<p class="abstract"><strong>Background:</strong> Displaced or unstable proximal humeral fractures fare poorly with non-operative treatment. These are better treated with surgical intervention in order to prevent minimal displacement of tuberosity or articular surface from compromising the long term articular function. The objective was to assess the functional outcome of patients treated with PHILOS (the proximal humeral internal locking osteosynthesis) plate in proximal humerus fracture.</p><p class="abstract"><strong>Methods:</strong> 42 patients age group range between 20 and 80 years 61.9% are male and 38.1% are female treated with philos plate. Functional outcome measured by using Constant and Murley score.<strong></strong></p><p class="abstract"><strong>Results:</strong> 50% were Neer two part fractures, 35.7%, three part fractures, 14.3%, four part fractures. After 6 month follow up functional outcome assessed by using constant and Murley score. Excellent outcome in 1 (2.4%) good outcome in 13 (31%), fair outcome in 19 (45.2%) and poor outcome in 9 (21.4%) noted.</p><p class="abstract"><strong>Conclusions:</strong> PHILOS plate fixation of proximal humerus fracture is an effective surgical technique in maintaining stability of fractures and there is significant improvement in functional outcome.</p>
<p class="abstract"><strong>Background:</strong> A major dilemma still exists regarding management of unstable fractures of thoraco lumbar region. A posterior short segment spinal fixation without bone grafting improves spinal alignment, early ambulation and subsequent decrease in complications arising out of prolonged bedrest.</p><p class="abstract"><strong>Methods:</strong> A total of 30 patients presenting at the Accident and Emergency Department meeting the inclusion criteria were recruited for the study. A complete neurological and radiological assessment was done preoperatively, immediate post operatively and after 6 months using Frenkels grade system and Denis pain scale and Denis work scale respectively.<strong></strong></p><p class="abstract"><strong>Results:</strong> A statistically significant difference was observed between the initial kyphosis of the injured vertebra as compared to immediate postoperative period (p<0.0001), Improvement in neurological status was statistically significant at 6 month follow up (Z=4.355, p=0.00). Functional assessment revealed that 47% of the subjects experienced a minimal pain with a mean pain score of 1.9 with a mean functional score of 3.83 at the final follow up.</p><p class="abstract"><strong>Conclusions:</strong> Our study shows that short segment spinal fixation in unstable fractures of the thoraco lumbar spine provides a comparable neurological and functional outcome and is a reliable management option.</p>
<p class="abstract"><strong>Background:</strong> In this study, unstable thoracolumbar spine fractures with neurological deficit fixed with Moss Miami pedicle screw and decompression were followed up for neurological improvement (sensory and motor functions). Patients were admitted in the department of Orthopaedics, Government medical college, Kottayam from November 2016 to October 2017.</p><p class="abstract"><strong>Methods:</strong> In this observational study, 96 patients (aged 17 to 60 years) are followed up. The preoperative neurological status and post-operative recovery are follow-up at 1, 3 and 6 months and graded by Frankel’s grading. Change from Frankel’s grade A OR B to Frankel grade C, D OR E was said to be improved neurologically.<strong></strong></p><p class="abstract"><strong>Results:</strong> 87.3% males and 12.7% females with 58.3% patients having fall from height sustained wedge compression fractures (49.1%), burst fractures (46.8%) and fracture dislocations (4.1%). vertebra fractured were L1-31.4%, T12-22.9% and L2-19.7%. Complete paralysis was 44.8% and 55.2% incomplete. At 6 months 75% patients showed improvement and 25% patients showed nil. 95.5% patients (18-30 years) showed improvement and only 50% (51-60 years). Incomplete neurological deficit showed significant improvement (100%) compared to patients with complete paralysis (44.2%). Preoperative Frankel score has significant relationship with final neurological (44% of patients with Frankel A and 100% with Frankel D.</p><p class="abstract"><strong>Conclusions:</strong> Moss Miami pedicle screw stabilization with decompression is an effective surgical technique in maintaining stability of spine in traumatic paraplegia and paraparesis patients and there is significant improvement in neurological status.</p>
<p><strong>Background:</strong> The primary goal in management of intra articular fractures of distal humerus is to achieve stable and mobile elbow. Type C fracture of distal humerus is a relatively uncommon fracture. Internal fixation is difficult but anatomical reduction is needed to prevent poor functional outcome and degenerative changes.</p><p><strong>Methods: </strong>Functional outcome of patients who underwent open reduction internal fixation with locking compression plates for intra articular fractures of distal humerus at the department of orthopedics, Government medical college Kottayam, from December 2017 to July 2019, were assessed using Mayo elbow performance index. A total of 30 patients were studied.</p><p><strong>Results: </strong>Excellent and good results were found in 25 cases, 3 patients had fair outcome and 2 patients had poor result. Complications encountered in our study were, infection (superficial treated with antibiotics-3 cases), heterotopic ossification (3 cases), hard ware prominence (2 cases) and non-union (1 case).</p><p><strong>Conclusions: </strong>Complications were minimal and outcomes were good in patients with type C distal humerus fractures who underwent bicolumn locking compression plates fixation by posterior approach.</p><p class="abstract"> </p>
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