Introduction: Three and four -part fractures represent 13%-16% of proximal humeral fractures. They occur more frequently in older patients after the cancellous bone has become weakened by senility and osteopenia. Treatment options for these displaced fractures include closed reduction and k-wire fixation, open reduction and internal fixation and arthroplasty. The purpose of the present study was to evaluate the functional results in patient with three and four-part proximal humeral fractures treated by different modalities, over a period of 2 years. Materials and Methods:We present a retrospective study of 40 three-part and four part proximal humeral fractures according to Neer's classification, treated by simple technique of Kirschner wire Osteosynthesis, open reduction and internal fixation with clover-leaf plate or proximal humeral locking plate system (PHILOS) and hemiarthroplasty of the proximal humerus. The criteria for inclusion were a diagnosis of undisplaced three-part fracture, displaced three and four part fractures confirmed by three independent observers. Results: The study was conducted over a period of two years with an average follow up of 20.7 months (Range: 12 to 40 months). There were 14 undisplaced three-part fractures impacted in valgus, seven displaced three part fractures, two three-part fracture with dislocated head, four four-part fractures with dislocated head. Conclusion: Three-and four-part proximal humeral fractures are difficult injuries to evaluate and treat. Nevertheless, an algorithm for treatment has been devised. Preoperative and intraoperative evaluation must address fracture pattern, bone quality, patient motivation, and expectations. A thorough knowledge of normal glenohumeral relationships is essential to achieve optimal surgical results.
<p class="abstract"><strong>Background:</strong> Subtrochanteric fractures are devastating injuries that not only affect the elderly but also the young. Despite marked improvement in implant design, surgical technique and patient care; subtrochanteric fractures continue to consume a substantial proportion of our health care resources.</p><p class="abstract"><strong>Methods:</strong> This prospective study consists of 20 adult patients of subtrochanteric fractures of femur, who were treated with internal fixation using PFN. All patients were followed up at an interval of 4 to 6 weeks till fracture union and then once in 3 months till 1 year.<strong></strong></p><p class="abstract"><strong>Results:</strong> Anatomical results are noted as good or poor depending upon shortening, varus deformity, hip movements and knee movements and functional result as excellent, good, fair and poor depending upon the hip pain, ambulatory status, ability to squat, and sit cross leg. In the study 2 patients had shortening of l cm. None of the patients had any varus deformity. Overall excellent to good results were achieved in 85% cases.</p><p class="abstract"><strong>Conclusions:</strong> The potential advantages of the proximal femoral nail over extramedullary devices with regards to minimal invasiveness due to closed technique and minimal soft tissue dissection, better biomechanical design to prevent implant failure and ability to bear more stress, shows that this technique holds considerable promise in complex fractures. Early rehabilitation, less blood loss, less surgical trauma, cosmetic incision, make it the implant of choice in complex, comminuted unstable subtrochanteric fractures in adults.</p>
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">With increase participation in sports activities, anterior cruciate ligament (ACL) tear is a common and functionally disabling injury. Hamstring tendon as autografts for arthroscopic ACL reconstructions have shown good clinical and functional outcome in patients. The purpose of present study was to compare the functional outcome of arthroscopic Anterior Cruciate ligament (ACL) reconstruction using single bundle six fold and four fold ST and G graft.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This was a prospective study conducted between period June 2008 to December 2010.181 patients undergoing ACL reconstruction were screened and 113 patients fulfilling the inclusion exclusion criteria were selected for the study</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">All patients completed a minimum of 1 years follow up. In 4 fold group 27.50% were having grade 1 anterior drawer test 22.50% were having grade 1 Lachman test and 17.50% had grade 1 pivot shift test as compared to 6 fold group 6.66% had grade 1 anterior drawer test, 11.66% had grade 1 Lachman test, and 3.33% had grade 1 pivot shift test respectively which was statistically significant (p<0.05). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Arthroscopic ACL reconstruction using six fold graft is effective modality of treatment in patient with ACL deficient knee. Six fold graft is thicker in diameter and cross sectional area as compared to four fold graft which occupies more surface area of normal ACL foot print and gives better stability of knee joint in both AP and rotational plane.</span></p><p> </p>
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">There is a considerable amount of literature on calcaneal fractures and their treatment; however the best management approach has yet to be determined. The results of ORIF and conservative treatment have been described and compared in several studies.These studies show improved outcome after operative management.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is a study of 30 patients with ages ranged from 18 to 65 years with displaced intraarticular fractures of the calcaneus treated by open reduction and internal fixation. 4 patients had bilateral fractures. Out of 34 fractures in 30 patients, 22 fracture calcaneum were joint depression type and 12 fractures were tongue type</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In 17 cases normal Bohler angle (i. e. 20<sup>0</sup>-40<sup>0</sup>) was achieved. There were 3 cases of post operative delayed wound healing, 2 cases of superficial wound infection and 1 case of sural nerve complication in the form of loss of sensation on lateral aspect of foot. According to American Orthopaedic Foot And Ankle Society (AOFAS) score, 13.33% of the patients had excellent results, 63.33% had good results, 13.33% had fair result and 10% had poor results. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Operative fixation of displaced intra-articular fractures of the calcaneus by reconstruction locking plate, restores the calcaneal height, allows early mobilization and weight-bearing, and maximizes the chances for good joint function</span><span lang="EN-IN">.</span></p>
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