgeries within 7 days of the fracture accident. Quick Dash score-, and Gartland and Werley score were used to assess the function of the hand and wrist. Results: All the fractures took the meantime of 8 weeks for the bone union. The mean Quick Dash score was 10, ranging from 0 to 60. According to Gartland and Werley’s score, 9 patients were excellent, 4 patients were good and 2 were fair. No postoperative complication occurred. Conclusions: Open reduction and internal fixation with locking compression plates of the volar Barton fracture is an effective treatment for functional and radiological restoration.
Aim: To make a comparison between functional results in intra-articular displaced calcaneus fractures which are treated conservatively and operative treatment Study design: A randomized controlled trial Place and Duration:This study was conducted at ward 17 JPMC Karachi from January 20221 to January 2022. Methodology: This study includes 32 individuals who had displaced intra-articular calcaneal fractures. These individuals were classified into two groups, each group with 16 individuals. They were randomly assigned to either operative or conservative treatment. Clinical results, as well as radiological results (Modified Rowe’s score), were assessed at a 1-year follow-up. Results: All results were measured using Modified Rowe’s score. With a 1-year follow-up of the operative group, according to Modified Rowe’s score, 6 individuals had excellent results representing 37.5%, 8 individuals had good results representing 50%, and only 2 individuals had satisfactory results representing 12.5%. On the other hand, with a 1-year follow-up of the conservative group, only 2 individuals had excellent results representing 12.5%, 7 individuals had good results representing 43.75%, 5 individuals had satisfactory results representing 31.25%, and 2 individuals had poor results representing 12.5%. A few challenges were seen in each group. In the operative group, delayed wound healing was a complication seen in 2 cases while in the conservative group, peroneal tendonitis, subtalar arthritis and malunion were seen as a complication. Conclusion: In conclusion, the operative group was seen to be more effective to cure displaced intra-articular calcaneus fractures rather than the comparative group. Only a few complications, better functional recovery, early rehabilitation, and early weight bearing were seen in the operative treatment. Keywords: Calcaneus fractures, functional outcome, rehabilitation, conservative treatment
Introduction: One of the major public health concerns across the world is the fractures occurring at the distal end of radius with an incidence rate of 25.4 per 10000 elderly people who are of about 65 years of age. These fractures are the most common fractures occurring in the upper extremities of elderly patients. More than 210 million dollars are regularly spent on the management of radial fractures of the distal ends which are expected to increase every year, however, the process of managing radial distal fractures is still controversial. Aim: To compare the outcomes of surgical and non-surgical management of distal radial fractures in elderly patients. Methodology: The current study involved 90 patients who were more than 65 years of age and were treated either surgically or non-surgically. Patients who were treated non-surgically were treated with cast immobilization whereas patients who underwent surgery had either plate or external fixation. Functional scores and baseline radiographs were recorded before treatment, and follow-up was conducted at 2, 6, 12, 24, and 52 weeks. Radiographic and clinical follow-ups were observed along functional scores were calculated and observed. Results: Patients who were treated without surgery had a mean age of 76 years, whereas 44 patients who were treated with surgery had a mean age of 73 years. No significant differences were observed between the groups in terms of other demographic factors. No differences in the functional status were observed in terms of arms, hands, and shoulders whereas pain scores also exhibited no significant differences. Conclusion: It is suggested that minor limitations exist between wrist motion range and grip strength which was diminished with the non-operative care, but functional recovery was not limited during 12 months follow-up.
Aim: To evaluate the functional outcomes of intramedullary interlocking nailing and minimally invasive percutaneous plate osteosynthesis. Study design: A longitudinal study Place and Duration: This study was conducted at Dow University of Health sciences Karachi Pakistan from January 2019 to January 2021. Methodology: A total of 100 patients were recruited for surgical procedures. All the patients were asked to visit the hospital at the 6th week, 3rd month, and 6th month of surgery for radiography assessment and for analyzing the knee and joint movements. When callus became visible on radiographs patients were allowed for partial weight-bearing. When callus was visible in 3 to 4 quadrants we considered it as fracture union on both anteroposterior and lateral views with no pain and mobility. Bone grafting was considered in case of fractures nonunion. Functional assessment was taken place after one year of surgery. Results: We observed that the IMIL group attained fracture union in an average duration of 25.90. But no statistical difference was observed between both groups. IMIL procedure has less duration of hospital stay when compared with MIPPO (6.40 (4–9) ± 1.19 vs 6.82 (5–10) ± 1.27. We observed 5° malunion in the MIPPO group whereas the IMIL group reported 10° malunion with a significant difference of 0.001. Conclusion: Our study concluded that the plating technique can better restore the distal tibia alignment but also has chances of postoperative complications which would be manageable. Keywords: Intramedullary interlocking nailing, minimally invasive percutaneous plate osteosynthesis, distal tibia
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