Background: Arthroscopic Bankart repair and open Latarjet procedures are the most frequent surgical treatments for shoulder instability and recurrent shoulder dislocation. Objectives: Therefore, we performed research to assess the clinical outcomes and recurrence rate of instability between both Arthroscopic Bankart repair and open Latarjet techniques. Methods: A cross-sectional study was performed at Lahore General Hospital, Lahore from 2021-23, comprising 74 patients, managed surgically for the condition of recurrent shoulder dislocation. The patients were allocated into two groups viz Group A and B comprising 37 patients in each, who were managed through Arthroscopic Bankart repair and open Latarjet techniques, respectively. Post-operative complications, re-occurrence and success rate were measured in terms of SSV scores. Results: Average age of patients in Arthroscopic Bankart group was 28.34+5.31 years while in open Latarjet group; it was 29.09+6.19 years. 14 (37.83%) patients of Arthroscopic Bankart repair group revealed recurrent shoulder dislocation, while no such complaint was found in the open Latarjet technique. Twenty-seven patients of Arthroscopic Bankart group showed satisfaction with the procedure and 33 out of 37 patients (89.18%) were satisfied with open Latarjet technique. Patients in open Latarjet technique group showed successful recovery of shoulder dislocation and their SSV was 87.91%, while the patients in Arthroscopic Bankart repair group showed less SSV score of 59.76%. Conclusion: Open Latarjet group patients had a greater rate of functional satisfaction, while the arthroscopic Bankart repair group showed a trend for more recurrence. Open Latarjet operation had a higher success rate and patients had a better rate of return to previous top-level sports than Arthroscopic Bankart technique. Keywords: Latarjet; Re-occurrence; Shoulder dislocation; Sports medicine; Surgical complications.
Background: Metacarpal bone plays vital role in supporting motor functions of the human palm and is subjected to frequent stress. If a fracture of the metacarpal bone occurs, it can destabilize the palm, disrupt muscular-tendon tension, impair functions of palm joints, and have adverse impacts on the daily life and work of the patient. Objectives: To compare early range of motion (ROM) in hand following K-wire fixation versus mini plate fixation in patients with multiple metacarpal shaft fractures. Methods: Cross-sectional analysis of patients with multiple metacarpal shaft fractures was done at Mufti Mehmood Memorial Teaching Hospital, between 2021 and 2022, and comprised 108 patients managed with K-wire Fixation and mini plate fixation. The success rate as well as clinical outcome of both techniques was measured as early ROM in the hand, which was assessed at eight weeks post-surgery using DASH scores. Results: Majority of patients (p<0.05) were males (73.14%), common fractures (p<0.05) were closed type (75.03%), right sided (62.96%) and common cause of injury (p<0.05) was traffic accidents (n=48), industrial accidents (n=13), fall (n=12), agriculture accidents (n=12) and assault (n=10). Our findings revealed that occurrence of complications was significantly higher among the patients of group K-wire fixation (11.11%) than mini wire fixation (6.48%) and assessment of ROM through DASH score system of mini plate fixation was better than K-wire fixation. Practical implication The surgeons will confidently apply mini plate fixation in patients with multiple shaft fractures rather than K-wire fixation after reading this article. Conclusion: Mini plate fixation may be more effective than K-wire fixation in restoring early ROM in the hand following surgery for multiple metacarpal shaft fractures. Keywords: DASH scoring; Palm fracture; Range of motion; Shaft fracture.
Objective: Obesity is the state of the body where weight of the individual is high as compared to his/her weight. It is taken with reference to body mass index according to WHO. In this study we are going to determine the frequency, distribution and determinants of obesity in a selected area. Study Design: A cross sectional study Place and Duration: Gomal Medical College, D.I.Khan, Pakistan. 16/08/2020 to 20/05/2020 Material and Results: Out of 206 subjects, 18 (8.73%, 90% CI 5.47-11.93%) were obese, while 188 (91.3%, 90% CI 88.07-94.53%) were non obese. There is no association between obesity and sex, obesity and age groups and obesity and occupation in our population. Conclusion: The frequency of obesity was significantly less in our population than the other national and international studies. The proportion of obese men in our study is more than expected values from literature and the reverse is true for women. The proportion of obese persons in age group 19-39 years in our study is more than the expected values from literature and the reverse is true for the age group of 40-59 years. The proportion of obese office workers in our study is same as in other studies and the same is true for obese physical workers. There is no association between obesity and sex, obesity and age groups and obesity and occupation in our population. Keywords: Obesity, Obese, Healthy.
