Objective: To compare the outcome of conservative treatment of distal ulna fractures with operative treatment Study design: A randomized control trial Place and duration: This study was conducted at Muhammad Medical College and Hospital Mirpurkhas from September 2021 to September 2022 Methodology:Patients with different types of ulnar fractures (base fractures, head fractures, and subchondral fractures) were divided into two groups based on a systematic approach that established the course of treatment for forearm fractures. The fractures of the distal radius in Group A were treated with plating osteosynthesis, while the fractures of the distal ulna were taken care of with a surgical procedure involving the implantation of an LCP Distal Ulna Plate (De PuySynthes, USA) Results: A total of 120 patients were enrolled in the study, 8 of whom had to be excluded due to the development of carpal ligament damage symptoms. The 112 patients who remained were divided into three groups: 36 in group A, 42 in group B, and 34 in group C. The results of distal forearm fractures were initially treated with closed repositioning in local anesthesia and plaster fixation in 89 cases. In 10 cases, external fixation was primarily applied due to soft tissue conditions. The definitive surgical procedure was performed on average 10 days (3-19) from the injury. In group A, osteosynthesis of both bones was performed during one operation in 30 patients. In 7 cases, it was necessary to perform a two-phase procedure due to the state of the soft tissues. Conclusion: Based on the study's results, osteosynthesis is the more successful treatment for sub-capital fractures, as it results in better early outcomes than a conservative approach. However, due to the low number of patients with this type of fracture, it is impossible to make definitive treatment recommendations Keywords: distal ulnar fracture, osteosynthesis, conservative treatment
Objective: To compare the outcomes between conventional versus Minimal invasive dynamic hip screw in fixation of intertrochanteric fracture of femur Materials and Methods: This is randomized control trial, conducted at Department of Orthopedic Surgery, Shaheed Mohtarma Benazir Bhutto Medical University (SMBBMU), Larkana, Pakistan from November 9, 2020 to May 8, 2021. All patients who fulfilled the inclusion criteria and visited to SMBBMU, Larkana were included in the study. After taken Informed consent, exclusion criteria were followed strictly. Results: Mean±SD of age in MIDHS group was 54.6±9.5 and CONDHS group was 55.8±9.8 years. Mean ± Standard Deviation of blood loss & duration of surgery was noted as (51.3±16.4 v/s 145.1±26.4; [P=0.0001] ml) and (54.5±11.4 v/s 76.2±17.7; [P=0.0001] mins) among MIDHS and CONDHS groups respectively. While duration of hospital stay was noted as 3.6±2.2 and 8.1±4.9 in MIDHS v/s CONDHS groups respectively with a highly significant difference i.e., (P=0.0001). Conclusion: It is to be concluded that highly significant difference was noted in comparison of outcomes between conventional v/s Minimally invasive dynamic hip screw for the fixation of intertrochanteric fractures of femur. Keywords: Conventional, Femur, Intertrochanteric Fractures, Hip Screw, Outcomes
Objective: This study aims to quantify the prevalence of destructive hip disease following intra-articular corticosteroid hip injections. Study design: A retrospective study Place and duration of study: Department of Orthopaedic, Khyber Teaching Hospital Peshawar during the period from January, 2022 to June, 2022. Methods: This study was conducted on two hundred cases of corticosteroid injection treatment. For finding the frequency of destructive hip disease, the radiological imaging was used. Patients were compared with their clinical, paraclinical, and demographic data. Observations of pain, joint mobility, and radiographic evaluation served as the foundation for the recently suggested clinico-radiological diagnostic criteria. The inter- and intraobserver reliability of the radiological grading system was evaluated. For statistical analysis, SPSS-20 was employed.. Results: From the total 200 cases, patients with POH were 80(40%), with RPOH were 20(10%), with femoral head avascular necrosis were 20(10%) and with secondary osteoarthritis of hip were 40(20%), patients went for THA were 90%. There were 30% males and 160% females with mean age of 53.9 ±3.3 and BMI >32. The corticosteroidal injection of 40mg triamcinolone-acetonide with 4 mL 1% lidocaine was placed in 21(77.8%). Conclusion: An elevated chance of quickly degenerative hip disease can result from intra-articular corticosteroid hip injection. Hip injections with intra-articular corticosteroids are probably not as safe as we had believed. Hip injections should only be used when absolutely necessary, and their usage should be reduced. Before administering a large and repeated dose of corticosteroids, the patient should also be warned about the possibility of the condition progressing faster. Keywords: RDHD, intra-articular corticosteroid hip injection, frequency.
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