ABSTRACT
Femoral shaft fractures are common in adult population due to vulnerability to road traffic accident and firearm injuries. There are various treatment modalities to treat the femur shaft fracture i.e. Plating and screws, Intramedullary nailing, External fixator and Interlocking nails. Comminuted fractures due to gun shot injuries are a challenging problem for orthopaedic surgeons. The objective of this study is to evaluate the role of interlocking nailing in the management of femoral fractures due to high velocity gunshot injuries. This descriptive study was conducted on 68 patients at Orthopaedic unit Postgraduate Medical Institute, Lady Reading Hospital Peshawar, from March 2002 to March 2004. The patients of each gender from age fifteen years onward having femoral shaft fracture due to high velocity gunshot injuries who had not previous surgical intervention were included in the study. The exclusion criteria were intertrochanteric, supracondylar femoral fractures and those who failed the follow-up. All the patients were treated with close or open interlocking nails. The outcome measures were graded excellent, good and poor according to radiological and clinical results. Follow-up was for eighteen months and in some cases up to thirty months. Out of 68 patients 64 [94.12%] were male and 4 [5.88%] were female patients. The age range was from 15 to 65 years [average age of twenty nine years. The close interlocking nails were done in 64 patients [94.12%] and open interlocking nails were done in 4 patients [5.88%]. The static interlocking nailing was performed in 58 patients [85.29%] while dynamic interlocking nailing was performed in 10 patients [14.71%]. Knee flexion contracture in 5 cases [7.35%] and limb shortening of less than 2 Cm in 2 patients [2.94%]. Non-union were in 4 cases [5.88%]. Excellent results were in 42 patients [61.76%], good in 18 patients [26.47%] and poor in 8 patients [11.77%]. Interlocking nailing is one of the best options for the management of femoral shaft fractures due to high velocity gunshot injuries
Subject(s)
Humans , Male , Female , Bone Nails , Wounds, Gunshot , Treatment OutcomeABSTRACT
Talipes Equino-Varus [TEV] is one of the most common congenital anomaly. It is managed by various methods i.e. conservative and surgery. Objective of this study was to determine the efficacy of modified Turco's postero-medical release in children's having congenital TEV. This descriptive observational study was conducted from June 2004 to June 2008 in the Orthopaedics Unit of Lady Reading Hospital [LRH] Peshawar. The inclusion criteria were children of age 6 months to 3 years of age having moderate and severe club foot. The exclusion criteria were clubfoot secondary to some other disorders such as cerebral palsy, arthrogryphosis multiplex congenita, myelodysplasia or congenital dislocation of the hip. The deformity was treated by modified Turco's one stage release. Follow-up was for one year. Results were graded according to modified McKay rating system. A total 70 patients were included in this study with the age range of 6 months to 3 years with moderate to sever deformity. Thirty-eight were male [54.2%] and 32 patients [45.72%] were female, twenty three patients [32.85%] had bilateral club foot while the rest of 47 patients [67.15%] had unilateral deformity. Positive family history of club foot was in 10 patients [14.2%]. Results were concluded on 52 patients who completed one year follow-up. Excellent results were observed in 34 patients [65.38%], good in 9 patients [17.30%], fair in 2 patients [3.84%], and poor in 7 patients [13.46%]. Children up to three years age with congenital TEV can be successfully treated in almost all the cases by modified Turco's one stage postero-medial release