Background: Unstable proximal femoral fracture occurs at the top of femur bone, typically in elderly people or those involved in high-impact accidents. The fracture can occur in different ways, including intertrochanteric, subtrochanteric, or femoral neck fractures. The two most common techniques implied for its repair are Proximal Femoral Nail (PFN) and Dynamic Hip Screw (DHS). Objectives: The research was conducted to evaluate these both techniques and compare their clinical outcome in terms of Harris Hip Score, clinical assessment and clinical complications. Methods: Cross-sectional study was completed in 2020-2022 and comprised 104 patients equally divided into Group A (DHS) and Group B (PFN). Both techniques were comparatively analyzed and the outcomes were evaluated using Harris Hip Score and clinical assessment. Results: Group A and B had mean surgery duration of 76.78+13.40 and 57.09+11.67 minutes, mean intra-operative blood loss of 239+32.98 and 149+17.29 ml, mean weight bearing time was 3.13+0.56 and 2.98+0.39 months, average incision length was 8.78+2.81 and 5.12+1.94 cm, radiological union of the fractured bones took 3.27+0.78 and 3.11+0.82 months, respectively. Harris Hip Scores were recorded on monthly basis and revealed that 1st monthly scores of Group A and B were 71 and 74, 2nd month had 77 and 81, 3rd month had 80 and 84, 4th month had 83 and 88, 5th month had 84 and 89 and 6th month revealed 86 and 90 scores, respectively. Practical implication: The surgeons would prefer PFN technique while surgery of unstable femoral fracture to avoid complications and achieve better results. Conclusion: PFN technique was associated with less blood loss, lower complications and a higher Harris Hip Score. It has marginally superior results to DHS. Thus PFN is a minimally invasive technique that necessitates less tissue dissection, resulting in negligible blood loss. In treating unstable femoral fractures, an analysis of clinical indicators revealed that PFN has superior clinical manifestation than DHS. Keywords: Femoral fractures; Harris Hip Scores; Intramedullary device; Osteoporosis.
Background: The closed reduction and percutaneous pinning are the min treatment approaches tested in pediatric humerus supracondylar fractures but the treatment approach preferred in fractures without closed reduction is remains unclear. Objectives: The purpose of this study was to compare three common orthopaedic procedures for treating children with supracondylar humerus fractures of the displaced extension type. Methods: The current retrospective analytical study was started in the Department of Orthopedic at Khyber Teaching Medical College from 2015 to 2020, with the approval of the clinical research ethics committee. This analysis was conducted on 64 patients between the ages of 1 and 12 years who underwent hospital surgery for Gartland IIb, Gartland IIb, and Gartland III supracondylar humerus fracture. Results: A total of 64, 22 patients were from group A, in which 18 (81.81%) were male and only 4 (18.18%) were female, while in group B and C were 21 (80.76%), 5 (19.23%) and 14 (87.5%), 2 (12.50%) male and female, respectively. The injury on left elbow and right elbow in group A was recorded 68.18 and 31.81%, respectively. Among the total injured children, the left elbow was fractured in 47 (73.43%) case and the right one in 7 (10.93%). Approximately the duration of injury to therapeutic procedure was recorded 7.53±3.03 hours in the study. When compared to the group of displaced supracondylar humeral fractures that were conservatively handled, the functional and aesthetic treatment outcomes between the closed and open reduction with K-wire fixation groups were significantly different. According to this system, excellent, fair, good and poor functional outcomes were recorded in 10 (45.45%), 6 (27.27%), 4 (18.18%) and 2 (9.09%) patients of A group, respectively, while 13 (50%), 5 (19.23%), 5 (19.235), and 3 (11.50%) patients in group B, respectively. The poor and fair functional outcome was noted in 1 (6.25%) and 3 (18.75%) patients, respectively in group C. Practical implication: This is a critical surgical condition in children and they should be provided with the appropriate treatment to acquire the child's ability of movement. According to our findings among three management techniques, the most favorable was open reduction with K-wire fixation, and therefore was recommended with good success rate. Conclusion: It was thus concluded that open reduction with K-wire fixation is a good alternative to closed reduction with percutaneous pinning for treating displaced pediatric supracondylar humeral fracture. Keywords: Children; Supracondylar humerus fracture; Surgical treatment; Pediatric fractures; Pakistan
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