Results: This study comprised of 25 patients and followed for minimum of 6 months. Success rate is 100 %, with 92% graded as excellent to good and rest 8 % with fair functional results. Conclusion: We conclude that Anterior Cruciate Ligament reconstruction with quadrupled semitendinosus graft has good functional results and high success rate.
Introduction:The conservative treatment of intertrochanteric (IT) fracture has high complication rate. The operative management of intertrochanteric fractures are sucussful. Commonly used implants for fixation of IT fractures are dynamic hip screw (DHS) and proximal femur nail (PFN). Debate still continues regarding the optimal implant for IT fractures. We aim to compare the results of DHS and PFN in the treatment of IT fractures at our institution. Materials and Methods: This is a prospective randomized comparative study of 40 patients of IT fractures treated surgically. Patients were divided equally into 2 groups of 20 each, with patients in group-A treated with DHS and those in group-B PFN. The functional outcome was evaluated based on Harris Hip Score (HHS). The radiographic outcomes was based on non-union or mal-union, femoral head necrosis, cut-out, periimplant fracture. Results: The Harris Hip Score in the D.H.S group at 1 month (Avg. 24.4) was less than that of the P.F.N group (Avg. 33), p<0.05. During follow-up period, Group PFNA improved from 33± 2.99 to 87.62 ± 7.53, and Group DHS improved from 24.4 ± 2.98 to 74.44 ± 7.95. Patients in PFN group had fewer complications as compared to those in DHS group and the difference was statistically significant. DISCUSSION: the most important result is that patients treated with the PFN technique exhibited functional improvement as early as 6 months after surgery, unlike DHS-treated patients. In practice, this means that PFN treatment is associated with faster improvement in quality of life than the DHS technique. Conclusion: PFN is better than DHS, as indicated by significantly less total complications, less reoperation rate, and higher postoperative HHS.
Introduction: In elderly patients suffering from a displaced femoral neck fracture, a cemented hip arthroplasty (HA) has been shown to reduce the reoperation rate and give better hip function. When using an HA two types of prosthesis exsists-unipolar or bipolar. It is hypothesized that bipolar prostheses lead to better long-term functional outcomes with less complications. Aim of this study is to compare the results of unipolar (Austin Moore's Prosthesis) and bipolar hemiarthroplasty done at our institution. Materials & Methods: This is a randomized control trial including 100 patients with fracture neck of femur, equally divided into 2 groups of 50 each. Patients in Group-A were treated using unipolar Austin Moore's Prosthesis (AMP) and in Group-B were treated using Bipolar prosthesis. Patients were assessed clinically based on Harris hip score, and radiologically for acetabular erosion according to the method described by Baker. Results: 66% of patients with bipolar prosthesis reported minimal or no pain at follow-up compared to 65% of patients with Moore's prosthesis. Hip function according to the HHS was similar at both followups. Acetabular erosion was observed in 2 patients belonging to the Moore's group but not in the bipolar group. Other complications were similar in both groups. Discussion: Hemiarthroplasty, as an effective technique for displaced femoral neck fractures. Controversy has persisted for a long time regarding the use of bipolar versus unipolar prosthesis. The results of our study did not demonstrate any differences between the two groups. However, at a mean follow up of one year signs of acetabular erosion were more frequent after the unipolar HA, but this difference was not statistically significant. Conclusion:This study suggests that Bipolar HA is associated with similar improvement in hip functionality, hip pain, and quality of life compared with Unipolar HA and that there are no significant differences between Bioplar HA and Unipolar HA at 1year follow up.
Background: Fractures of the humeral shaft are commonly encountered in the emergency department and are treated conservatively or surgically. Quantification of the results forms an important part of the treatment protocol and scoring systems are one of the best ways for quantification without bias. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a questionnaire which is filled by the patient and is used to assess the results in the upper limb. Methods: Between October 2004 and December 2008, 68 patients with fracture of the shaft of the humerus were managed surgically in our institutions. Four were lost to follow up and the remaining 64 were assessed clinicoradiologically and by the DASH questionnaire. The results given by the two methods of assessment were then compared. Results: There were 30 excellent, 18 good, 11 fair and 5 poor results when assessed clinically and radiologically. There were 32 excellent, 18 good, 9 fair and 5 poor results when the same patients were assessed by the DASH questionnaire. Conclusion: The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is an efficient instrument to quantify the results in fractures of the humerus.
Background: The shoulder is the most commonly dislocated major joint in the body and this dislocation causes severe and agonizing pain. Prompt and painless reduction forms the cornerstone of treatment. We studied the efficacy of the Milch technique in the reduction of anterior dislocation of shoulder. Materials: Between September 2011 and March 2014, 60 cases of anterior dislocation of shoulder were reduced by Milch technique in C.S Hospital Shivamogga and Dhruva Orthopaedic Clinic Shivamogga and the pain experienced by the patient was quantified by Visual Analogue Score. Results: Reduction was successful in 56 cases (93.3%). The mean Visual Analogue score was 1.82. There were no complications. Conclusion:We conclude that the Milch technique is a very effective and relatively painless method for reducing anterior dislocation of the shoulder.
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