ABSTRACT
Background: Patellar fractures are more common in country like India due to the activity of daily life and constitute 1% of all skeletal injuries by direct or indirect mechanism. Direct injuries due to the subcutaneous location of patella and indirect injuries because of forceful contraction of quadriceps with knee in flexed position are common. Thus, improper operative procedure can lead to disability in the patient. Therefore, this study was conducted to assess of advantages and complications associated with fixation technique so as to manage the fracture of patella. Methods: The study was conducted on 60 cases of transverse patellar fracture treated by Modified tension band wiring. All patients who had closed and open type I displaced transverse patellar fractures, acute fractures and who were medically fit for operative procedures were included in the study. Results: The most common age group in our study was 41-50 years. Male patients were 46 (76.7%) and female patients were 14(23.3%). Fracture due to direct injury was seen in 12(20%) patients and 48(80%) cases were with indirect trauma. Right side injury was seen in 26(43.3%) patients while 34 (56.7%) patients had injuries on the left side. The outcome of our study was excellent in 90% of cases, 8.3% was good and only 1.7% was poor. Conclusion: According to our study modified tension band wiring showed better outcome for the early mobilization and management of displaced transverse patellar fracture.
ABSTRACT
Background: Fractures of neck of femur are a major cause of morbidity and mortality in elderly population. Intertrochanteric fractures in elderly people are usually comminuted and unstable because of osteoporosis. Unstable intertrochanteric fractures in elderly patients are associated with high rates of morbidity and mortality2 although the results have improved with the use of Bipolar Hemi-Arthroplasty. Methods: All the patients were selected from among the admissions in the Department of Orthopaedics, MNR Medical college and hospital, Mediciti institute of medical sciences, Archana hospital, Hyderabad, from june 2013 to 2015 May. Cemented bipolar hemiarthroplasty (Non modular bipolar hip prosthesis of OSIM) with or without greater and lesser trochanter fixation by tension band wiring was done. The follow up was carried out at 6 weeks, 3 months, 6 months, and 1 year. The results were evaluated using Harris Hip Score Rating. Results: The average age of patients in our series was 65 years with a range of 60 years to 75 years. Out of 70 patients 42 (60%) were female and 28 (40%) male. Left side is more commonly involved with 38 patients (54%) than right side (46%). The average duration of hospital stay was 10 days, with a range of 10-25 days. Out of 70 patients 35 (50%) had excellent outcome, 14(20%), 14(20%), 7(10%), had good fair and poor outcomes respectively. Conclusion: Cemented bipolar hemi-arthroplasty with anatomical reconstruction of trochanteric region preserves abductor mechanism thus allowing early mobilization, safe early weight bearing on the injured hip and had a relatively low rate of complications.