ABSTRACT
Objective of this study: to analyze the result of A.O. condylar blade plate for the treatment of sub trochanteric fractures and to assess the union of the fractures after the definitive surgical management
Material and methods: a prospective study of 56 sub trochanteric femoral fractures treated by 95o A.O condylar blade plate was conducted in Department of Orthopedic Surgery, Liquate University of Medical and Health Sciences Jamshoro from March 2005 to February 2008. The follow- up period ranged from 6 - 36 months [average 12 months]. Fractures were included according to Siensheimer's classification type IIA, B and C and III A and B with their subtypes. Type I, IV and V were excluded from this study. The age of the 56 patients ranged between 25 to 55 years average age 37.6 years. There were 39[69.64%] male and 17 [30.35%] female patients. Male to female ratio was 2.9: 1
Results: total 56 patients were evaluated; excellent results were achieved in 27 [48.21%], good in 17 [30.35%], and poor in 12 [21.42%]. Out of 56 patients 34 [60.71%] were type II and were distributed in subtypes as 18 [52.94%] IIA, 7 [20.58%] IIB, and 9 [26.47%] IIC. The 22 [39.28%] type III cases were distributed in subtypes as 14 [63.63%] IIIA and 8 [36.36%] IIIB. The union time ranged between 3.5 to 12 months [average time 4.6 months]. The rate of non-union in this study was 12.5%. In this series 5 cases were complicated by malunion, 3 patients unacceptable Varus angulation of more than 15 degree was noted, and in remaining 2 cases Varus less than 15 degree was noted. Malunion rate in this study was 8.92%
Conclusion: we conclude that the choice varies from place to place, and depends on fracture morphology, expertise available, and whether it is cost effective. We feel condylar plate will find its use in selected cases and certain situation for many years to come
ABSTRACT
Objective: To document the outcome of Ponseti method in the treatment of clubfoot
tudy Design: Observational-descriptive study
Place and Duration: Department of Orthopedic Surgery and Traumatology, Liaquat University of Medical and Health Sciences [LUMHS] Jamshoro, Sindh - Pakistan, from January 2007 to December 2010 [4-years]
Methodology: Clubfeet were treated by Ponseti technique. Pirani score was recorded for all subjects at the time of presentation and a foot was considered fully corrected when scored 0- 0.5. Immediately after the removal of last cast, foot abduction braces were used. Follow-up pattern was at two weeks, at three months, then at four month interval up to 3-years age, then at six month interval up to 4- years age, and then once a year. Any relapses were treated accordingly. Tenotomy was repeated in equines, whereas castings were repeated in adduction of forefoot, intoeing and cavus
Results: During the study period 49 children presented 71 clubfeet with 27 [55.1%] unilateral and 22 [44.9%] bilateral cases. The mean Pirani score at the time of presentation was 5.44. Majority [63.38%] feet required casting up to 5-weeks and in 69.01% feet complete correction was acquired by five casts [mean 5.6 casts]. Achilles tenotomy was performed in 65 [91.55%] feet. Pirani score of 0-0.5 was achieved in 69 [97.18%] cases within 1-year follow-up. Thirteen [18.31%] cases of relapse were reported. Among these, 2 [2.82%] cases of equinus underwent repeat tenotomy; whereas 7 [9.86%] cases of adduction, 3 [4.23%] cases of cavus and 1 [1.41%] case o intoeing were treated by repeat casting
Conclusion: Ponseti method can be used in our setup with excellent correction of clubfoot deformity, and surgical complications can be minimize by this technique
ABSTRACT
Background: Unstable intertrochanteric fractures pose a challenging problem. Severe communication in elderly osteoporotic patients renders internal fixation difficult. Several methods, techniques and fixation devices have been advocated for treating these difficult fractures but each one has different rate of complications. The purpose of conduction of this study was to compare the results of Wayn country [valgus] reduction with anatomical reduction by using dynamic hip screw [OHS] in unstable intertrochanteric fractures
Material and methods: This was a prospective randomized study. Forty patients of unstable intertrochanteric fractures were treated with anatomical and Wayn county reduction, fixed with DHS. AO type A2 and A3 were included. Out of 40 cases 20 were treated by anatomical reduction, 20 cases included in Wayn county reduction group. All cases were followed up for 6 months and assessed with Larson's evaluation score for hip
Results: Out of 40 patients 23 [67.5%] were male and 17 [42.5%] were female. Average age was 64.25 years having higher incidence between 60 to 70 years [23 patients], 18 [ 45%] patients had associated diseases, 33 [82.5%] patients had A2 type fracture and 7 [ 17.5%] had A3 type fractures. 36 patients out of 40 were fully followed, there was no death during hospital stay, 4 patients died during follow up. All 4 patients were of Wayn county reduction group. Average delay in surgery was 10 days, average postoperative hospitalization was 11.6 days. Average operating time was 56 minutes in Wayn county reduction and 70 minutes in anatomical reduction. Average healing time was 14 weeks in Wayn county reduction and 13 weeks in anatomical reduction group. Implant placement in femoral head 27 were central - central and 13 were posterior-inferior. Overall results were excellent and good 87% in Wayn county reduction and 80% in anatomical reduction, mechanical failure was present in 0% in Wayn county and 20% in anatomical reduction group
Conclusion: Result showed that Wayn county reduction had better results than anatomical reduction with less chance of mechanical failure, p <0.05