ABSTRACT
Background: Intercondylar fractures of lower end of humerus is a challenge for orthopedic surgeon to fix rigidly for early mobilization. We hereby have devised a novel technique of fixing an intercondylar fracture of lower end of humerus by transosseous route utilizing the Tension band wiring. We successfully obtained a rigid, stable reconstruct without affecting the anatomy of the region. Aims & Objective: To study the effect of transosseous fixation of intercondylar fracture of lower end humerus by tension band wiring technique. Materials and Methods: We have followed a novel technique for treating intercondylar fracture of lower end of humerus. Till date we have treated 10 patients of supracondylar fracture of humerus with intercondylar extension. All patients were selected randomly the only criteria was a supracondylar fracture of lower end of humerus with intercondylar extension. This method gave us four cortices fixation in the lower intercondylar region which was not possible till date by other methods of fixation. So now T-Y elbow type of fracture is converted into a supracondylar fracture. Rest fixation of supracondylar fracture was done with perpendicular plating and k wire TBW in case of osteoporotic bones. Results: Out of 10 treated cases with this method all get rigid fixation and radiological union at average of 8 weeks. Average ROM was 5-100. One case had postoperative stitch infection, one had k wire impinging on skin and two patients lost follow up after 3 months. Conclusion: Complicated fractures of intercondylar region of distal humerus can be successfully managed by interosseous TBW technique. We recommend such technique and further research regarding it.
ABSTRACT
Extraction of broken implant is a challenging task for orthopaedic surgeons. Many times it requires innovative ideas or some unusual methods, all of which has not been listed in literature. We hereby report such a case of 40-year-old male who presented with severe limping and history of previously treated right femur fracture. The radiographs showed an intramedullary nail which was segmentally broken. Femur nail was broken at the non-united fracture and below the fracture at the level of distal interlocking screw. We successfully removed a broken implant by using such one innovative -close retrograde method. The segments of broken nail were removed through knee arthrotomy without opening the fracture site. Non-union was treated by exchange nailing without bone grafting and patient recovered well on follow up. To our best of knowledge very few cases of extraction of segmentally fractured nail have been reported in literature until now.