<p class="abstract">In this study outcomes of arthroscopic management of tibial eminence fracture have been described. We conducted a study of 15 patients of ACL avulsion fractures especially Meyer and Mckeever type II and III treated arthroscopically by pull through sutures. Outcome measures were assessed through International Knee Documentation Committee (IKDC) form, Tenger Activity scale and Lysholm knee score. The study group consisted of 15 patients who met the inclusion criteria, of which 9 were male and 6 were female. The range of patient age consisted of 13-37 years and the average patient age was 20.6 years. The average male age was 22.11 years and the average female age was 18.33 years. The fracture classification showed 7 being type II while 8 were type III. Tegner Activity level at follow up ranged from 5-8 and the mean score was 6.4. On follow-up evaluation, the mean Lysholm score was 92.8 (ranging from 76-100). 6 patients who had inter-meniscal interposition was retracted or resected showed no difference in functional outcome. We found that displaced tibial eminence fractures could be successfully treated using arthroscopic pull through sutures, with most patients returning to their previous activity level. Complications were avoided by anatomic reduction of fracture fragments and early post-operative rehabilitation.</p>
<p class="abstract"><span lang="EN-US">The purpose of this study was to present new surgical technique for MPFL reconstruction. We also describe its functional outcome, complications, and the advantages of the procedure. This study is a prospective analysis of collected data during the period of august 2018 to January 2020. Ten cases of patients with recurrent symptomatic patellar instability and who underwent isolated MPFL reconstruction were included in the study. Kujala scoring and lysholm scoring was done to assess the functional outcome at follow-up. Post-operative dislocation and apprehension were recorded in each case along with any complication. Pre-operative Kujala score was 36.80 which improved to 89.80 postoperatively at the time follow-up. Pre-operative lysholm score was 36.80 which improved to 92.70 postoperatively at the time follow-up. The improvement in Kujala score and Lysholm score was found to be highly significant (p<0.01). We have done a simple technique where MPFL is reconstructed anatomically to restore kinematics and stability. Consistent good results with early rehabilitation can be obtained using the described technique.</span></p>
Minimally invasive plate osteosynthesis in metaphyseal fractures of tibia Introduction: Treating tibial metaphyseal fractures is still great challenge. However, two of most used techniques are locked intramedullary nail and minimally-invasive bridge plate. Minimally invasive plate osteosynthesis (MIPO) offers biological advantages. Reduced soft tissue dissection and exposition results in low surgical trauma and preservation of blood supply. Aim of study was to evaluate results of MIPO in treatment of metaphyseal fractures of tibia and to compare efficacy in treating metaphyseal fractures of tibia with other similar studies. Materials and Methods: This study was performed with 30 metaphyseal fractures of tibia with MIPO in hospitals attached to BMCRI. All cases were fresh fractures and traumatic. There were 12 proximal tibial and 18 distal tibial fractures. Temporary joint spanning external fixation was used for severe soft tissue injuries in 6 patients. All the fractures were stabilized by minimally invasive plating. Cases were followed up for an average of 14.1 months. Results: All fractures united. Proximal and disal tibia fractures united after an average of 6.3 and 6.6 months respectively. In proximal and distal tibia fractures, average range of motion achieved was 81.75° and 48.8° respectively. One patient with distal tibia fracture had a malunion with valgus alignment of more than 5°. Conclusion: Minimally invasive percutaneous plating facilitates in early mobilization of the patient which helps in healing of the fracture and prevents joint stiffness. It promotes early union as it does not disturb anatomy and physiology of vascularity at fracture site. There is minimal risk of infection and minimal blood loss.
<p class="abstract">Trimalleolar fracture are complex and challenging to treat. We conducted a study on 15 patients with trimalleolar fracture. Fractures were classified based on Lauge Hansen classification. They were treated with open reduction and internal fixation (ORIF) with plate and screws for posterior malleolus and lateral malleolus, tension band wire (TBW)/cannulated cancellous (CC) screw for medial malleolus functional and radiological outcomes were assessed by Olerud and Molender score and Kristenson’s criteria respectively. Functional outcome was satisfactory in 93% of cases and radiological outcome in 86%. Early treatment without delay, anatomical reduction of fracture with stable fixation of every fracture component, stringent post operative mobilization should help to improve outcome in operated trimalleolar fracture patients.</p>
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