Introduction: Incidence of spondylolisthesis in general population is 5% -7%. No matter what the etiology is, patients usually have significant functional disability. Few studies have investigated the long term effect of posterolateral fusion on functional outcome. Objectives: To study the efficacy of posterolateral fusion in spondylolisthesis especially in terms of functional outcome. Methodology: From July 2010 to June 2012, a total of 86 patients, operated with postero-lateral fusion were followed up and evaluated based on VAS for low back pain, ODI and neurological deficits. Results: Follow up was 83% of original study population (86). Average follow up was 13 months.The mean difference between pre-operative and post-operative VAS at final follow up was 3.5 cms (SD = 2.94); ODI was 28% at 4 months and 36% at 8 months. Claudication pain relieved in all; functional outcome was good in 67%, fair in 27.5% and failed in 5.5%; 75% had fusion at an average of 5.5 months. Conclusion: Posteriolateral fusion is still a safe, promising and appealing technique.
In the literature the best results for pediatric supracondylar humerus fractures have been achieved by closed reduction and wire fixation. However there are certain indications where open reduction and k wire fixation is required. This prospective study compared open and closed reduction with pinning, to determine the elbow status functionally. MATERIALS & METHODS: The study included 20 children with displaced extension-type supracondylar fractures of humerus who had complete follow-up. Open reduction and pinning were performed through a posteromedial incision in 10 patients for specific indications and closed reduction and pinning 10 patients. Mean duration surgery was 15 h with open reduction and 17h with closed reduction. Mean follow up was 18 months in both groups. Humeral-ulnar angle was compared to the contralateral elbow, clinical flexion deficiency and extension lag, and complications were evaluated. RESULTS: At the latest follow-up by Flynn criteria 70% excellent results seen in closed reduction whereas 40% excelnt result in open reduction. CONCLUSIONS: Closed reduction and pinning is superior to open reduction and pinning for the treatment of pediatric supracondylar humerus fractures. Open reduction through lateral approach and internal fixation wire K wires is safe and effective method of treatment, if indicated, in supracondylar fractures of humerus in children and is associated with a good outcome
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