ccccccThus improving the outcome for function and quality of life of patients with fractures. While the healing progress of bone fractures clearly benefitted by the method of plate and screw fixation construct, a new application of plate fixation started Introduction of the locking compression plate was a revolution in the evolution of management of fractures where prolonged bed rest is avoided and return to work is satisfactorily helpful. Local examination of the injured extremity revealed swelling, deformity and loss of function. Palpation revealed abnormal mobility and crepitus at the fracture site. Distal neurovascular status was assessed by the posterior tibial artery and dorsalispedis artery pulsations, capillary filling, local temperature, pallor and paraesthesia. The closed reduction not only helps in achieving reduction in difficult situations, but also in rapid union, because it facilitates preservation of the blood supply to the fragment and helps to achieve near normal anatomical reduction of the fracture.

No abstract

Biological' internal fixation avoids the need for precise reduction, especially of the intermediate fragments, and takes advantage of indirect reduction. This principle applies equally to locked nailing, bridge plating, and internal fixator-like devices. Indirect reduction aims only to align the fragments. It avoids exposure of the bone thus reducing the surgical trauma. Flexible fixation is advocated to induce formation of callus and is achieved by using wide bridging of the area of the fracture. The patients were followed up at intervals of three weeks for up to 6-10 months to assess the radiological union. After the 1st follow up of 4 weeks patient is allowed to partially bear weight. The fracture was designated as united, when there was periosteal bridging callus at the fracture site at least in three cortices in the anteroposterior and lateral views. Trabeculations extending across the fracture site was also taken into consideration. Partial and full weight bearing were allowed. Two of the patients developed superficial skin infections, which were treated with daily dressings and appropriate antibiotics according to the culture and sensitivity reports. All the infections subsided on the above said treatment. We had 1 patient with ankle stiffness. Probably due to the lack of compliance to the advised physiotherapy at home after discharge of the patient. Ankle stiffness ranged from restriction of ankle movement from 20-40%.

During standing, the joint reaction force increases with increasing knee flexion as the force vectors of quadriceps and patellar tendons become more parallel to the joint reaction force. It has been calculated, patella-femoral joint reaction forces is of 2-5 times body weight during activities of daily living; during squatting to 120 degree of knee flexion, the joint reaction force may be as high as 7-8 times body weight. During knee flexion, the patella makes a rolling or gliding motion along the femoral articulating surface. This study was conducted in Department of Orthopaedics, twenty patients who Consented (12 female and 8 male) and underwent SBTKR for tricompatrmental arthritis of knee using a posterior stabilized type of knee prosthesis, were assessed functionally using knee society score and oxford knee score. In the present study Knee society score and oxford scores were assessed in patients post operatively after simultaneous bilateral total knee replacement at 3 months, 6 months and 12 months. it was observed that the mean KSS score right knee improved from 132.9 at 3 months to 144.57 at 6 month and 159.86 at 12 months. Mean KSS score left knee improved from 133.7 at 3 months to 145.29 at 6 month and 161.1 at 12 months. Mean oxford score improved from 32.4 at 3 months to 36.76 at 6 month and 40.38 at 12 months.

The functional outcomes and patient satisfaction scores are comparable, or higher, in persons undergoing bilateral TKA, and this occurs without a subsequent increase in out-of-pocket or insurance-covered medical expenses. Opponents of simultaneous bilateral TKA contend the procedure carries a higher mortality rate than staged bilateral TKA. Other opponents of simultaneous bilateral TKA cite an increase in postoperative complications and higher rehabilitation costs. Detailed history of all patients was taken. All patients were assessed clinically and functionally using the Knee Society Score and oxford knee score. The preoperative medical evaluation of all patients were done to prevent potential complications that can be life-threatening or limb-threatening. One way ANOVA was performed to assess the improvement in KSS score in left knee it was observed that the increase in score was statistically significant with F value of 65.6 and p<0.05. Further post Hoc analysis was done to assess the level of significance by multiple comparison it was observed that KSS score of left knee was significantly more at 3 months, 6 months, 12 months compared to preop levels p<0.05. The KSS score of left knee was significantly more at 6 months, 12 months compared to 3 months p<0.05 and The KSS score of left knee was significantly more at 12 months compared to 6 months p<0.05.