ABSTRACT
Background and Objective: Fractures of the distal radius are common with a variable prognosis in case of intra articular extension. The available options include Plaster, External fixation, Prefabricated Splintage using Ligamentotaxis, K-wire fixation, and open reduction internal fixation with T-plate without an as yet clear advantage of one over the others. If these fractures are allowed to collapse, radial shortening, angulation and articular incongruity may cause permanent deformity and loss of function. This limited small scale study was intended to compare the functional results of treatment of these fractures with a T plate and K-wires
Methods: This was a prospective experimental study conducted at department of Orthopedics of PGMI/Lahore General Hospital, Lahore. Total 30 patients were included and randomized into two groups of 15 patients each. Group-A patients were treated with Krischner's wires and Group-B patients were treated with a T-Plate with open reduction. Informed consent was taken. Post operative follow up was done for 12 weeks for the outcome parameters [Green and O'Brien score]
Results: Mean age of patients in Group-A and B was 36.13 +/- 9.81 and 44.73 +/- 7.86 years respectively. In Group-A there were 10 male and 5 female patients and in Group-B there were 8 male and seven female patients respectively. In Group-A nine patients presented with Fernandez type-II and six patients presented with Fernandez type-III fracture. While in Group-B 10 patients presented with Fernandez type-II and five patients presented with Fernandez type-III fracture. Among Group-A patient's final outcome was excellent in 86.67% patients while in Group-B only 53.33% patients had excellent outcome at three months follow up
Conclusion: Percutaneous Kirschner's wires appeared to be more effective as compared to T-Plate fixation in terms of functional outcome for treating intra-articular distal radius fractures
ABSTRACT
To study the results of treatment of fractures of shaft of Humerus using percutaneous Titanium Nails. This is a quasi-experimental, prospective, interventional, study of 30 clinical cases that were operated with retrograde, per cutaneous elastic Titanium nails for treatment of diaphyseal fractures of adult Humerus. Cases close to either ends of the bone, those presenting with Grade II open fractures and neurovascular injury were excluded along with pathological fractures. All complications were noted. All cases were followed up for one year postoperatively. The age range of the 30 patients included in the study was 33.50 + 11.08 [18-65] years with a follow up period of one year. There were 21[70%] male patients and 9[30%] female patients in the study. We observed clinical and radiological union in 23 patients, delayed union in 5[bone grafting done later], non union in 2 patients. Both these nonunion cases were treated later with internal fixation with plating. All united fractures were in acceptable range of angulation and rotation. On an average radiological union occurred between 3 to 4 months. We observed average 10 degree of limitation in shoulder abduction and extension lag of 10 degree at elbow joint. Two cases reported with deep infection. The use of Titanium Elastic Nails in the treatment of diaphyseal Humerus fractures seems to be a safe option with minimal morbidity. Percutaneous fixation of adult Humerus fracture is a less time consuming procedure with minimal blood loss, minimal soft tissue disruption and facilitates natural healing at fracture site.
ABSTRACT
Medical literature observes clear racial/demographic trends in Palmaris longus absence; with the incidence of agenesis ranging from 5 to 25% in numerous populations. The Arabs remain relatively less explored regarding this phenomenon; more so when it comes to native Saudi populace. This study reports congenital Palmaris Longus absence in young Arab adults. A cross-sectional study recorded the incidence of Palmaris Longus agenesis in male and female volunteers [N=400; 200 Male and 200 Female; age range 21-25yrs] of Jazan University, Jazan, Saudi Arabia. Schaffer, Pushpkumar and Thompson tests were applied to confirm Palmaris Longus absence. The incidence of Palmaris Longus absence was 24.5% [an overall 16.7% unilateral and 7.75% bilateral absence with Left sided absence being more common in the cohort]. Gender wise, right sided agenesis was more common in males and left sided agenesis was more common in females while the prevalence of bilateral absence was analogous between the two sexes. Palmaris Longus tendon is now a morphologically ebbing entity and its absence/ agenesis is frequent in numerous populations. The incidence of Palmaris Longus absence in Saudi population is towards the higher limit of the range observed in other races. Interestingly, it is more akin to 'Caucasian' values rather than 'Asians'. 'Sexual' and 'limb sided' dimorphism is noted in absence trends. The knowledge of population specific incidence of Palmaris Longus absence and dimorphism trends is important for tendon grafts, reconstructive surgery and holds significant implications for anatomists, orthopedicians and biological anthropologists.
ABSTRACT
To study retrospectively the results of treatment of cases of pathological fractures presenting with osteitis fibrosa cystica due to hyperparathyroidism. Records of cases of hyperparathyroidism treated for pathological fractures in the past seven years were reviewed to assess success of treatment by various modalities. All patients had been investigated for vitamin D deficiency, parathyroid levels, serum calcium and phosphate levels along with renal function tests. All X-rays were restudied for evidence of osteitis fibrosa cystica. Thirteen cases healed uneventfully, one died of unrelated reasons and one failure led to non union. All patients had received oral calcium supplements and injectable vitamin D for three months at least. There were no complications of this treatment regimen. Pathological fractures due to bone weakness caused by hyperparathyroidism can be treated by various treatment modalities supplemented by oral calcium and injectable vitamin D
ABSTRACT
To evaluate the standards and uses of communication skills of specialist doctors during the doctor-patient interactions among a sample of specialists belonging to various specialities and based at different hospitals of Lahore. One hundred specialists were asked to participate in the prospective, questionnaire based survey in Lahore. These volunteers were asked to fill a form keeping in view their current practices. The scores thus achieved were measured using a proposed SKAF score. The results were graded into four parts depending upon the score achieved by the subjects. Twelve people never returned the survey instrument. Of those who did majority scored as good or excellent. Females showed a better score than males. Those who had previously been instructed formally did better on the SKAF scale. The need of formal hands on training workshops on Communication Skills in both under graduate as well as post graduate trainees cannot be reiterated