Intra-articular distal radius fractures; functional outcome of percutaneous kirschner wire fixation and short arm cast in patients of 20-70 years

To determine functional outcome of percutaneous Kirschner wire fixation and short arm cast in intra-articular distal radius fractures in patients of 20-70 years. Descriptive case series. Department of Orthopedic Surgery, Dow University of Health Sciences / Civil Hospital Karachi. 1[st] April, 2013 to 30[th] September, 2013. A total of 62 patients with closed type III distal fractures according to Frykman classification were included in this study. Patient lying in supine position and after general anesthesia, closed reduction was done with the forearm in prone position, aiming to restore normal anatomical position. Two Kirschner wires were inserted from radial styloid process in parallel and oblique fashion to the medial cortex of the radius and one transversely from lateral to medial for intra-articular fragments. Final functional outcome was assessed after 12 weeks of surgery and recorded on pre-designed Proforma. Acceptable functional outcome of percutaneous Kirschner wire fixation and short arm cast in intra-articular distal radius fractures was observed in 80.65% [50/62] cases. It is concluded that functional outcome of percutaneous Kirschner wire fixation and short arm cast procedure is satisfactory in intra-articular distal radius fractures and it appears to be an easy, technically less demanding and effective method for stabilization, so this procedure can be applied for patients with these fractures

Pediatric forearm fractures; functional outcome managed with intramedullary rush nails - experience in a tertiary care hospital

Unstable forearm both bones fracture in children more than 10 years of age are difficult to manage with cast and surgical intervention is required. To determine the functional outcome of patients with unstable forearm fractures managed with intramedullary rush nail. This study was conducted at Department of Orthopedics, Civil Hospital Karachi from July 2011 to August 2013. All the patients with age in between 10 to 15 years, with close radius ulna unstable fracture presenting within 7 days of trauma or fall were included in the study. All the fractures were stabilized with intramedullary rush nails. Functional outcome was assessed at 12 weeks. There were 79 patients included in the study. Mean age was 13.17+/-2 years. There were 52 male patients [65.8%] and 27 females [34.2%]. There were 24 patients with history of road traffic accident, 29 patients with fall and 26 patients with blunt injury. Acceptable outcome was found in 64 [81%] patients and observed more in male children [p=0.001] and children above 13 years of age [p=0.027]. Union was achieved in all the patients. Six patients had pin site irritation and 2 had superficial infection. Intramedullary fixation with rush nail in unstable forearm fractures in the children appeared to be an effective method of fixation and provided acceptable outcome in 64 [81%] patients

Intelocking versus kuntscher nails in the management of femoral shaft fractures

To compare the outcome of Femoral shaft fractures managed with Interlocking and Kuntscher intramedullary nails, in terms of healing time, full weight bearing and post-operative complications. Prospective, quasi-experimental study from March 1999 to May 2002. Orthopaedics Unit I, Civil Hospital, Karachi. A total of 200 cases of Femoral shall fractures. Half [100] the cases of Femoral shaft fractures were treated with Kuntscher intramedullary nails and the other half [100] with Interlocking nails, the cases being assigned randomly. The detailed data of the patients was recorded, computed and analyzed using Chi-square test and Students t-test. The main parameters compared included fracture healing time, full weight bearing time and post-operative complications. There was no significant difference between the two groups in terms of demographic data, fracture type and associated co-morbidities. The average operating time was 110 +/- 25 minutes for the Interlocking nail and 80 +/- 15.8 mins for the K-nail. All patients of K-nail group needed blood transfusion, while only 17 patients of interlocking group needed blood transfusion. The fill weight bearing time was significantly shorter [p < 0.005] in cases of Interlocking nail. Out of 200 fractures 182 [91%] healed with in six months while 18 [9%] did not. The latter included 6 [3%] cases treated with Interlocking nails and 12 [6%] with Kuntscher nails, p < 0.005. Interlocking intramedullary nailing is better than Kuntscher nailing in every respect

Correction of post-polio residual deformities of hip and knee joints by conventional methods

This prospective study was conducted in Orthopaedic Unit-I of Civil Hospital, Karachi from Jan. 2000 to Dec. 2002 to find out the prevalence of post polio residual deformities in our society and to assess the outcome of corrections done by conventional methods. A total of 50 cases were seen during the study period. Of these 35 were male and 15 females. Minimum age of onset of the disease was six months while maximum age was six years. The deformity was seen commonly in the lower socio-economic group coming from urban slum areas. Hip joint was involved in 35 patients whereas knee joint was involved in all the 50 cases. Fixed flexion deformity was noted in 48 patients with involvement of knee and 33 cases with involvement of hip joint. In hip joint only soft tissue procedures were done to correct the deformity. On the other hand in patients with knee joint deformity Younts fasciotomy was done in 25 cases, supracondylar osteotomy of femur in eight and posterior capsulotomy in 15 patients. It is concluded that conventional methods of correction of post-polio deformities are good, economical and less cumbersome