Aim and Objective: Antebrachium fractures are one of the common fractures in paediatric population. Fractures of forearm comprises of about 40% in the fractures of paediatric population [1] . These fractures usually have a high degree of remodelling potential and are usually managed non operatively by closed reduction and maintaining it in a plaster cast. Nowadays the trend for management of these fractures changes towards operative management because of increasing complications by nonoperative methods. The aim of this study is to evaluate the functional outcomes of unstable both bone forearm fractures treated operatively using titanium elastic nailing. Materials and Methods: Study was conducted in the department of orthopaedics at Rajah Muthiah Medical College and Hospital. Total of 20 patients aged were treated using TENS. Closed reduction with internal fixation under c-arm guidance was done in 13 cases and open reduction with internal fixation was done in 7 cases. Results: Patients were followed up for a period of 6 months. Results were analysed with respect to union of fracture, symptoms with activities, range of motion of joints adjacent to the fracture using Price et al. criteria and Anderson et al. criteria. In all cases fractures united at an average of 8 -10 weeks without any malunion. All 20 cases had excellent outcomes. 3 patient had nail prominence on the ulnar entry side leading to superficial pin site infection. Conclusion: Fixation of both bone fractures of forearm using titanium elastic nailing systems showed many advantages over the conventional plating methods, in terms of smaller incision, minimal soft tissue meddling during fracture fixation, prompt osseous healing, maximum range of motion at the earliest, decrease in complication rate with excellent clinical and radiological results. Thus, titanium elastic nailing used intramedullary is an effective treatment option for the treatment of unstable both bone forearm fractures in paediatric population.
To evaluate the reason behind the extensor hallucis longus weakness transiently after proximal fibular osteotomy for the management of medial compartmental osteoarthritis of knee, and to determine the correct level of osteotomy below the level of tip of fibular head. Materials and Methods: A prospective study from October 2019 to October 2021 at Rajah Muthiah Medical College and Hospital, in 15 patients who underwent proximal fibular osteotomy for medial compartmental osteoarthritis of knee, three patients postoperatively develops EHL weakness transiently analysed and evaluated in this study. All postoperative complications are noted and evaluated periodically for all patients, recovery of power of EHL muscle and other motor sensory status also noted. Results: Out of 15 patients surgically managed with PFO, only three patients developed transient EHL weakness and one patient developed transient numbness over lateral aspect of foot. Among those three patient two patient recovered from neuropraxia within 6 weeks and one patient recovered after 8 months .transient numbness over lateral aspect of foot in a patient recovered with in 3 weeks. Commonly fibula resected with in or at the level of 6cm below the fibular head develops EHL weakness. Post operative EMG and NCS also done to confirm neuropraxia. later on fibula resected 24% length of total fibula below the fibular head, not encountered the immediate postop EHL weakness. Conclusion:The optimal site for fibular osteotomy for PFO in medial compartmental osteoarthritis of knee is at the junction of 24% of fibular length above and 76% below the osteotomy location. Provides good pain relief and functional recovery without transient EHL weakness and other complications. EHL weakness occurs mostly due to traction neuropraxia to the nerve which supplying the EHL muscles, more likely to occur in very high osteotomy less than 6cm from tip of fibular head.
Introduction: Chronic plantar fasciitis accounts for 15% of all foot disorders with 10% of the population affected over their life time. PRP is a biological blood derived autologous component rich in numerous growth factors and cytokines which is being widely used in various musculoskeletal disorders in recent times. In this study we compare the efficacy of PRP with steroid injection in the treatment of chronic plantar fasciitis. Materials and Methods: 50 patients with unilateral chronic plantar fasciitis who were not responding to conservative management for 6 weeks were included in this study. The study was done at orthopaedics department at Rajah Muthiah Medical College and Hospital, Annamalai University from October 2020 to October 2021. Patients were randomly allocated into two groups. Group A [25 patients] received 2 cc of single dose platelet rich plasma [PRP] injection and group B [25 patients] were given 40 mg of 2cc depomedrol injection. Functional outcome was evaluated using visual analog score [VAS] and Foot and ankle ability measure [FAAM] scores at 0,4,8,12,24 weeks. Plantar fascia thickness was measured preinjection and 6 months post injection using ultrasound. Results: Group A [PRP] had pre-treatment VAS score of 8.5and FAAM score of 30.08 after 6 months follow up the score was 1.60 and 82.86 respectively. Where as in group B [STEROID] had pretreatment VAS score of 8.3 and FAAM score of 29.96, 6 months follow up score of 3.85 and 70.18 respectively. Pre-treatment Plantar fascia thickness in group A was and group B was 5.95 and 5.76 respectively. 6 months follow up study shows thickness of 3.76 and 4.33 in group A and B. Conclusion: Platelet rich plasma was found to be more effective in relieving the symptoms, increases the functional outcome compared to steroids in long term follow up.
To compare the functional outcome of supracondylar fractures of distal femur managed by Supracondylar nailing (retrograde) and locking femoral compression plate. Introduction: Early before 1980, supracondylar fractures of femur were treated with non locking plates. Plaster immobilization and traction were mode of treatment for non-operative patients. Nowadays the knowledge of internal fixation has evolved as to treat complex fractures by cancellous screws, 95 degree blade plate, dynamic condylar screw and plate, condylar buttress plates, locking femoral compression plate and supracondylar nailing (retrograde). Trending procedures for supracondylar fractures of femur are supracondylar nail (retrograde) and locking femoral compression plate. Materials and Methods: Totally 30 patients of extra articular distal femur fractures treated in Rajah Mathai Medical College from May 2019 to June 2021. Patients were treated by random allocation as 15 patients by retrograde nailing and other 15 patients by distal femur locking compression plate. Functional outcome was compared between them according to Neer's Scoring System at 24 weeks. Results: In our study, the patients were screened upto 1 year. Assessment was based on both radiologically and clinical scoring. Neer's score was higher in nailing (54%) compared to plating (46%). Conclusion: From our study, nailing proved to have good functional outcome in terms of early weight bearing, knee flexion and less union time. Both nailing and plating have excellent results with proper preoperative planning.
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