Total hip arthroplasty is a surgical treatment that has been thoroughly documented. The capacity of Total Hip Replacement arthroplasty to treat pain associated with hip joint pathology while retaining mobility and stability of the hip joint is the key to its effectiveness.The goal of this study was to use the Modified Harris hip score and radiological examination to assess the clinical and functional outcomes of total hip arthroplasty.The study was carried out on 33 hips of 30 patients of Total Hip Replacement operated in the Department of Orthopedics, Vinayaka missions medical College and Hospital and Vinayaka missions Hitec Hospital, Salem, from August 2012 to September 2014. This was a retrospective as well as prospective study. Patient follow up was for a minimum of 6 weeks to a maximum of 12 months (1yr).9 patients underwent uncemented total hip replacement in which for 5 patients the acetabular cup was fixed with 2 acetabular screws each. During the procedure 1 patient had Type A2 Vancouver fracture of the proximal femur which was fixed with SS wire cerclage which united as documented by the follow up X-rays. Postoperatively, for two patients we came across dislocation due to adductor contracture, was reduced following adductor tenotomy. Patients were found to be doing normal daily activities by the follow-up. The mean overall pre-operative score was 33.3, which improved to a mean score of 94.2 after surgery.Dislocation was seen in 2 individual patients.After THR, which was conducted on a population of active individuals, 96.9% of patients experienced excellent or good pain reduction and function. When pain sufferers were included, the overall average score was 90 points, but after a minimum of five years of follow-up of 91 hips treated with the PCA prosthesis, the average score was 93 points.
Background:The aim of the study is to evaluate the functional outcome of displaced fractures of the proximal humerus managed surgically. Methods: A prospective analysis of the functional outcome of 20 cases under surgically managed displaced proximal humeral fractures were undertaken in our hospital. The indications of the surgery were displacement to more than 1 cm and angulation of more than 45°. The patients were operated by the standard anterior deltopectoral approach, deltoid splitting or percutaneous procedure depending upon the type of fracture and bone quality. Results: The mean age of the patients was 44 years. The mode of injury was fall at ground level in 10(50%) patients, road traffic accident in 6(30%) patients, fall from height in 3(15%) patients, fall due to epilepsy in 1(5%) patients. Based on Neer's sytem 10 patients (50%) had two part fractures, 5(25%) patients had 3 part fractures and 5(25%) had four part fractures. Greater Tuberosity fractures were the predominant type in 2 part fracture. Patients underwent the surgery on an average of 7.95 days after injury. The mean follow-up period in this study was 12.2 months. Conclusion: Displaced proximal humeral fractures when treated surgically produce less pain, less stiffness and greater range of motion. Earlier the surgery better are the results. Results are better with fractures than with fracture dislocations. Results are best when operative method results in stable fixation that allows early passive mobilization. Functional outcome of 2 part fractures is better than 3 part and 4 part fractures.
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