Background: Tibial condylar fractures are often associated with depression of articular surface and commonly used classifications describe various fracture patterns. However, these classifications do not address the types of depression of articular fragments, so we tried to classify various types of depressions of articular surface associated with tibial condylar fractures and developed a treatment algorithm based on our study, with an aim to facilitate step-wise approach for classifying and modes of elevation of depressed fragments. Material and Methods: This was an intervention study of 950 tibial condylar fractures operated at our center by single surgeon between March 2002-2016. These patients were retrospectively evaluated for radiographic and functional outcomes.
Results:The study revealed mean post op condylar tilt of 5.38 ±3.55, (0-12), condylar widening of 2.68 ±1.25 (0-6mm), articular step 2.98±1.86 (0-8mm), valgus tilt 6.64±3, (0-13) and mean knee society score of 84.39±6.3, (60-98) at follow-up of 12 months post-op. All the cases were followed up for at least 24 months, mean follow-up time 87.39 35. 97 months (7.25+2.91 years).The average radiographic bony union time was 17.07 ±1.4, (14-22wks) weeks, the average full weight bearing time was 15.04 ±2, (12-24) weeks. The average range of motion of the affected knees at 12 months was 127. 6±4.46, (120-135). Conclusion: Based on our study of the various types of depression of articular surface in tibial condylar fractures, we were able to classify depression, facilitate steps of surgery and improving outcomes.
Background: Various situations in orthopedic surgery needed a second surgery. Though the need of a second surgery cannot always predicted. Despite a well-done procedure, 3.6% cases may still need a second surgery. In modern-day-trauma, with increasing speed-of-travel, we have to face the challenges of 21 st -century and rate of Complex-Comminuted-Devitalized-Fractures (CCD) have tremendously increased. Aim and Objectives: To help identify common orthopedic situations which need a second surgery. Material and Methods: This retrospective study was carried from 1989-2010, on 25,550-procedures operated at our-centre of total 3060 patients. The study included patients from 5-80 years of age, and excluded surgeries done for congenital and neoplastic disorders. Results: Out of 25,550 procedures, 3,060 procedures were second surgeries. Indications for the second surgeries were studied and analyzed.
Conclusion:We conclude that this is a revolutionary concept and would help each orthopaedic surgeon across world to classify every fracture with this classification, where they feel need for second surgery. It would improve our rationale of treatment and significantly improve prognosis and final outcomes.
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