Introduction: Spontaneous bilateral neck femur fracture occurs following many conditions. It is very rare event. It can be seen in young, middle aged, and elderly people with no preceding trauma. We report a case in middle aged person who got fracture secondary to chronic liver disease and Vitamin D3 deficiency and who underwent bilateral hemiarthroplasty. Case Report: A 46-year-old man came with sudden onset of bilateral hip pain with no history of trauma. It was started with difficulty in moving the left lower limb since February 2020 and after about 1-month period patient got right hip pain which made the patient completely bedridden. He also complained of yellowish discoloration of eyes associated with weight loss, malaise. No history of tremors in hand. No history of seizures. Conclusion: It is a not a common condition. Spontaneous bilateral neck femur fracture occurs following chronic liver disease and Vitamin D3 deficiency. Both these conditions lead to increase osteoporosis and osteomalacia thus making it more susceptible to fracture. Keywords: Spontaneous, bilateral, chronic liver disease, Vitamin D3, neck femur.
Introduction:The following study was conducted to examine the short term clinical and radiological results particularly early complications and healing rate of tibial plateau fractures treated with LCP by minimally invasive technique. Methodology: The study was conducted in patients treated for tibial plateau fractures (type 1 to 4 Schatzker classification) at Adhichunchangiri Institute of Medical Science, BG Nagar from the month of May 2011 to May 2016. Fifty tibial plateau fracture patients were taken into the study, all were fixed with LCP using minimally invasive technique. Patients' age ranged from 20 to 70 years with a mean of 45. Results: The sample consisted of twenty patients with 38 males and 12 were females. The patients' ages ranged from 20-70 years with a mean age of 45 years. The causes of fractures were motorvehicle accident in 36 patients and fall in 14 patients. There were no sports or industrial accidents. 31 fractures involved the right side and 19 involved the left. The average length of hospitalisation was 12 days with a range of 7 to 20 days. The average number of days from injury to surgery was 5 days with a range of 2 to 10 days. The operative time ranged from 45 minutes to 100 minutes. Patients were followed up from 01 to 24 months. Functional outcome was rated as per NEER'S RATING SCORE, we got excellent results in 24 cases, good in 15, fair in 08 and poor in 03 patients. Conclusion: Treatment of tibial plateau fractures using LCP provides good results. Since we have used minimally invasive technique soft tissue damage is minimal thus promoting good healing of fracture and less infection rates. Our early results were encouraging but long term studies are needed to prove definitively acceptable outcomes so that the technique can become part of the in the armamentarium of the orthopaedic trauma surgeon. Keywords: Tibial plateau fracture, Schatzker classification, Minimally invasive technique, Locking Compression Plate, NEER'S Rating Score IntroductionTibial plateau fractures are on a raise due to increased incidence of road traffic accidents and also at the same time the surgical management for the same are also being modified continuously [1] . The luxuries of our life in the present time is at the cost of rapidly increasing industrialization, urbanization and mechanisation -so also the traumatic cases are on increase. Crowded cities, irregular traffic arrangement, fast moving vehicles are the most important contributory factors causing bony injuries, particularly polytrauma, comminuted fractures and also the soft tissue injury [2] . Tibial plateau fracture is one of them. Tibial plateau fractures have been studied and reported extensively and exhaustively but still controversy exists over its management, whether surgical or conservative. Even undisplaced tibial plateau fractures should be operated, so that early mobilization of knee is possible [1] .
Background and Objectives:With increasing number of vehicles on the roads in India, complex trauma cases caused by traffic accidents have increased progressively. Fracture Tibia are among the commonest fractures sustained in road traffic accidents due to the subcutaneous nature of the tibia, they are frequently open and contaminated fractures. Due to the poor blood supply and poor soft tissue coverage these fractures are frequently complicated by delayed union, malunion, non-union and infection. Controversy exists as to the optimal method of stabilization of compound fractures of Tibia. External Fixation devices had been quite popular in the management of these fractures, but lately unreamed intramedullary nail is being used as the initial management of these fractures as external fixation devices are associated with complications such as communition, displacement, soft tissue injury and pin tract infections moreover wound management and skin closing procedures are easier with Intramedullary nailing, Studies have shown that reaming disrupts the cortical blood flow to a greater extent than the Unreamed nails thereby increasing the susceptibility to infection. When comparing the Unreamed IM nail to the Reamed IM nail, the Unreamed nail with interlocking may provide the same stability as a closely fitting tubular nail but without the danger of jamming. Thus considering all these studies, the Unreamed IM Nail can be used for the management of Compound fractures of Tibia. This study was conducted at the Department of Orthopaedics, Adichunchanagiri institute of medical sciences to evaluate the results of interlocking intramedullary nailing using an unreamed nail in the treatment of the compound fractures of tibia. It was done to compare the advantage of using an interlocking intramedullary nailing without reaming in the treatment of compound fractures of tibia with various studies in terms of time required for union, rate of malunion and malrotation, infection and range of motion of knee and ankle. Materials and Methods: This study was performed on 50 compound fractures of tibia with an unreamed interlocking intramedullary nail at Adichunchanagiri Institute of Medical Sciences & Research centre after attaining ethical clearance. All the cases selected were fresh fractures and mostly traumatic in nature. The procedure was done as early as possible and the secondary procedures of Dynamisation, skin grafting and musculocutaneous flap were done as and when needed. The cases were followed up for an average period of 18 months with 4 visits (6 weeks, 3 months, 6 months and 12 months) Results: Compound fractures of the tibia managed using an unreamed interlocking intra medullary nail gave good functional results and patient satisfaction. It involved minimal surgical trauma and less blood loss. It provides the advantage of early ambulation, lower rates of infection, non-union, mal union and delayed union compared to other treatment modalities. It allows early weight bearing and shorter hospital stay. Interpretation a...
Background and Objective: Femoral neck fractures have been considered 'unsolvable fracture' in the olden era of orthopaedics due to high rate of associated complications, which include nonunion and avascular necrosis of the femoral head. Prosthetic replacement as a primary procedure eliminates osteonecrosis and non union as complications of femoral fractures and also allows immediate weight bearing to return elderly patients to activity and help avoid complications of recumbency and inactivity. 2 The decision to perform hemi arthroplasty using a unipolar or bipolar prosthesis remains controversial, with proponents on either side. So, in view of varied opinions we desire to compare the efficiency of these two prosthesis unipolar and bipolar prosthesis for the management of intra capsular fracture neck femur in elderly. Methods: 112 patients above 60 years and an acute displaced fracture of the femoral neck were randomly allocated to treatment by either AMP or bipolar HA, in the department of Orthopaedics, AIMS BG Nagara between May 2013 to May 2016.The patients were followed up at 6weeks, 12 weeks, 6 months and 1year. Functional outcome was assessed and compared with Harris hip score and radiological parameters Results: The two groups of patients with mean age of 70.4 in AMP group and 69.1 in Biploar group did not differ in their pre-injury characteristics (sex, fracture pattern, comorbidity, mode of injury and preinjury ambulatory status) and perioperative parameters such as duration of operation, blood loss, hospital stay and mortality. The mean Harris hip score in Bipolar and AMP group was 90.03 and 84.4, respectively. Functional activities like use of public transport was better with bipolar group. Incidence of complications like Superficial infection, haematoma and acetabular erosion was encountered in AMP group. Conclusion:The use of a bipolar endoprosthesis in the management of displaced femoral neck fractures in the elderly was associated with better mean Harris hip score and incidence of complications was limited. Hence, bipolar would be a better option in elderly patients with fracture neck of femur. Moreover the cost difference between AMP and Bipolar prosthesis is not much in our country.
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