ABSTRACT
Background: Cervical spine injury leads to significant functional impairment, one of them is quadriplegia. Debate between surgical versus conservative management of trauma to cervical spine has been going on since early 19th century. Aims & Objective: This study has been conducted to compare functional and neurological outcome of conservative and operative management in patients with cervical spine injury with complete quadriplegia. Materials and Methods: This was a retrospective study. Case records of 30 patients were analyzed. Patients were divided into 2 groups according to treatment given, i.e. Surgical and conservative. These two groups were compared retrospectively in terms of age, sex, type of injury, Mechanism of injury, mode of injury, stability, hospital stay, complications, neurological involvement and outcome. All patients were evaluated based on four parameters work, Functional independence measure, stability and neurological impairment. These parameters were measured and graded with appropriate modified scale. Results: Mean age of patients in this study was 35 Yr. (Operative 31.88 Yr, Conservative 38.2 Yr.) With approximately 73 % belongs to 20 to 40 years group of young and active individual. Road traffic accident was the major culprit for cervical spine injury in this study. It accounts for 46.66% of total patients, followed by fall from height and fall of heavy object on patient. In operative group out of 15 patient 3 had stable cervical spine injury & 12 had unstable injury. In conservative group 5 had stable cervical spine injury and 10 had unstable cervical spine injury. Overall among 30 patient only 15 patient (50%) improve neurologically other remained same or worsened. Neurological improvement in conservative (46.66%) and operative (53.33%) group was found practically to be with negligible difference. Conclusion: The ultimate neurological and functional outcome of cervical injury was probably decided at time of injury itself rather than by chosen management. Improvement in neurological function was independent of factor like type of surgery, Mechanism of injury (flexion-extension), spinal deformity and type of management. Surgical stabilization result in batter alignment and stability, early rehabilitation and probably decrease in length of stay but has its own complication and great economic burden to patients.
ABSTRACT
Background: Distal Femur fractures are one of the common fractures occurring in road traffic accidents. Various modalities are used for fracture of distal femur, one of them is condylar buttress plate. Various studies have claimed better results in surgical management of distal femur fracture. This study was planned to compare two treatment modalities for supracondylar and intercondylar fracture of the femur, open reduction and internal fixation with a condylar buttress plate. Aims & Objective: Objective of this study was to study the surgical technique for fixation of lower end femur fractures with condylar buttress plate and its functional and anatomical outcome. Materials and Methods: Total 30 patients above 18 years of age irrespective of gender, having fresh displaced and undisplaced fractures type A1, A2, A3, C1, C2,C3 and nonunion of distal femur fractures. Distal femur fracture was fixed with condylar buttress plate Results: A total of 30 cases were studied comprising 21 males (70%) and 9 females (30%) of which mean age is 37 years. Mean hospital stay was 35.8 days, out of 30 patient 11 patients developed some complication. 22 patients have good to excellent results as outcome. Conclusion: The Condylar Buttress Plate is an effective method for the treatment of Supracondylar and intercondylar fractures of the femur.