Purpose. To evaluate the postoperative knee function and results of unreamed retrograde nailing for distal third femoral shaft fractures. Methods. Between January 2002 and 2003 inclusive, a consecutive series of 27 patients (with 28 fractures) who underwent retrograde nailing were prospectively evaluated. Outcome measures were union time, initiation of weight bearing, deformity and shortening, functional length of the nail, knee function assessed using a modified Knee Society Knee Score. Correlations between union time and other variables were also studied. Results. In these patients 26 (93%) of the 28 fractures achieved union, of which 5 underwent dynamisation; the mean union time for the other 21 fractures was 4.4 months. Angular malalignment was present in 4 patients and shortening in 4 others. There was negligible correlation between union time and variables of nail-canal diameter mismatch, functional length of nail, fracture geometry, or initiation of partial weightRetrograde nailing for distal third femoral shaft fractures: a prospective study KN AcharyaDepartment of Orthopaedics, SDM College of Medical Sciences, Dharwad, Karnataka, India MR RaoDepartment of Orthopaedics, Jubilee Mission Hospital, Thrissur, Kerala, India Address correspondence and reprint requests to: Dr K Narayana Acharya, Meenakshi Nilaya, BMA Road, Gandhinagar, Bellary, 583103, Karnataka, India. E-mail: knacharya@hotmail.com 2006;14(3):253-8 bearing ambulation. Knee flexion of more than 100 degrees was achieved in 26 patients. 19 patients had anterior knee pain and 10 had instability. By the end of one year, excellent or good scores for pain and function were recorded in 77% and 73% respectively, of the 26 patients. Conclusion. In view of such favourable union rates but significant deterioration in overall knee joint function, at best retrograde nailing is a reliable alternative in the management of selected complicated fractures of the distal femoral shaft. Journal of Orthopaedic Surgery
Background:Despite variations in technique, the results of primary and revision lumbar discectomy have been good. The aim of this study was to retrospectively review cases of primary and revision lumbar discectomy performed in our institute over a three-year period.Materials and Methods:The case records of 273 patients who underwent lumbar discectomy between January 2001-2004 and fulfilled our inclusion and exclusion criteria were reviewed. Of these, 259 were primary discectomies and 14 were revision surgeries. Recurrence was defined as ipsilateral disc herniation at the previously operated level. Demographic parameters, magnetic resonance imaging of the disc, patient satisfaction and rate of recurrence were analyzed.Results:The primary surgery group had 52 (20.08%) contained and 207 (79.92%) extruded or sequestered discs, while the numbers in the revision group were three (21.43%) and 11 (78.57%) respectively. “Satisfactory” outcome was noted in 96.5% of the primary surgeries, with a recurrence rate of 3.5%. In the revision group 78.6% had “satisfactory” outcome. In 9.4% of the primary group we encountered complications, while it was 21.43% in the revision group.Conclusions:Lumbar discectomy is a safe, simple and effective procedure with satisfactory outcome in 96.5% of primary disc surgery and 78.6% of revision disc surgery.
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