ABSTRACT
To evaluate the outcome [radiographic union and functional] of subtrochanteric valgus osteotomy in younger adults with nonunion of femoral neck fractures. It was an observational study. This study was conducted in the Department of Orthopaedic Jinnah Post Graduate Medical Center during the period from 01-08-2001 to 31-07-2003. Fifteen patients of ages between 18-50 years with nonunion of femoral neck fractures. Valgus subtrochanteric osteotomy was done and fixed with 120° double angle blade plate. Radio-graphic union and functional outcomes were observed on Salvati and Wilson hip score and Harris hip score. Average delay in presentation of patients was 9 months [range 2-30months]. At an average follow up of 13.5 months non-united neck fractures in 11[73%] out of 15 patients united. In these patients average Harris hip score was 88 and Salvati. In 3[%] patients severe head collapse developed after surgery and in 1 [%] patient fracture remained non united due to broken plate. For an active young patient with non-united or neglected femoral neck fracture, subtrochanteric val-gus osteotomy provides satisfactory results even in early stages of avascular necrosis of head of femur
ABSTRACT
To evaluate results of operative management of established non-union of humeral diaphysis with Dynamic compression plating [DCP] and Rush pinning with cancellous bone graft. Hospital based prospective study. Conducted at Department of Orthopedic Surgery, Jinnah Postgraduate Medical Centre, Karachi. A total of 21 patients of established un-united humeral diaphyseal fracture, between 15 to 65 years were included in this study. Patients underwent DCP and Rush pinning with bone grafting. Union of fractures clinico-radiographically and functional outcomes with Modified Constant and Murley Scale for shoulder and range of motion for elbow were considered. Among 18 available patients, 14/18 nonunion [77.8%] united within 5.1 +/- 1.8 months. For DCP group 11/13 [84.6%] united in 4.45 +/- 0.96 months. For Rush pin group 3/5 [60%] united in 7.7 +/- 2.1 month [P< 0.001]. Modified Constant and Murley Scale for shoulder assessment, for DCP group, excellent 05, good 03, fair for 03, poor 02 and for Rush pin group excellent 00, good 00, fair 02 and poor 03. Average range of motion of elbow joint 71.7 +/- 15.3% to 82.7 +/- 16.0%. Persistent non-union in four, radial nerve palsy in one, implant failure in two and shoulder impingement in one case noticed. No severe deep infection occurred. Dynamic compression platting with bone graft has shown significantly higher union rate for non-union of humeral diaphysis, while the functional outcome regarding shoulder [P<0.03] and elbow movements [P<0.05] are also proved to be significantly better in DPT as compared to Rush pin