Introduction: Open vertical patella fractures in combination with distal femoral or proximal tibial fractures are a rare combination of injuries that pose a challenge for adequate fixation and gaining favorable outcome. Case Report: Case 1 had an open fracture of sagittal fracture of patella with one half comminuted and a sagittal plane fracture of lateral femoral condyle with a 2 × 2 cm of articular bone loss. Case 2 had an open sagittal fracture of patella with ipsilateral lateral femoral condyle fracture and proximal tibia medial condyle fracture in sagittal plane. Case 3 had a closed comminuted fracture of patella with sagittal plane lateral femoral condyle fracture. Conclusion: Open vertical plane patella fractures with associated distal femoral or proximal tibial fracture when treated properly can restore knee function optimally. Keywords: Vertical patella fracture, open knee injuries, complex knee trauma.
The wrist joint is one of the most important joints in human body, essential to carry out day to day activities. Fractures of the distal end of the radius are amongst the most common fractures encountered in clinical orthopaedic practice. Learning how to anatomically fix these fractures, so that good functional outcome is obtained is very important. The principle of ligamentotaxis can help in reduction of certain fractures. However, some specific fractures require additional stability. This can be done with certain closed procedures like K-wires and External fixator in adults. In this prospective study, we studied 26 patients from July 2020 to October 2021 having AO type 2R3C1 and C2 treated with K-wires + External fixator. Patients were followed up for an average of 9 months and functional outcome was calculated using Green O'Brien and Gartland and Werley scoring system.
<p class="abstract"><strong>Background:</strong> The aim of this study was to evaluate the results of intramedullary nailing in diaphyseal fractures of radius and ulna in age group of 10 to 49 years and to understand its clinicoradiological and functional results.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective case series study of forearm bone fractures and the selected management for the same over a period of 3 years. We chose the cases in which intramedullary nailing was the treatment modality which were followed up over a period of minimum 6 months. Patients with galeazzi variety, monteggia variety, pathological fracture or non-union after previous surgery were excluded. The outcomes were then evaluated with disabilities of the arm, shoulder and hand (DASH) score, Green and O’Brien score, and Grace and Eversmann functional outcome score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of the 22 patients, 10 patients had excellent functional outcome according to Grace and Eversmann score, 7 patients had good outcome, 4 patients had acceptable while 1 was unacceptable. Green and O’Brien also had similar results, except that patients among fair category were 3 and poor category were 3. The mean DASH score was 16.2.</p><p><strong>Conclusions:</strong> This study shows that closed method for fixation by intramedullary nailing of both bone forearm fractures leads to excellent to good functional outcomes (according to DASH score, Green and O Brien, and Grace and Eversmann score) with less complications. In 6 months follow up x ray there is radiological union in all cases with no angulation, malunion or non-union. </p>
Background: Proximal humeral fractures are one of the commonest fractures in elderly population. They are right behind hip and distal radius fractures in incidence constituting about 1/7 th of all fractures. Due to the debatable management of proximal humerus fractures in elderly population, we decided to evaluate the long term outcome of the same. Method: In this study 62 patients having proximal humerus fracture were included who were treated with locking plate fixation over a period of 4 years. Out of those patients, 51 patients who completed 3 years of follow up were evaluated for this study by using Constant Morley score (CMS). We used SPSS 16 for statistical analysis. (P <0.04). Result: Excellent outcome was seen in 17.64%; Good in 35.32%; Moderate in 33.32% and Poor in 13.72%. Score was found to be less in AO-OTA Type 3 fractures & for older patients (>60 years age). Loss of fixation was seen more with a varus malalignment. Complications included Infection, avascular necrosis, loss of fixation, axillary nerve palsy, screw perforation of head and sub acromial impingement. Conclusion:The use of PHLP for fixation of Proximal Humerus fractures leads to reasonably good functional outcomes. It is much better than the use of non-locking plates. However the procedure requires extensive surgical skill and knowledge of mechanisms of locking plates.
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