<ul><li><p class="abstract"><strong>Background:</strong> The present study was undertaken to to compare the efficacy of treatment of intracapsular neck of femur fracture operated by anterior and posterior approaches.</p><p class="abstract"><strong>Methods:</strong> A total 100 patients of either sex, aged >65 years with intracapsular neck femur fracture were operated with hemiarthroplasty. The patients were divided into two equal groups and patients were operated alternatively one with anterior approach and the second with posterior approach. Functional outcomes were compared using Harris hip score and range of movements assessed clinically. Hip function and final outcome measures were noted and compared between two groups.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of patients was 63.1±5.3 years in group A and 65.8±5.4 years in group B with female to male ratio was 1.7:1 for group A and 1.8:1 for group B. Operating time for group A and for group B was 65 and 78 minutes respectively. Mean intraoperative blood loss was 120 ml in group A and 150 ml in group B. The most common complication in both the groups were infection and rate in group A was 9.70% and in group B was 13.50%. Posterior approach carried an increased risk of prosthetic dislocation as compared to anterior approach. There was no intraoperative mortality seen in follow up period.</p><p class="abstract"><strong>Conclusions:</strong> Anterior approach for hip hemiarthroplasty in elderly population with intracapsular femoral neck fractures provided significant benefit in early postoperative period when compared to the posterior approach in terms of duration of surgery, intraoperative blood loss, time of recovery, hip dislocation rate.</p></li></ul>
Background: Proximal tibia is one of the most critical weights bearing part of the human body. Fractures of the plateau affect knee alignment, stability, and motion. The present study was conducted to decide whether pre-operative CT scan significantly changes the line of action and plan of surgery, against simple digital radiographs, in managing fractures of the upper tibial condyles and hence should it be an essential investigation for treatment in proximal tibial fractures. Materials & Methods:The present cross-sectional, prospective study was conducted on 42 cases (males-37, females-5) of traumatic fractures of the proximal tibia. First opinion was taken on the basis of the X-ray alone and second opinion was taken after showing the CT scans. Results: There were 16 (38.09%) patients in age group of < / = 30 years, 17 (40.48%) patients in age group of 30-45 years, 8 (19.05%) patients in age group of 45-60 years and only 1 (2.38%) patient is the age group of 60-75 years. There were 02 (04.76%) patients diagnosed to have no fracture based on X-ray, 14 (33.33%) patients diagnosed as Schatzker's type-1, 02 (04.76%) patients diagnosed as Schatzker's type-2, 05 (11.91%) patients diagnosed as Schatzker's type-4, 13 (30.95%) patients diagnosed as Schatzker's type-5 and 06 (14.29%) patients diagnosed as Schatzker's type-6 based on X-ray alone. A total 12 cases were included in Schatzker's type 1. Management of 01 case was drastically changed, that of 03 cases had subtle changes and that of 08 cases remained unchanged. Plan of 01 case out of 04 included in Schatzker's type 2 was changed drastically, 02 underwent subtle changes while that of 01 was unchanged. Only 01 case was included in Schatzker's type 3. Its management underwent subtle change. 02 cases were diagnosed as type 4. Treatment of 01 underwent subtle change while that of 01 remained unchanged. Plan of 02 cases out of 06 included in type 6 were drastically changed. 04 had no changes. Conclusion: CT scan contributes significantly in management of proximal tibia fractures especially in Schatzker's type 1 and type 4. It reveals articular depressions and fracture fragments that are often obscured on X-rays. It helps surgeons to prevent dreadful postoperative complications.
<p class="abstract"><strong>Background: </strong>Evaluate functional outcome of use of platelet rich plasma versus steroid in frozen shoulder.</p><p class="abstract"><strong>Methods: </strong>The study was conducted in Department of Orthopaedics in RNT Medical College, Udaipur. Adult patients with periarthritis shoulder (frozen shoulder or adhesive capsulitis) admitted to Trauma centre in Maharana Bhupal Government hospital attached with R.N.T. Medical College, Udaipur were included in this study after obtaining their informed, valid written consent. This is a prospective study from October 2018 to February 2020.</p><p class="abstract"><strong>Results:</strong> Our study demonstrated that PRP is not inferior to CS in any of the measured parameters. Both of the groups experienced similar benefits from the injection therapies with no statistical differences detected in ROM or VAS scores at 1 week, 1 month and 3 months. No adverse effects were detected in either of the two groups.</p><p class="abstract"><strong>Conclusions: </strong>We can conclude that both PRP and MPS showed efficacy on treating frozen shoulder. The current study provides strong evidence in support of a statistically significant effect of platelet concentrates in the treatment of frozen shoulder in vivo where steroid contraindicated or refused by patient. However, inj. Methylprednisolone has sudden onset of action because of anti-inflammatory action with respect to inj. PRP, so has better result at 1 week follow up post injection. But in long term (at 3 months follow up) inj. PRP has better effect in compared to Inj. MPS.</p>
