Background: Distal fractures of the femur especially comminuted, intra-articular distal femoral fractures AO classification 33-C remain challenging fractures for orthopaedic surgeons. Due to soft tissue damage, comminution, articular involvement and extensor mechanism injury functional outcome is poor in fracture distal femur.
Materials and Methods:We have done prospective study of 20 patients of intraarticular distal femur fracture AO classification 33-C treated operatively with locking compressive plate at S.S.G. hospital and medical college, Baroda during January 2014 to March 2016.We have studied functional outcome using neer's score, radiological outcome and complication associated with fracture fixation using LCP. Result: Out of 20 patients 14 were males and 6 were females. The youngest patient was 18yrs old and the oldest 70 yrs.4 patients had C1,10 pt had C2 and 6 pt had C3 type of fracture according to AO classification,12 patients were operated with extensile lateral approach.8 patients were operated using Swashbuckler approach. In 3 patients primary bone grafting was done for severely comminuted type C3 fracture. Secondary bone grafting was done in 1 delayed union case at 4 month. Pt shows sign of union at 9 month.1 Pt develop non-union treated with secondary bone grafting at 9 month with signs of union at 12 month.1 pt develop infection on 4 th post-operative day resolved with surgical debridement and antibiotic. The average duration of weight bearing was12 weeks. Average time for fracture healing was 20 weeks. Average range of motion of knee was 110 degrees. Among 20 patients there were 9 excellent result, 5 good results, 3 had fair results and 3 had poor results. Discussion: The LCP acts on the internal fixator principle as screws once locked to the plate do not pull the fracture towards the implant, and hence there is no displacement of the fracture once reduced. Distal femur locking plate provides angular stability and provides multiple options to secure fracture fragments, both metaphyseal and articular. In our study we get better functional outcome using locking compression plate for intraarticular distal femoral fracture. Along with anatomical reduction and rigid fixation, early mobilization and aggressive physiotherapy are key for better functional outcome. Conclusion: In present study better functional outcome achieved using locking compression plate for intraarticular distal femoral fracture along with aggressive physiotherapy.
Background: Degenerative changes in the knee occur with increasing frequency after the third decade of life. In early osteoarthritis with no mal-alignment of the knee, arthroscopic surgery is an attractive alternative for many elderly patients as it reduces the degree of surgical insult and postoperative rehabilitation with hope of restoration of painless mobility. To study the role of arthroscopic debridement in alleviation of pain in cases of osteoarthritis knee and to evaluate the effectiveness of arthroscopy in diagnosis of osteoarthritis knee and its co-relation with radiological diagnosis. Methods: The present study is cross-sectional study of consecutive cohort of 53 patients. Body mass index was calculated based on height and weight of the patients and from their assessment of X-Rays patients were graded from 0 to 4 based on Kellegren-Lawrence radiological grading method. Selected patient were then assessed by pain domain of the knee society scoring system, which is joint specific score ranging from 0 to 50. These patients were then subjected to arthroscopic examination and debridement. Results: Overall 17 (32.08%) out of total 53 cases studied showed improvement after one year. Majority of patients improved were grade 2 (57.89%) but none of the grade 4 patients showed improvement at 1 year. Conclusions: Arthroscopic debridement does not influence the ongoing pathological process; it is only useful for symptomatic relief in cases of low grade osteoarthritis where it provides pain relief. Conversely, in patient with sever osteoarthritis there is very limited role of arthroscopy.
Femoral and tibial fractures are common long-bone injuries in children. Above five years of age all such fractures, when treated conservatively could lead to loss of reduction, malunion, intolerance and complications associated with plaster. The goals are to stabilize the fracture, to control length and alignment. Flexible Elastic Nailing has become the choice of stabilization in paediatric long bone fractures. The aim of our study was to see the outcome of Flexible elastic nailing system in diaphyseal fractures of children of 5-14 years age. The study included total of 50 children treated with flexible elastic nailing system and they were followed up at 3, 6, 12 and 24 weeks. The average duration of callus formation was 3.8weeks (4.2weeks in Tibia & 3.4 weeks in femur). Radiological union was seen in a mean time of 9.65 weeks. Full weight bearing was possible in a mean time of 10 weeks. According to flynn's scoring criteria, excellent and satisfactory results were in 90% and 10% respectively. There were 2 cases of post-operative superficial infection which resolved with regular dressing and no cases of physeal injury and implant failure. Flexible elastic nail is a safe and satisfactory mode of treatment and is relatively easy to perform in disphyseal fracture of femur and tibia in children. It avoids the chances of physeal injury, infection and offers early mobilisation and rapid healing.
Introduction: Intracapsular femoral neck fractures are common in the elderly population. To avoid the poor outcome of internal fixation and for early mobilization, hemiarthroplasty is performed.
Aims & Objective:To study the management of fracture neck of femur by bipolar prosthesis and to study post-operative prosthetic components motion radiologically.
Distal radius fractures account for 17% of all fractures in adults. The fracture of the lower end of radius crush the mechanical foundation of man"s most elegant tool, the hand. No other fracture has a greater potential to devastate hand function. Today, open reduction of the fracture with internal fixation and closed reduction of the fracture with external fixation, forms the mainstay of the treatment of an uncomplicated distal end radius fracture in a patient unless specifically contraindicated. AIMS AND OBJECTIVES: To compare functional outcome, complications & results of two commonly used surgical methods; Open reduction & internal fixation with volar placed buttress plate and Closed reduction & external fixation with "Jess fixator" and internal fixation with "k-wire" in volar displaced distal radial fractures. MATERIALS AND METHODS: Total 30 cases were included in the study. 15 patients were treated with Open reduction & internal fixation with volar placed buttress plate and 15 were treated with Closed reduction & external fixation with "Jess fixator" and internal fixation with "k-wire" in volar displaced distal radial fractures. Patients were followed up at regular intervals and Anatomical and functional outcomes were evaluated in all the patients. RESULTS: Patients treated with Open reduction & internal fixation, 8 showed excellent results, 5 good and 2 fair results. Patients treated with closed reduction and external fixation 4 showed excellent results, 5 good, 4 fair and 2 showed poor results. CONCLUSION: O.R.I.F is generally preferred modality gives better results in terms of functional recovery and decrease morbidity to patient.
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