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

Fracture shaft of femur; management outcome in children between 10 to 14 years of age treated by intramdullary rush nail

In school going children surgical treatment is favoured with the introduction of elastic intramedullary nails. The aim of this study was to determine the management outcome of fracture shaft of femur in children between 7-14 years of age by intra medullary rush nail. This study was conducted at department of orthopedic surgery, Dow University of health science and civil hospital Karachi. Duration of study was 12 months from 01-09-2011 to 31-8-2012. Children with closed fracture shaft of femur age 7-14 years of either sex meeting the inclusion criteria were included. Children were diagnosed clinically and confirmed on X ray, open reduction and internal fixation with appropriate size rush nail was done by senior orthopedic surgeon. Thereafter patients were followed every month and the final outcome was measured at the end of third month post operatively. Male were 58% while female were 42%, the average age of the patients were 11.78+/-1.40 years. Management outcome of fracture shaft of femur in children by intra medullary rush nail showed that 100% children fracture were healed. We found a very high success rate in the management of closed fracture shaft femur with intramedullary rush nail. This surgical procedure is simple, technically less demanding, and suitable in peripheral rural hospital in developing countries

Successful reductions of anterior shoulder dislocations using intra articular lidocaine injection

To find out the frequency of successful reductions in acute anterior shoulder dislocations after the use of intra-articular lidocaine injection. This study [case series] was conducted in Emergency Department of Civil Hospital Karachi from July 2009 to January 2010. Patients with acute anterior shoulder dislocation [diagnosed with examination and X-Rays] were reduced in emergency department by Hippocratic method after infiltration of 1% Lidocaine in the affected shoulder joint. Reduction was confirmed by post reduction shoulder X-Rays. Frequency of successful reduction and complications were recorded. Majority of the patients [34.3%] were between 18-30 years of age group with mean age of 40.14 [ +/- 15.14] years. Males were affected more than females with male to female ratio being 2.9:1. They commonly had predominant right shoulder dislocation [71.4%]. Successful reduction was achieved in 32 [91.4%] patients after infiltration of 1% lidocaine injection. No complication was recorded. Use of intra-articular lidocaine for reduction of shoulder joint appears to be a safe and effective method and associated with successful reduction in majority of cases