<p class="abstract"><strong>Background:</strong> Hip fractures are a leading cause of morbidity and mortality in the elderly population posing significant burden on health care resources. The purpose of this study is to determine the epidemiological analysis of hip fractures at a tertiary care center.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study done on patients with hip fractures admitted during the period 2015-2017 in Moradabad district of Uttar Pradesh. Case files and radiographs of patients were reviewed for age, gender, nature of trauma, associated comorbidities, type of fracture and presence of osteoporosis.<strong></strong></p><p class="abstract"><strong>Results:</strong> During the 2015-2017 period, 2214 patients with hip fractures were admitted, out of which 1180 were males and rest females. The mean age of patients was 56.8 years with 41.6% belonging to age group 60-75 years. In elderly patients, a low energy simple fall accounted for >85% of fractures with presence of significant osteoporosis (Singh’s index grade 3). The in hospital mortality was 2.1%. Hip fracture characteristics included intertrochanteric 57.81%, femoral neck 30.26% and sub trochanteric 11.93%. Smoking and medical comorbidities were present in a significant number of patients.</p><p class="abstract"><strong>Conclusions:</strong> With increased longevity, hip fractures are an increasing health care problem. Various preventive measures for osteoporosis and falls will decline the prevalence of these fractures.</p>
<p class="abstract"><strong>Background:</strong> The distal tibia extra-articular fractures are treated with both intramedullary nailing (IMN) and medial minimally invasive percutaneous plate osteosynthesis (MIPPO). The aim of this study was to compare the results of IMN and medial MIPPO in distal tibia fractures. The complications and secondary interventions in both groups were compared.</p><p class="abstract"><strong>Methods:</strong> Fifty patients with distal tibia were randomly assigned to IMN (group 1) and medial MIPPO group (group 2). The functional outcomes were evaluated using American Orthopaedic Foot and Ankle Society (AOFAS) score. Complications like infection, delayed union, non-union, malunion, hardware prominence and secondary interventions were compared.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average union time was 21.12±6.93 weeks in group 1 and 23.56±6.96 weeks in group 2 (p=0.220). The mean AOFAS scoring was 90.76±7.9 in group 1 and 88.4±8.33 in group 2 (p=0.339). Five patients in group 1 and one in group 2 had malalignment. Deep infection was present in one and superficial infection was present in two cases in group 2. None of the patients in group 1 had infections. Three patients in group I developed anterior knee pain and six in group 2 had hardware prominence. Seven cases in IMN group required secondary interventions and fourteen in medial MIPPO group.</p><p class="abstract"><strong>Conclusions:</strong> Extra-articular distal tibia fractures are successfully treated with IMN and medial MIPPO with comparable functional outcomes. Prevalence of malunion was higher in IMN group and hardware prominence was more prevalent in MIPPO group. Implant removal are more in medial MIPPO group mostly due to implant irritation.</p><p class="abstract"> </p>
Background: Various osteotomies have been in use for correction of varus deformity at elbow in adults. The objective of the study was to determine the clinical, radiological and cosmetic outcome of closing wedge step cut osteotomy and lateral plating in adults with cubitus varus. Methods: This retrospective study was conducted among 15 cases of cubitus varus at an average age of 23.94 years (range, 18-31 years) and underwent closing wedge step cut osteotomy. Osteotomy was fixed with precontoured lateral locking plate. The carrying angle and range of motion of the elbow in preoperative period and final postoperative follow up was evaluated. Results: The average carrying angle improved from 20.8° (range, 12°-30°) varus to 8.66° (range, 5°-14°) valgus. Osseous union was radiographically demonstrated in all patients at an average of 13.33 weeks (range, 10-18 weeks). Lateral condylar prominence index improved from a mean of 6 (ranging from 2.5 to -8) to -12(ranging from -8 to -14). The preoperative (127.85°) and postoperative (124°) range of motion was almost similar. The average preoperative internal rotation was 14.66• (range, 0-25), which was corrected to 4.66• (range, 0-10) postoperatively. According to Oppenheim criteria, results were excellent in 6, and good in 9. The average final Mayo Elbow Performance Score was 93.33 points (range, 85-100 points). No patient had residual or recurrence of varus deformity, ulnar nerve palsy, elbow instability, implant failure or wound problems. Conclusions: Closing wedge step cut wedge osteotomy with lateral plating is an effective, reliable and technically less demanding corrective surgery in adults with minimum complications.
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