Comparison between Distractor Application on Both Radial & Ulnar Side and Radial Side Only for Fracture Distal Radius with Ulnar Styloid Fracture

Abstract

Background: Fracture of distal radius with involvement of the ulnar styloid process is a common clinical problem. It can be treated conservatively, usually involving wrist immobilization in plaster cast or surgically. A key method of surgical fixation is external fixation by distractor. Distractor can be applied either only on the radial side or on both ulnar and radial sides. Materials and Methods: A prospective randomized and comparative study of 1 year duration was conducted on 32 patients admitted in the Department of Orthopaedics of BSMC & H in the age group of 20 to 75 years old with AO types B and C distal radius fracture along with involvement of the ulnar styloid process. The parameters studied were restoration of radial length, restoration of radial angle, intracarpal step-off and palmar tilt which were statistically evaluated and Fisher's exact test was performed. The two tailed P-value was calculated and both the groups were statistically compared. Results: In our study, 37.5% patients in Group A and 81.25% in Group B had a radial difference <3 mm which was statistically significant (Table 1, Chart 1). 43.75% patients in Group A and 87.5% in Group B had radial angle <5' which was significant (Table 2, Chart 2). 31.25% in Group A and 75% had intra carpal step off <2 mm which was again statistically significant (Table 3, Chart 3). 62.5% had an abnormal palmar tilt in Group A while only 6.25% had an abnormal palmar tilt in Group B which is extremely statistically significant. On an average, 2 mm of distraction was required in 75% patients of Group A while only 30% patients in Group B required distraction (Table 4, Chart 4). Conclusion: In our study, the radial difference, radial angle, intra carpal step off and palmar tilt returned significantly to normal in the patients treated with distractor on radial side only when compared with distractor application on both radial and ulnar sides for distal radius fracture with ulnar styloid process involvement. Also post-operative distraction required under image intensifier was higher in the group treated with distractor on either side than those with distractor only on radial side.

A prospective comparative study between proximal femoral nail and dynamic hip screw treatment in trochanteric fractures of femur

“…These results conclude that that PFN procedure was technically difficult compared to DHS procedure which is in line with the studies Jonnes et al and Faisal et al 10,15 In our study average hospital stay was 17.13 days for DHS and 16.86 days for PFN. This was similar to the studies of Bhatti et al 16 There were less delayed complications in the PFN group compared to DHS group in the current study, which was supported by the studies Faisal et al and Bhakat et al 17 DHS treatment involves wide surgical exposure there by involves considerable blood loss. Also, complications such as varus collapse, implant cut-out was commonly associated with it.…”

Dynamic hip screw versus proximal femoral nail in the treatment of intertrochanteric fracture of femur

“…In their study, Bhakat et al found fewer complications in the PFN group compared to the DHS group. 14 Gupta et al found in a case series of 400 intertrochanteric fracture patients that PFN has a superior functional prognosis with unstable fractures and requires a reduced operation time. 15 The aggregate ratios for non-union and implant failure in PFN were 1.9% and 2.2%, respectively, according to a meta-analysis.…”