Aims and Objectives: To evaluate the results with regard to function, to restoring proper limb length after surgery and to study the associated complications in intertrochanteric fractures treated by cemented bipolar hemiarthroplasty in elderly. Methodology: This is a prospective study of 25 cases of Intertrochanteric fractures admitted to a tertiary care center between August 2013 and November 2015 treated with Cemented Bipolar Hemiarthroplasty for intertrochanteric fractures. Cases were taken according to inclusion and exclusion criteria. Results: In our study of 25 cases, there were 14 male and 11 female patients with mean age of 72.8 years. 80% of the cases admitted were due to trivial trauma, 20% due to RTA with left side being more common side affected. According to OTA classification Type 31A2.2 fractures accounted for 60% of cases & Type 31A2.3 accounted for 40 %.. Mean duration of hospital stay was 13.2 days and mean time of full weight bearing was 4.7days in our patients. Excellent was seen in 24% cases Fair to Good results were seen in 72% of cases in our study according to Harris Hip Score. Conclusion: From our study we conclude that Cemented Bipolar Hemiarthroplasty for intertrochanteric fractures in elderly reduced the complications of prolonged immobilisation, prolonged rehabilitation, marked residual deformities and need for revision surgeries. The procedure offered, faster mobilization, rapid return to pre injury level, improved the quality of life.
Purpose: To study functional outcome for upper limb phalanx fracture treated by Joshi’s External Stabilizing System (JESS) fixator. Material and Methods: 68 patients were operated for Upper limb phalynx fracture in a tertiary health care setup with JESS fixator and were reviewed at 3 weeks, 6 weeks and 3months. After the procedure, the patients were assessed for the functional outcome using DASH (Disabilities or Arm, Shoulder and Hand) scoring scale. Results: Mean Adjusted DASH scores of the operated finger over consequent visits at 3 weeks, 6 weeks, and 3 months. We found that the mean adjusted DASH score improved in each consequent visit as compared to the first visit for all the joints (p<0.001). Out of the total 68 study participants, 63 had no complications (92.65%). Only 5 study participants had complications, out of which 2 each had joint stiffness (2.94%) and superficial pin track infection (2.94%) while 1 had pin loosening (1.47%). Conclusion: From the results, we can safely conclude that JESS is an effective alternative treatment for fractures of the phalanges. It is cheap and easily available. Technically, also it is less demanding. Also there is a good functional outcome as suggested by our study findings in terms of improvement in the range of motion as well as the mean adjusted DASH scores over a period of three follow up visits planned at 3 weeks, 6 weeks and 3 months with very few complications.
Osteonecrosis of the femoral head is not a specific diagnostic entity, but rather the final common pathway of a series of derangements that produce a decrease in blood flow, leading to cellular death within the femoral head. It can present with a number of clinical manifestations. The most common complaint is a deep, intermittent, throbbing pain in the groin region which has an insidious onset. In the early stages, prophylactic measures are used to prevent further progression of the disease. When the patient is diagnosed in later stages, the collapse and distortion of the femoral head can be seen, for which a reconstructive procedure is the treatment of choice. The goals of total hip arthroplasty are to relieve pain, to provide motion with stability and to correct deformity so that they are able to return to their normal daily activities. Total hip arthroplasty can be the first treatment of choice. especially in the advanced stages of hip osteonecrosis, or can be reserved as a salvaging procedure when other more conservative treatments fail. Total Hip Arthroplasty is a good modality of treatment for patients with very poor pre-surgical functional scores combined with an excellent long term survival of the cement-less implants.
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