Introduction:The study was conducted to assess for clinical and radiological outcome particularly complications and healing rate of distal tibia fractures treated by locking compression plate using minimally invasive percutaneous plate osteosynthesis technique. It preserves soft tissue with limited operative exposure. Objectives: Assess the clinical and radiological outcome of distal tibia fractures treated by locking compression plating using minimally invasive percutaneous plating. To evaluate the healing rate, radiological outcome and complications in these cases. Methodology: Study was conducted in all patients with distal tibia fractures admitted to our Al-Ameen medical college hospital, Vijayapur from November 2015 to November 2017. Twenty patients with mean age of 38 years was taken into the study. Patients were followed up at regular intervals. Clinical and radiological outcome were evaluated at the end of one year. Results: There were fourteen males and six female patients enrolled in the study. Fracture united in all twenty patients. All were extra articular fractures which were classified based on Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification. Seven patients had associated fibula fracture. Mean duration for fracture union was 18.8 weeks. Post operatively three patients had ankle stiffness, three had occasional pain and two patients developed superficial wound infection. Based on modified ankle score of Olerud and Molander, we got excellent results in five cases, good in eight, fair in five and poor in two cases. Conclusion: Locking compression plating using minimally invasive percutaneous plate osteosynthesis technique is a good treatment option for fractures of distal tibia. Accurate positioning and proper fixation of the plate with minimal dissection are essential to produce good clinical and radiological outcome. We strongly recommend this procedure for all extra articular distal tibia fractures.
<p class="abstract"><strong>Background:</strong> The objective was to study the effectiveness and drawbacks of short proximal femoral nail in the management of unstable intertrochanteric fractures.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in the department of orthopaedics Al-Ameen medical college, Vijayapura, Karnataka, India from July 2010 to June 2017. Total 175 patients (130 males and 45 females) aged between 41 to 80 years with unstable Intertrochantreric fracture (155 had type IV and 20 had type III according to Boyd and Griffin classification). All patients were operated using Short proximal femoral nail and followed at least for a minimum period of 6 months and were evaluated radiologically and clinically by Kyle’s Criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> Anatomical reduction was achieved in 125 patients, 105 (60%) had no complications post operatively. Complications included 5 cases of avascular necrosis and screw cut out, 5 cases of delayed union, 5 cases of Z-effect, 20 cases of varus malunion, 10 cases of antirotation screw breakage, 5 cases of distal bolt breakage and 15 cases with lateral thigh discomfort. 125 patients had No shortening and the average shortening was 0.34 cm, average time of union was 19.26 weeks (15-30 weeks) in 170 cases. At the end of 6 months, good to excellent results were seen in 71.5% of cases, 57% patients returned to their pre injury functional level.</p><p class="abstract"><strong>Conclusions:</strong> Short proximal femoral nail provides good fixation for unstable intertrochanteric fractures, if proper pre-operative planning, good reduction and surgical techniques are followed leading to high rate of bone union and minimal soft tissues damage especially for Asian patients with relatively small femora.</p>
Subtalar dislocation is an unusual clinical case with very little mention in literature constituting nearly 1% of all traumatic dislocations. Here a 40 year old male who sustained fall over inverted foot was diagnosed as closed isolated medial subtalar dislocation with no associated fractures. This is an even more rare entity. Immediate closed reduction was done and immobilised for 4 weeks with below knee cast. This case report describes the mechanism of injury, ligaments involved, manoeuvre of closed reduction. This case report highlights the importance of prompt and urgent reduction and short period of immobilisation to avoid complications and better prognosis. Keywords: Subtalar dislocation, Basketball foot, Isolated, Medial, Arthritis.
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