Objective: The aims & objectives of the study are to compare the results of tibialplateau fracture treated by plaster of paris cast and percutaneous screw fixation. Study design:Comparative study. Place and duration of study: Study was carried out at the OrthopaedicsUnit-II, Liaquat University Hospital Hyderabad / Jamshoro , from January February 2010 tooctober 2011. Methodology: Between February 2010 to october 2011, 31 men and 9 womenaged 20 to 40 years with means 28.25 years underwent plaster of paris and percutaneous screwfixation for schatzkar type I closed tibial plataue fracture in Orthopaedics Unit-II, LiaquatUniversity Hospital Hyderabad / Jamshoro. Data was analyzed through SPSS software version16.0. Results: In both groups 31(77.5%) men and 9(22.5%) women with male: female ratio of3.4:1 and aged 20 to 40 years with means 28.25 years. Union time range 10 to 24 weeks in bothgroups(p value 0.001). The mean healing time in PSF group was 11.6 weeks while in POP groupit was 13.9 weeks. The complications seen in this study were pain during walking (5 (25%)patients in POP VS 3 (15%) patients in PSF group), knee stiffness (4(20%) patients in POP VS 2(20%) patients in PSF group ), ankle stiffness (3(15%) patients in POP VS 1(5%) patients in PSFgroup), delay union (2(10%) patients in POP VS 1(5%) patients in PSF group ), non union (2(10%)patients in POP VS 0(0%) patients in PSF group ) P value 0.040. The longer duration of hospitalstay about -10-20 days in 13(65%) of POP patients as compared to PSF cases where majority16(80%) were discharged within 1 to 10 days( p value 0.148). The patients with complications hadstill longer stay in both group. The mean hospital stay in POP group was 14.6 days and PSF groupwas 8.4 days. The clinical results seen in this study were excellent (5(25%) patients in POP VS13(65%) patients in PSF group), good (8(40%) patients in POP VS 5(25%) patients in PSF group),fair (5 (25%) patients in POP VS 2 (10%) patients in PSF group ) and poor (2(10%) patients in POPVS 0 (00%) patients in PSF group. Conclusions: We conclude that percutaneous screw fixationgives better results in type I schatzkartibial plateau fracture compared to plaster of paris cast. Thecomplications were seen higher in POP cast.
OBJECTIVE: To evaluate the Ponseti treatment in neglected club foot patients. Result of this study shall help us to manage untreated or neglected patients with club foot in better way and this study shall provide platform for bigger studies on clubfoot in Pakistan. METHODOLOGY: This multicentre observational cross sectional study was conducted on retrospective data of patients registered to Ponseti Club foot Clinic between July 2013 to Dec 2016 at Dr Ruth Pfau Civil Hospital Karachi and Jinnah postgraduate Medical Center, Karachi. In this study 41 feet in 28 patients with Neglected club foot between 3 to 11 years were treated by Ponseti guidelines for older child (already walking child). Deformity was assessed with pirani scoring. Average follow up time was 3 years. RESULTS: Painless plantigrate foot was obtained in all patients. In 3 patients equinus deformity recurred. Two were managed with recasting while in the third one along with recasting and retenotomy was undertaken. In 2 patients mild varus was recurred, which was managed with recasting. One patient was lost to follow-up after 2 years. CONCLUSION: This study conclude that treatment of neglected idiopathic club foot patients presenting to us after walking age with Ponseti method according to Ponseti guidelines for older children is safe, effective and low cost method. It also reduces the risk of excessive surgical procedures.
Objectives: Our experience by dynamic condylar screw in the treatment ofsupracondylar femur fracture, which is quite a long time, has stayed challengeable issue inorthopedic surgery, at LUH. Study Design: An observational cross sectional study. Setting:Orthopedic Surgery Department, Liaquat University. Methodology: Cases along both sexeswith additional articular fractures, conceded inside of 2-3 days were incorporate and caseshaving open epiphysis, open fracture, pathological and intra articular fractures were not a pieceof this study. Hospital stay average was 18 days. Follow up was done of every one of thePatients after each third week for two only visits, then every 6th week for about 6 months. Allthe data were recorded on particularly outlined proforma. Results: In this study 19(63.3%) maleand 11 female (36.6%) patients. Mean age was found 35yrs. Commonest cause of injury wasRTA in 80% patients. 65% patients got injury to left lower limb while 35% to right lower limb. Therewere only two infections i.e. the infection rate was 6.66%. Union rate was 93.3% and nonunionrate was 3.3% and there was only one mal union i.e. mal union rate was 3.3% .Bone grafting wasdone in 21 patients. The overall good to excellent results were in 84% cases and fair to poor in16% cases. Conclusions: DCS gives solid fractures fixation after decrease and makes postoperativerecovery simple, so in light of patient’s financial state in Pakistan. DCS is perfect insertfor distal femoral exceptionally for these fractures.
