A total of 10% of all bone fractures are found in the ankle, making it the most often broken bone in the body. Objective: To assess the outcome and the pattern of bimalleolar ankle fractures in adults. Methods: A total of 72 individuals with bimalleolar ankle fractures were recruited in this study and followed up for a total of 12 weeks. An evaluation of the results after 12 weeks was done using the American Orthopedic Foot and Ankle Score & the Visual Analog Pain Scale. The amount of discomfort, functional ability, and alignment were the three key indicators of the results. Results: The average age of the patients was 36.4 10.4 years, ranging from 19 to 60 years. There were 3:2 more men than women. Half of the fractures were due to falls, 36.1% by automobile accidents, and 13.9% by motorcycle accidents. Of the cases, 63.9 percent included closed fractures. According to the Weber classification, B and C fractures were the most frequent, occurring in 33 (45.8%) and 31 (43.1%) individuals, respectively. The mean AOFAS at three months was 78.2. Between 1 and 3, the VAS was 43.1%. 38.8% of the patients, or 28, reported no discomfort. Conclusions: Patients tended to be young in this study. Delaying final care for up to a week after a fracture does not seem to have a negative impact on the result. The medial clean space (less than 4mm) was the primary indicator of a successful result.
Objective: The present study aims at the assessment of the radiological union and clinical outcomes of scaphoid fracture followed by fixation by Herbert Screw. Study design: A cross-sectional study Place and Duration: This study was conducted Muhammad Medical College and Hospital Mirpurkhas from may 2021 to may 2022 Methodology: A total of 20 patients were included in the study and all of them had sustained a scaphoid fracture. All of them were treated with Herbert screw fixation. Overall 18 of them were male and 2 were female. Serial radiographs were obtained for the assessment of union and the Modified Mayo wrist scoring (MMWS) system was used for the assessment of functional outcomes. The patients were called after 6 months of surgery for a follow-up visit. A total of 9 (45%) patients were treated within the first week of the injury. Overall 5 (25%) were treated in two weeks and 6 (30%) were treated in 2 to 4 weeks Results: Out of 20 patients included in the study, 17 had fractured at the waist of the scaphoid and the remaining 3 had sustained fractures at the proximal pole of the scaphoid. The dorsal and volar approach of fixation by Herbert Screw was used for treating all the fractures. A good alignment was observed post-operatively. Out of all the 20 patients, 12 (60%) patients showed excellent outcomes with a full range motion of the wrist, 6 (30%) had shown good results, and 2 (10%) showed poor results. A final follow-up was arranged during the sixth month of treatment and 18 (90%) patients showed adequate radiological union. Conclusion: Fixation of scaphoid fracture with a Herbert Screw in a convenient and effective mode of treatment which has shown excellent functional outcomes and exceptionally reduced complications. Keywords: Herbert Screw, Fixation, Functional outcomes, Scaphoid fracture
Aim: To determine the causes and treatment of birth trauma related femoral fractures. Study design: A longitudinal study Place and Duration: This study was conducted at DIMC, Dow University of Health Sciences, Karachi from January2021 to January 2022. Methodology:The study included cases of femoral fractures in neonates caused by birth trauma. The cases of birth histories were investigated in terms of gestational age, birth weight,and mode of delivery. The category of femoral fracturesand the treatment performed were both noted. Cases were followed until they were recovered.A comprehensive clinical examination was performed. Other birth traumas, fractures, nerve palsies, and/or symptoms of other musculoskeletal, genetic diseases, such as blue sclera and hypermobile joints (osteogenesis imperfecta), were noted. Results:A total of 15 newborns with femoral fractures were included in this study.The average gestational age was 38.2 weeks, with an average diagnosis time of 3 days. In the majority of cases, the infant was born breech and delivered via Caesarean section. Eleven instances had mid-shaft fractures, while four had subtrochanteric fractures. After an average of 3.1 weeks, all patients had a complete union. Conclusion:A femoral fracture in a neonate due to birth related trauma is quite uncommon. It occurs more frequently in Caesarean sections performed for breech presentation. Preterm and/or low birth weight newborns are at a higher risk. The femur shaft is commonly fractured. The prognosis for these fractures is excellent, and they heal completely after immobilization. Keywords: Birth Trauma, Femoral Fracture, Management, Risk Factors
Introduction: One of the major public health concerns across the world is the fractures occurring at the distal end of radius with an incidence rate of 25.4 per 10000 elderly people who are of about 65 years of age. These fractures are the most common fractures occurring in the upper extremities of elderly patients. More than 210 million dollars are regularly spent on the management of radial fractures of the distal ends which are expected to increase every year, however, the process of managing radial distal fractures is still controversial. Aim: To compare the outcomes of surgical and non-surgical management of distal radial fractures in elderly patients. Methodology: The current study involved 90 patients who were more than 65 years of age and were treated either surgically or non-surgically. Patients who were treated non-surgically were treated with cast immobilization whereas patients who underwent surgery had either plate or external fixation. Functional scores and baseline radiographs were recorded before treatment, and follow-up was conducted at 2, 6, 12, 24, and 52 weeks. Radiographic and clinical follow-ups were observed along functional scores were calculated and observed. Results: Patients who were treated without surgery had a mean age of 76 years, whereas 44 patients who were treated with surgery had a mean age of 73 years. No significant differences were observed between the groups in terms of other demographic factors. No differences in the functional status were observed in terms of arms, hands, and shoulders whereas pain scores also exhibited no significant differences. Conclusion: It is suggested that minor limitations exist between wrist motion range and grip strength which was diminished with the non-operative care, but functional recovery was not limited during 12 months follow-up.
Aim: To evaluate the functional outcomes of intramedullary interlocking nailing and minimally invasive percutaneous plate osteosynthesis. Study design: A longitudinal study Place and Duration: This study was conducted at Dow University of Health sciences Karachi Pakistan from January 2019 to January 2021. Methodology: A total of 100 patients were recruited for surgical procedures. All the patients were asked to visit the hospital at the 6th week, 3rd month, and 6th month of surgery for radiography assessment and for analyzing the knee and joint movements. When callus became visible on radiographs patients were allowed for partial weight-bearing. When callus was visible in 3 to 4 quadrants we considered it as fracture union on both anteroposterior and lateral views with no pain and mobility. Bone grafting was considered in case of fractures nonunion. Functional assessment was taken place after one year of surgery. Results: We observed that the IMIL group attained fracture union in an average duration of 25.90. But no statistical difference was observed between both groups. IMIL procedure has less duration of hospital stay when compared with MIPPO (6.40 (4–9) ± 1.19 vs 6.82 (5–10) ± 1.27. We observed 5° malunion in the MIPPO group whereas the IMIL group reported 10° malunion with a significant difference of 0.001. Conclusion: Our study concluded that the plating technique can better restore the distal tibia alignment but also has chances of postoperative complications which would be manageable. Keywords: Intramedullary interlocking nailing, minimally invasive percutaneous plate osteosynthesis, distal tibia
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