Ilizarov technique in the treatment of compound tibial fracture with bone defect

Open tibial fractures with bone loss is difficult to manage mainly due to soft tissue problems, risk of infection and high rates of non union. We report our experience in the management of such cases using Ilizarov technique. We report our experience with the use of llizarov technique in 12 patients with grade IIIA and IIIB open tibial fractures with bone loss. The causative injury was either, high energy missiles, motor vehicle accident or direct trauma with fall of heavy object. The length of the tibial bone defect ranged from 3.5 cm to 10 cm. All cases eventually untied and infection was eradicated in all cases. The bone results were graded excellent in 11 cases and good in one case. The case that graded as good united in 10 degree varus. The functional results were graded excellent in 6 cases, good in 5 case, fair in one case, and poor in one case. We found Ilizarov technique is quite satisfactory in management of open tipial fractures with bone defects. This was associated with high rates of union, eradication of infection and very good functional results

Elastic stable intramedullary nailing of femoral shaft fractures in children

In this study, the use of elastic stable intramedullary nail [ESIN] in 80 fractures of femoral shaft in children was reported. Flexible rods are introduced through the distal metaphyseal area to develop a bridging callus. Early weight bearing is possible and is recommended; also, it is technically easier and less time-consuming than other internal fixation tools. There was no case of infection, delayed union, nonunion or psychological complications. Complications were minimal, the most common being minor skin ulceration caused by the ends of the rods. A low incidence of growth changes with a mean lengthening of only 1.5 mm after an average follow up period of 24 months was observed. Compared with the conservative treatment, ESIN obviates the need for prolonged bed rest; thus, it is particularly advantageous for treating children

Surgical management of dorsolumber tuberculous spondylitis in adults

In this study, 16 cases of single level tuberculous spondylitis were treated. All cases were managed by anterior decompression debridement and strut graft using anterolateral decompression or retroperitoneal approach. No internal fixation was used, but postoperative plaster jacket was applied. Four patients were presented with neurological deficit; one case was grade B, one case was grade C and two cases were grade D according to Frankel classification. The functional and neurological recoveries were satisfactory. The follow up period ranged from 18 months to 3 years [average 20 months]. Fusion was achieved at 5-6 months in 14 cases and delayed for 9-10 months in two cases

Labral stitch for open repair of bankart lesion. Simple, safe and effective technique

In this study, 32 patients with recurrent traumatic anterior shoulder instability were treated prospectively by vertical apical labral stitch technique. All had many episodes of documented complete anterior dislocation. All were men with an average age of 23 years. The minimum follow up duration was 2 years [range 24-41 months]. The patients were evaluated according to the shoulder instability score of Rowe et al. Rowe score was excellent and good in 94% of the patients and fair in 6%. The limitation of movement did not exceed 5 degrees in forward flexion and 10 degrees for external rotation with the arm to the side. There was no postoperative re-dislocation or reoperation. Apprehension was persistent in two patients. All patients returned to preoperative work

Contoured plate fixation in subtrochanteric fractures of the femur

Seventeen patients with subtrochanteric fractures of the femur [Type III, and IV of Seinsheimer s classification] were treated with a contoured plate. The average follow-up period was 3 years. All of the patients received external support. An indirect reduction technique was used to gain optimal alignment and stability without aiming at anatomical reduction. All but one of the fracture united between 4 and 6 months. Complications were: delayed union [one case]; which was treated by bone graft; infection [one case] and mild coxa vara [one case]. Our conclusion is that the contoured plate provided good fixation in subtrochanteric fracture of the femur and could be a successful alternative for these fractures

Early weight - bearing after statically locked intramedullary nailing of femoral shaft fractures

Twenty-five patients with diaphyseal femoral fractures [Winquist type I, II, III and IV] were treated with statically locked closed reamed intramedullary nailing. The 25 patients were followed for at least 1 year. Early weight bearing was allowed and encouraged in the first 2 weeks after the operation. The nail diameters were 13 mm in 2 patients, 12 mm in 3 patients, and 11 mm in 12 patients and 10 in 7 patients, and 9 mm in 1 patient. Most of the patients could start weight bearing between the first 2 and 4 weeks postoperatively. None of the patients, except one, were using any walking aids at the second month postoperatively. All the fractures healed without any significant complications. Nail bending or breakage did not occur in any patients. There was slight internal rotation in one patient and mild external rotation in another one. We concluded that early weight bearing after reamed static inerlocking nailing of femoral fractures is a safe and effective method, and the risk of implant failure does not preclude the procedure