Objectives: To analyze the comparative results of dynamic DHS fixation in stableand the unstable intertrochanteric fractures at LUH. Study Design: Comparative study. Setting:Orthopedic unit I of LUH Jamshoro. Period: 26th May 2010 – 25th August 2011. Methodology:All 40 patients with femur intertrochanteric fracture were enlisted. All cases isolated in 2 groupsevery having 20 patients, group A stable fracture and group B unstable fractures. After completephysical examination, examinations and fracture arrangement evaluation, patients were readiedfor operation. Fracture table was used in each operation. Fracture reduction was initiallyattempted by close manipulation and was successful in 30 (75%) cases. Lateral approach forproximal femur was used in every case. All fractures, whether stable or unstable, were reducedanatomically without any type of osteotomy and then fixed with 135o dynamic hip screw.Results: Mean age was 62.8.2 years of the cases. Gender ratio was 3:1. According to modeof injury were found RTA in 21 (70%) patients. Postoperative complications were recorded as;superficial infection noted in 2 (5%) patients and there was no case of deep infection. Averagestay of hospital found 16.5 days in 17 (42.5%) patients belongs to stable group and 06 (15%)patients belong to unstable group. All (n=40) patients were pain free on their discharge fromhospital. In all (n=40) patients we achieved union and there was no case of delayed unionor non-union. We assessed functional outcome of our patients on the base of Stinchfield HipAssessment system. According to SHAS 28 (70%) patients were excellent, 05 (12.5%) patientswere good, 04 (10%) were fair and 03 (7.5) were poor. We had not found mortality in our patients.Conclusions: According to our conclusion DHS is the best implant for intertrochanteric fracturefixation. No matter; whether fracture is stable, unstable and fresh or old.
All 40 patients with femur intertrochanteric fracture were enlisted. All cases isolated in 2 groups every having 20 patients, group A stable fracture and group B unstable fractures. After complete physical examination, examinations and fracture arrangement evaluation, patients were readied for operation. Fracture table was used in each operation. Fracture reduction was initially attempted by close manipulation and was successful in 30 (75%) cases. Lateral approach for proximal femur was used in every case. All fractures, whether stable or unstable, were reduced anatomically without any type of osteotomy and then fixed with 135 o dynamic hip screw. Results: Mean age was 62.8.2 years of the cases. Gender ratio was 3:1. According to mode of injury were found RTA in 21 (70%) patients. Postoperative complications were recorded as; superficial infection noted in 2 (5%) patients and there was no case of deep infection. Average stay of hospital found 16.5 days in 17 (42.5%) patients belongs to stable group and 06 (15%) patients belong to unstable group. All (n=40) patients were pain free on their discharge from hospital. In all (n=40) patients we achieved union and there was no case of delayed union or non-union. We assessed functional outcome of our patients on the base of Stinchfield Hip Assessment system. According to SHAS 28 (70%) patients were excellent, 05 (12.5%) patients were good, 04 (10%) were fair and 03 (7.5) were poor. We had not found mortality in our patients. Conclusions: According to our conclusion DHS is the best implant for intertrochanteric fracture fixation. No matter; whether fracture is stable, unstable and fresh or old.
<p><strong>Objective:</strong><strong>Â Â </strong>To determine percutaneous screw fixation (PSF) as fair treatment option for Schatzker type I, closed tibial plateau fracture in adults.</p><p><strong>Patients and Methods:</strong><strong>Â Â </strong>30 male and female adults between the ages of 20 and 40 were included. Only displaced Schatzkar type I closed tibial plateau fractures without any associated injury or complication were included. Type II, III, IV, V and VI, fractures with infection, patients with other severe injuries and neurovascular compromise fractures were excluded. Patients were followed weekly for one month, every alternate week for four months, thereafter monthly for up to six months to assess range of motion, deformity, union or any other complication.</p><p><strong>Results:</strong><strong>Â Â </strong>Mean healing was 11.6 weeks. Mean hospital stay was 8.4 days. The overall clinical results were excellent in 20 (66.6%), good in 8 (26.6%), fair in 2 (6.6%) cases.<strong></strong></p><p><strong>Conclusion:</strong><strong>Â Â </strong>Percutaneous screw fixation provided</p><p>better results in close displaced type I Schatzker tibial plateau fracture in adults. It is minimally invasive and achieved articular anatomical reduction, rigid fixation and early mobilization.</p>
Methodology: Cases along both sexes with additional articular fractures, conceded inside of 2-3 days were incorporate and cases having open epiphysis, open fracture, pathological and intra articular fractures were not a piece of this study. Hospital stay average was 18 days. Follow up was done of every one of the Patients after each third week for two only visits, then every 6th week for about 6 months. All the data were recorded on particularly outlined proforma. Results: In this study 19(63.3%) male and 11 female (36.6%) patients. Mean age was found 35yrs. Commonest cause of injury was RTA in 80% patients. 65% patients got injury to left lower limb while 35% to right lower limb. There were only two infections i.e. the infection rate was 6.66%. Union rate was 93.3% and nonunion rate was 3.3% and there was only one mal union i.e. mal union rate was 3.3% .Bone grafting was done in 21 patients. The overall good to excellent results were in 84% cases and fair to poor in 16% cases. Conclusions: DCS gives solid fractures fixation after decrease and makes postoperative recovery simple, so in light of patient's financial state in Pakistan. DCS is perfect insert for distal femoral exceptionally for these fractures.
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