Introduction:The understanding of the anatomical configuration of the fractures of the capitellum has enhanced in the last few years and the classification of these fractures continues to evolve. It is essential to tailor the surgical approaches to these fractures based on the state of the art classifications. Materials and methods: 33 patients with fractures of the capitellum were included in this retrospective study conducted at Bidar Institute of Medical Sciences, Bidar. The mean age of the patients was 37.5 years and the mean follow-up period was 24.6 months. Seventeen patients had Bryan-Morrey type I fracture, three had type II fracture, two had type III fracture and eleven had type IV fracture. Of the 11 patients with Bryan-Morrey type 4 fracture, 5 patients belonged to Dubberley 2A and 3A category and 6 patients belonged to Dubberley 2B and 3B category. Bryan-Morrey type 1 fractures were approached via extended lateral approach. Bryan-Morrey type 2 and type 3 fractures were approached via anterolateral approach. Dubberley 2A and 3A fractures were approached via the anterolateral approach and Dubberley 2B and 3B fractures were approached via the posterior trans-olecranon approach. Results: Fracture united in all except two patients who showed slight delay in union. Two patients had avascular necrosis of the capitellar fragment. The mean range of flexion/extension was 135.3 °and pronation/supination was 168.8 °. The mean Mayo Elbow Performance Index at final follow-up was 92.5 (S.D±5.8). Based on the MEPI score, 14 patients had excellent, 10 patients had good, 6 patients had fair and 3 patients had poor results. Conclusion: Correct choice of surgical approach facilitates accuracy of reduction and fixation of these difficult fractures. Poor results were seen mainly in fractures belonging to Dubberley type 3B category.
In younger patients, proximal humerus fractures are usually caused by high-energy trauma, such as traffic accidents or sporting accidents. In older patients, the most common cause is a fall on the outstretched arm from a standing position, which is a type of low-energy trauma. The study design was two year prospective study. Patients sustained with proximal humerus fractures presenting at Department of Orthopedics, were included in the study. In this study, 56% of the patients presented with 2-part fracture, 37% with 3-part fracture and 7% with 4-part fracture of the proximal humerus according to Neer"s classification.
Fracture of middle third of the clavicle is greatly underrated with respect to pain and disability they produce especially during the first three weeks of treatment. It is also impossible to support and immobilize a fracture of middle third of clavicle in an adult by external means with figure -of-eight bandages. General information like name, age, sex, occupation and address were noted. Then a detailed history was elicited regarding mode of injury like fall on the shoulder, Road traffic accident, direct injury to shoulder and fall on outstretched hand. Enquiry was made to note site of pain and swelling over the affected clavicle. Past medical illness and family history were also recorded. In type-2 middle third fracture type-2 B1 (displaced with simple or single butterfly fragment) occurred in 18 patients (90%) and type-2 B2 (displaced with comminuted or segmental) fracture occurred in 2 patients (10%).
Introduction:The definition of polytrauma varies among different specialty and different countries, polytrauma patients are the subgroup of severely injured patients who have sustained injuries to more than one body region and organ with any one of the injury being life threatening. Early appropriate care (EAC), is an immediate resuscitative treatment protocol in orthopaedic trauma management in which we aim to feature any major trauma and address the most time critical injuries of body without adding to their physiological overload to the system. The aim of early appropriate care is to fix and stabilize the central skeletal system along with peripheral long bones of the skeletal system to reduce the risk of complications. Materials and Methods: It is a prospective observational study conducted from October 2016 to November 2017 and 29 patients in the study with a mean age of 35years. All patients were managed by Early Appropriate Care. The average time taken to resuscitate the patients was 8 hrs. Following surgery patients were followed up for one month to observe post operative complications. Results: In our series 3 patients developed pulmonary embolism, patients who developed complications were managed successfully without any mortality. Thus, a low incidence of mortality seems to be associated with EAC protocol in our series as well as in the existing literature. Conclusion: Following adequate resuscitation and correction of acidosis early definitive fixation is possible for bony injuries of polytrauma patients which avoids the need of second surgery, also reduces the hospital stay duration, reduces post operative complications and early rehabilitation protocols can be made.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.