Introduction: Freiberg's disease, the osteochondrosis of the metatarsal seen in our part of the world, usually at late stages, are refractory to the conservative treatment. Objective:The purpose of this study was to evaluate the results of dorsal closing wedge osteotomy and pin fixation besides debridement and synovectomy. Material and Methods: Twenty patients (14 females, 6 Males), mean age 19.3 years; range 14 to 26 years were evaluated and teated by dorsal closing wedge osteotomy and pin fixation besides debridement and synovectomy, between september 2016 to 2018 at our institution. The presenting symptoms were pain on walking or sports, limitation of daily routine activities, footwear problems, cosmetic deformities of forefoot and failed conservative treatment. Three patients had a history of trauma. According to Smillies's classification twelve patients were type IV and eight were Type V.Mean follow-up period was 14.85 months(range 6 months to 24 months). Results: Patients were assessed by the lesser metatarsophalangeal interphalangeal (LMPI) scale by kitaokaetal. At the final follow-up, scoring had changed from (44-66) with an average 54.65 to (76-100) with an average 85.3. There was no case of infection, avascular necrosis, arthritis or pseudoarthrosis. Conclusion: Treatment of freiberg's disease with dorsal closing-wedge osteotomy shows satisfactory pain relief and improvement in quality of life.
Introduction: Incidence of displaced fracture neck of femur is high and there is lack of consensus over the definitive treatment of such fractures as the incidence of complications especially avascular necrosis remains very high. Objective of the study was to evaluate the incidence of avasular necrosis and its pattern in displaced fracture neck of femur managed with osteosynthesis Material and methods: This study was a prospective study conducted in Bone & Joint Hospital, Srinagar from 2003 to 2018 on patients with displaced fracture neck of femur. Close reduction was done on traction table using Whitman's Method and reduction was confirmed under C Arm and was labelled satisfactory using Lowell's S Method and fixation was done using 3 Cannulated Screws of 6.5mm. Results: 118 patients {70 males and 48 females} with mean age 42.5 years {range 18 to 55 years} presented late in our hospital which resulted in a delay in fixation from 24 hrs to 7 days post trauma. Patients were followed till 2018 for a minimum period of 10 years. Conclusion: Our study suggest same AVN rates as of other studies if fixation is done within a period of one week.
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