Background: The purpose of this prospective randomized study was to evaluate the results of dynamic condylar screw (DCS) system and 95º angle blade plate fixation in the management of sub-trochanteric femoral fractures, regarding stability, union time, complication rate and functional out come.Methods: Total 30 consecutive patients with sub-trochanteric fracture were studied. The inclusion criteria were closed sub-trochanteric fractures in adults of both gender aged 18 years or above. Pathological fractures and open fractures were excluded from the study. After fixation of fractures with dynamic condylar screw system and 950 angle blade plate patients were followed up in OPD at an interval of 2 weeks till full weight bearing was started and then after at an interval of 4 weeks. Results of treatment were assessed by the Harris hip score for clinical and radiological assessment at the end of 6 months.Results: Among 30 studied cases, males were 22 (73.30%) and female 8 (26.70%). Most common mode of injury was road traffic accidents that occurred in 17 patients (56.70%) and the rest 13 patients had a history of fall. Patients were divided into two random groups (A &B) of 15 cases each. Group A was treated with DCS and Group B was treated with Angle Blade Plate 95º implants. Radiological union in most of the patients (13 out of 15 cases) treated with 95°angle blade plate occurred between 14-18 weeks, while in cases treated with dynamic condylar screw radiological union in most of the patients (14 out of 15) occurred between 12-16 weeks. According to Harris hip score, good to excellent results were achieved in 10 cases (66.66%) of 95°angle blade plate group and 14 cases (93.33%) of dynamic condylar screw group.Conclusions: Patients with sub-trochanteric fractures treated with dynamic condylar screw had earlier radiological union, better functional outcome, less complications and earlier weight bearing.
Objectives: This study aims to assess and compare the role of oral glucocorticoids and only analgesics in treating patients with idiopathic frozen shoulder. Patients and Methods: Fifty eight patients having primary idiopathic frozen shoulder syndrome were included in this study. Secondary causes (trauma, infection) and systemic disease related to frozen shoulder were excluded. Patients were randomized into two groups: patients in the first group (18 males, 11 females; mean age 45.3 years; range 32 to 67 years) were given 0.5 mg/kg/day methylprednisolone (32 mg maximum dose) halved each week, ceased at the end of each month and patients in the second group (11 males, 18 females; mean age 46.5 years; range 29 to 73 years) were given only oral analgesics. Physical therapy as a home program was initiated as the pain subsided in both groups. Visual analog scale (VAS), active range of motion (ROM) of the shoulder joint and Disabilities of arm, shoulder and hand (DASH) questionnaire scores were evaluated at baseline every week for one month then at end of third , sixth month and first year. Results: Visual analog scale, DASH and active ROM scores in both groups were significantly improved. Statistically significant difference was detected between steroid and only oral analgesic in terms of post-treatment VAS scores. Conclusion: Glucocorticoids with physiotherapy is an effective treatment for idiopathic frozen shoulder.
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