PurposeThe purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients.Materials and MethodsIn this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun. A Richard screw was inserted and the plate was fixed over the femoral shaft. Patients were mobilized and clinical outcomes were rated using the Salvati and Wilson's scoring system.ResultsMore patients included in this study were between 66 and 70 years old than any other age group. The most common fracture according to the Orthopaedic Trauma Association classification was type 31A2.2 (46.7%). The T-score was found to be −2.506±0.22 (mean±standard deviation); all patients were within the range of −2.0 to −2.8. The duration of radiological union was 13.67±1.77 weeks. Salvati and Wilson's scoring at 12 months of follow up was 30.96±4.97. The majority of patients were able to perform their normal routine activities; none experienced implant failure or screw cut out.ConclusionBone cement augmentation may effectively prevent osteoporosis-related hardware complications like screw cut out in elderly patients experiencing intertrochanteric fractures.
Introduction: Ganglions contain transilluminant growths that seem to be tight, smooth, and cystic. They are by far the most frequent soft tissue swelling of the hand, with the dorsum of the wrist being the most prevalent location. Ganglion management options currently include aspiration, loop suture, and surgery. Some supported aspiration combined with steroid injection and loop suture method into the cyst to improve therapeutic outcomes. Objectives: To assess discomfort alleviation, visual results, and recurrence rate in ganglion therapy utilizing aspiration, intralesional steroids (triamcinolone acetate) administration, loop suture approach, versus surgical resection. Material and Methods: -In this prospective and observational study, 50 participants were categorized into 3 groups and managed at GMC Kota during March 2019 and December 2020. Aspiration followed by intralesional steroid (triamcinolone acetate) injection was given to Group A (89 participants), loop suture method was given to Group B (55 patients), and surgical excision was given to Group C (16 patients). Patients were monitored on for up to a year after therapy at one, three, and six months. Results: Out of 89 patients in group A, 88 (98.76%) had pain alleviation, no scars, and just four (4.49%) had recurrence, which was handled by repeating the treatment. Out of 55 patients in group B, 52 (94.55 percent) experienced pain reduction, while three (5.45%) experienced recurrence. In group C, out of 16 patients, 14 (87.5%) experienced pain reduction, while 16 (100%) experienced linear scarring with recurrence (6.25 percent). Patients in group Aexperienced recurrence, which was treated with intralesional steroid.
The aim of the study was to evaluate results of benign cystic lesions of proximal femur treated by non vascularized autologous fibular strut graft and supplementary fixation using cannulated cancellous screw. Non vascularized autologous fibular strut graft which act as mechanical as well as biological graft. The hypothesis behind this study to add fixation to fibular strut graft which helps in immediate structural support, early consolidation of defect and remodeling. Methods and Materials: We prospectively and retrospectively evaluated clinical outcomes of surgically treated 8 patients with benign lytic lesions of proximal femur. Out of these 6 were males and 2 females with mean age of presentation was 17 years. Average follow up time was 36 months. Histological diagnosis included simple bone cyst, aneurysmal bone cyst, fibrous dysplasia. Results: 8 patients with benign cystic lesions of proximal femur were treated with curettage and autologous fibular strut grafting. The average operation time was 148 minutes. All patients were allowed unprotected full weight bearing by a mean of 13.2 weeks after surgery. All patients had regained normal unrestricted activity without pain by 12 months of follow up. None of the patients sustained pathological fracture of femur following the surgery. All patients achieved partial or complete consolidation of the lesion within 8 months. None of the patients had local recurrence of tumor in their long follow up. None of the patients were suffered from postoperative wound infection, deep vein thrombosis, chronic hip pain. Conclusion: We conclude that non vascularized autologous fibular strut graft with internal fixation using cannulated cancellous screws is a safe and effective method of treatment for benign cystic lesions of proximal femur.
Original Research Article Objectives: The treatment of femoral neck fractures shows a relatively high number of poor outcomes, usually due to late complications, such as avascular necrosis of the femoral head,non/mal union. The aim of this prospective study was to evaluate a group of patients treated by osteo-synthesis for intra-capsular femoral neck fractures at our department, and to find appropriate implant choice for subtype of fracture neck of femur and complication. Methods: A prospective study carried out on 30 patients aged 18-55 years, who had complete femoral neck fracture. All fractures were classified on the basis of pauwel'sand anatomical classification.All patients were treated between 2 to 7 days after injury and followed for 12 months. Results: Basicervical type fractures were diagnosed in 10 patients, transcervical 12 and 8 had subcapital type fractures. Bone union without complications was achieved in 66.6 % of the patients within 12 months of surgery. Late complications were found in 33.3 % fracture. Conclusion: DHS with derotation screw is biomechanically and functionally very stable construct for fixation of fracture neck of femur fracture in young adults.in basicervical and transcervical types of fracture, results are satisfactory but in subcapital types of fracture its use is still in dilemma.
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