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.
Introduction: Since last two decades there has been growing trends towards a more operative treatment in patient over 7 years of age for long bone fractures (Tibia, Femur, Humerus) Method: Twenty patients (13 boys and 7 girls) aged between 7 to 14 of fractures of Tibia, Femur and Humerus treated with enders nail All patient underwent surgery in 7-8 days of injury Result: All patients followed average 2-4 weeks radiological union in 8-10 weeks and full weight bearing possible after 2-3 weeks Results:Excellent 75% Good 20% Poor 5% Conclusion: Enders nailing is effective form of treatment in long bone fractures (Diaphyseal) Tibia, Femur and Humerus in age between 7-14 years in Rural population.
Introduction: Supracondylar humerus fractures in children is the second most common fracture in children accounting to 16.6% due to fall on out stretched hand. At present, the preferred and most widely practiced method to treat Supracondylar humerus fracture in children is by k wire fixation by closed reduction in Garland's type 2 and 3. Method: 20 patients (4 female and 16 male) patients aged 3-15 years with supracondylar humerus fractures treated with percutaneous k wire fixation were included in the study. Result: Result was calculated based on Flynn criteria and was found to be excellent in 70% patients, good in 20% patients and fair in 5%patients and poor results were obtained in 5% patients. Conclusion:The incidence of supracondylar humerus fractures in children is seen in a higher in male children as compared to females as males have higher exposure to the outdoors. Falling on an outstretched hand is the most common method of injury and resulted in extension type fractures.The management of such a fracture is difficult because of maintance of reduction of fracture and preserving neurovascular status of the limb. The main goal of treatment was to recover normal range of movements with restored anatomy of distal humerus, which was achieved with k wire fixation. Anatomical reduction and k wire pinning in the management of supracondylar humerus fractures in children provide good results and provide full range of movement with relatively fewer complications.
Globally, traumatic injuries of long bones shaft fractures in children are the most leading causes of fractures in children. Now a days the use of elastic stable intra-medullary nails has dramatically increased with the introduction of a variety of nails for paediatric fractures [1] . The Titanium Elastic Nail (TEN) is intended for fixation of diaphyseal fractures of long bones where the medullary canal is narrow or flexibility of the implant is paramount. The aim of this study of biological, minimally invasive fracture treatment is to achieve a level of reduction and stabilization that is appropriate to the age of the child. The biomechanical principal of the Titanium elastic nailing is based on the symmetrical bracing action of two elastic nails inserted into the metaphysis, each of which bears against the inner bone at three points. This was a prospective longitudinal study done over a period of one year in children between 5-14 yrs age groups. The complication rates associated with Titanium elastic nailing have been reported to be minimal.
Introduction: A majority of metacarpal and proximal phalynx fracture can be effectively managed with closed reduction and cast and buddy taping. However a group metacarpal and proximal phalynx fractures are unstable and reducible, but difficult to put in reducible position within plaster cast or buddy taping till union of the fractures, for those fractures cross pinning with 'k' wires is required. Lots of other technique i.e. external fixation, miniplate, L pinning for fixation of metacarpal and proximal phalynx fracture are also available. Aim: Aim of this study is Functional outcome of cross pinning of metacarpal and proximal phalanges fracture of the hand. Material and method: 25 patients with metacarpal and phalynx fracture were treated with cross intramedullary 'k' wire fixation between June 2016 -2018 in Pravara rural hospital-loni (Maharashtra). Out of 25 patients 18 are males and 7 are females, of which 14 were having metacarpal fracture and 11 were having proximal phalynx fracture. Result: All 25 patients were followed up for more than 3 months. 1 patient (female) developed sudecks osteodystrophy. At final follow up 4 patients had residual pain measuring 2-3 on visual analogue scale. All patients regained full range of motion at metacarpo-phalyngeal and interphalyngeal joints. Fracture union was evaluated at each x-ray and patient satisfaction was evaluated as excellent, good, fair or poor. Discussion: In our study early mobilisation of the joint to reduce the stiffness k wires used for fixation are cheap, easily available and doesn't require costly instrumentation. Clinicoradiological confirmation was done at the end of every surgery to confirm acceptable reduction. There was no clinical shortening of metacarpals and phalanges. Conclusion: Comminutted fractures and intra-articular fractures, k wire not suitable. It is relatively simple, cost effective and definite advantages over other techniques for fracture stabilisation.
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