<p class="abstract"><strong>Background: </strong>The proximal tibial fractures are one of the commonest intraarticular fractures. Generally these injuries fall into two broad categories, high energy fractures and low energy fractures. The tibial plateau fractures are mostly due to high velocity road traffic accidents and fall from height, where fractures result from direct axial compression, usually with a valgus (more common) or varus moment and indirect shear forces.</p><p class="abstract"><strong>Methods: </strong>This is a prospective study and includes operations by MIPPO technique that were undertaken between January 2020 till June 2021 in RNT government hospital; Udaipur. The total number of cases studied were 25 with the youngest being 25 years old and oldest 70 years old. Intraoperative complications were noted. Functional outcome was assessed using Modified Rasmussen’s Criteria.</p><p class="abstract"><strong>Results: </strong>Patients with fracture in our study occurred between the age of 25 to 70 years with maximum incidence involving the productive age group of 21-30 years (90%). Majority of the patients was males- 90%.</p><p class="abstract"><strong>Conclusions: </strong>From the minimally invasive percutaneous plate osteosynthesis of proximal tibial fracture there is an increase in the complexity of proximal tibial fractures with increasing road traffic accident. As most of the patients sustained these fractures belong to physically highly active and productive age group, they need optimal treatment to get back to their previous work capacity and avoid long term complications like osteoarthritis. We treated all fractures in our study with MIPPO technique and found rapid healing by secondary fracture union and hence achieving strong bone union across the fracture site due to inherent benefits of less tissue damage and minimal disturbance of fracture site biology. We operated 20 proximal tibial fractures with MIPPO technique and observed rapid healing and good functional recovery.</p>
<p class="abstract"><strong>Background: </strong>Treatment of distal tibia fractures poses significant challenge to orthopedic surgeon because of poor blood supply and paucity of soft tissue coverage. There is considerable controversy regarding the superior option of treatment for distal tibia fracture between the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique and intramedullary interlocking (IMIL) nailing for extra-articular distal tibia fractures. The aim of our study is to compare the functional outcome between the two treatment methods.</p><p class="abstract"><strong>Methods:</strong> This was the prospective comparative study of 50 patients with distal third tibia fractures divided into two groups. First group of patients were treated with MIPPO technique while second group of patients were managed by IMIL nailing. Patients were followed up in outpatient department to assess the functional outcomes, malunion, delayed union, non-union, superficial and deep infection between the two groups.</p><p class="abstract"><strong>Results: </strong>Average time taken by patients for full weight bearing in group A was 17.6 weeks as compared to 16.7 weeks in group B. All patients were able to bear weight prior to complete union of fracture. By the process of weight bearing, we believed that it would promote secondary bone healing. On taking X-rays during follow up of included patients starting of radiological union was observed carefully by looking for bridging callus, haziness of fracture line. Appearance of callus was taken average time of 12.5 weeks in group A and 12.1 weeks in group B.</p><p class="abstract"><strong>Conclusions: </strong>Both procedures have shown the reliable method of fixation for distal extra-articular tibia fractures preserving the soft tissue, bony vascularity and fracture hematoma that provide a favourable biological environment for fracture healing. Considering the results of the study, we have slightly more preference for the MIPPO technique.</p>
<p><strong>Background:</strong> PCL ligament avulsion fracture injuries constitute about 3-20% of all the knee injuries. Isolated posterior cruciate ligament injuries are uncommon and often go undiagnosed in acutely injured knees. fracture. In the long run they cause severe functional disability of the knee joint. There is no consensus concerning the optimal surgical treatment approach for these injuries. Our study was to assess the functional and clinical outcome of isolated PCL avulsion fractures with open reduction and internal fixation.</p><p><strong>Methods:</strong> This is a prospective study of 27 patients with isolated PCL avulsion fractures, done in the department of orthopaedics in RNT medical college over a 2-year period. All were treated with open reduction and internal fixation with 4 mm cannulated cancellous screw and washer. Postoperatively, patient leg was immobilized in posterior POP slab for 2 weeks, allowing toe touch weight bearing. All patients were regularly followed-up. 3 cases of post operative wound infection were detected.</p><p><strong>Results:</strong> Of the 27 patients, there were 19 males and 8 females. All the cases showed good fracture union in an average of 12 weeks post operatively. In the first 6 weeks, all of them acquired an average knee flexion of 90 degrees and by 3 months, all of them had 125 degrees of free flexion possible.2 cases showed negative posterior draw sign. The knee scoring system assessment showed 21 cases of excellent result, 4 cases of good result and 2 cases of fair result.</p><p><strong>Conclusions:</strong> Though rare, PCL avulsion fractured are to be managed properly and treated surgically. PCL tibial avulsion fractures treated through Burk and Schaffer approach with open reduction and internal fixation produces good results.</p>
<p><strong>Background: </strong>There are several options for dealing with tibial bone defects during total knee arthroplasty in severe primary osteoarthritis. The aim of this study was to report the midterm results of TKA with screw and cement augmentation of moderate-sized tibial bone defects.</p><p><strong>Methods: </strong>Patients with osteoarthritis who had posterior stabilised TKA with screw and cement augmentation of the tibia were reviewed retrospectively. Patients were assessed preoperatively and at follow-up using the International knee society knee score and function score, and radiographic analysis of alignment and signs of loosening.</p><p><strong>Results</strong><strong>:</strong> 60 knee in 60 patients were included in the study. The mean age was 71 years; mean follow-up was 58 months. KS improved from 46 to 76 and FS from 51 to 92. The femorotibial mechanical angle changed from 174 to 178. There were no signs of osteolysis or loosening, and no revisions. Radiolucent lines at the cement bone interface were common but non- progressive.</p><p><strong>Conclusions: </strong>Midterm clinical and radiographic results of TKA with screw and cement augmentation for moderate tibial defects were satisfactory.</p>
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