Proximal humerus fractures account for 4-5% of all fractures. Traditionally, the surgical treatment options for fractures of proximal humerus includes transosseous suture fixation, intramedullary nailing, plate-and-screw constructs and percutaneous pinning. The ideal treatment of displaced proximal humeral fracture is still the centre of scientific debate. The use of external fixators in the management of proximal humeral fractures has begun to gain acceptance over the last 10 years. The idea of biological fixation now leads to the fact that the blood supply to the head of the humerus is preserved. The smaller K-wires used in JESS have lesser risk of soft tissue, neural, and vascular injury. Multiple K-wires used add to the rotational stability to a reduced fracture. We hereby present our clinical experience in treating 18 such patients over a period of4 Years and 9 months by JESS. We used a novel frame structure as compared to those described elsewhere. The mean Constant -Murley score was 81 in our series. Overall, the results could be regarded as good. In our view, JESS should be considered as an alternative option in treating Neer's 2 part, 3 part and 4 part valgus impacted fractures with minimal complications and good results.
OBJECTIVES:The present study is conducted to evaluate the fracture healing and functional results of combined dynamic with static external fixator for comminuted distal radius fracture. Material and methods: Twenty three adult patients with twenty six comminuted distal radius fractures between age group of 21-67yrs were included. There were five Fry kman type 6, ten Frykman type 7 and eight Frykman type 8 fractures. Closed reduction with ligamentotaxis and percutaneous k-wire fixation was done. Wrist spanning mini external fixator was applied and the kwires supporting the intra-articular reduction were incorporated into the fixator. The fixator was dynamized at 3 weeks by removing the metacarpal pins and cutting short the connecting rod. The dynamized frame was maintained for 3-6weeks. The patients were followed up for 1 year. Gartland and Werley scoring system was used to assess functional outcome. RESULTS: Average time to union was 7.4 weeks. 11 patients (48%) were rated as excellent, 9 (40%) rated as good and 3 (12%) as fair under Gartland and Werley score. CONCLUSION: Our technique of modified JESS fixator did demonstrate good anatomical restoration and early objective functional results.
Introduction: Femoral neck fractures occur most commonly in elderly females. They are common in patients above 60 years of age. Materials and Method: We undertook this study to assess the functional outcome of bipolar hemiarthroplasty. 30 patients above 60 years of age, with intra-capsular fracture neck of femur were undertaken for the study. They were operated with either cemented bipolar hemiarthroplasty. The clinical and radiological follow-up was done for a minimum period of 6 months. The results were assessed using Harris hip scoremodified (HHS). Results: Out of 30 patients, 18 were females and 12 were males with an average age of 64 years. 14 patients had associated co-morbidities. After 6 months of follow-up using HHS, 14 had excellent results, 12 had good results, 1 had fair results and poor results were observed in 1 patient. The mean Harris hip score was 88.5. There was one mortality and one patient was lost to follow up. There was no stem subsidence, acetabular erosion, acetabular protrusion, or heterotopic ossification in any of the patients during the follow-up period. Conclusion:All the patients had satisfactory functional outcome. To conclude, bipolar prosthesis is a safe option in treating fracture neck of femur in the elderly with good recovery in-spite of having several co-morbidities.
BACKGROUND: High energy complex tibial plateau fractures are usually associated with severe soft tissue injury overlying the fracture. Locked compression plating has clear biomechanical advantages and loss iatrogenic tissue damage when compared with conventional plating. MATERIAL AND METHOD: Between January, 2012 to June, 2013, 20 patients with Tibial plateau fractures were included in this prospective study. All fractures were treated with locked compression plating using open/MIPO approach. Clinical and radiological data, including fracture pattern, changes in alignment, local and systemic complications, and hardware failure and fracture union were analyzed. RESULTS: Twenty patients have been evaluated, with mean follow up of 13 months fractures were treated percutaneously in 30% of cases. All but 1 fracture progressed to union at a mean of 15.5 (14-18) weeks, 95% cases had acceptable anatomical and functional outcome (Rasmussen's criteria). CONCLUSION: Biomechanically, this plate works as an "Internal fixator" rather than a plate. It preserves periote blood supply and provides fixed angle stability.
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