Introduction: The management of undisplaced fractures of the scaphoid is controversial. Conventional management of these fractures has been with significant risk of scaphoid nonunion. Objectives: Our objective was to study if early per-cutaneous fixation of scaphoid fractures results in early return to work and sports activities, better union rates, better pain relief and better range of motion of wrist. Methodology: This study examined the results from 30 patients who underwent per-cutaneous screw fixation using a Herbert screw in an un-displaced scaphoid fracture. All patients in the study group were followed up for average 2 years evaluating them according to the Green & O'Brien score. Results: All had healed successfully after the index procedure. There were three complications consisting of wrist pain and decreased range of motion of wrist. These also went on to heal, resulting in better union rates. Conclusion: Thus per-cutaneous fixation of acute, un-displaced scaphoid fractures with percutaneous Herbert screws is an effective treatment which reduces the need of prolonged immobilization and helps in an early return to the routine activity.
Shoulder instability is a common problem that is encountered in young population nowadays due to the increase in the number of road traffic injury cases causing shoulder dislocations. The most common amongst them is anterior shoulder instability which can be diagnosed clinically and radiologically. The aim of the paper is to evaluate the correlation of these clinical and radiological findings to arthroscopic findings and treat these injuries arthroscopically and compare their clinical outcome to open repair of anterior shoulder instability. Materials and Methods: To assess 20 cases of anterior shoulder instability clinically, radiologically and corelate it with arthroscopic evaluation of the instability and to compare open repair and arthroscopic repair of these injuries. Results: 20 patients who had anterior shoulder instability and underwent a diagnostic shoulder arthroscopy showed that all 20 of them had Bankart's lesion with 14 of them having an accompanying Hillsach's lesion. Amongst the 14 patients with Hillsach's lesion, 12 of them had a bone loss of less than 10% so were operated for arthroscopic Bankart's repair and the remaining 2 patients had a bone loss of 13% and 15 %. Both these patients underwent an additional Bristow Latarjet capsulolabral repair as the bone loss was less than 25% where using the Tasaki technique the coracoid process was transferred and fixed to the anterior glenoid. Conclusion: Overall, we have come to a conclusion that "Arthroscopic Evaluation and Management of Anterior Shoulder Instability" is a better method in evaluating the instability as it has a better sensitivity and specificity in identifying the pathology compared to an MRI, gives excellent results when repaired using suture anchors and gives excellent range of motion of the shoulder.
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