Open Reduction and Internal Fixation of Unstable Fractures of Distal Radius in Adults by Volar T Plate

The aim of this study is to evaluate the functional results of internal fixation of unstable fractures of distal radius in adults by volar T plate. This study included 15 patients [4 Males and 11 Females] who attended to the emergency department in the Suez Canal University hospital during the period from November 2003 to April 2005. The average age of patients was 53.3 years [range 33-70 years]. Patients included in this study had an intra-articular fractures or extra-articular fractures with angulation more than 200, shortening [impaction] greater than 5 mm. and metaphyseal comminution. The scoring system according to MissaKian et al., [4] is designed to assess the final result was graded and it depends on clinical and radiological assessment. The overall functional results of all patients are excellent results in eleven patients [73%], good results in three patients [20%], and fair results in one patient [7%]. The overall anatomical results were found to be as follows, twelve patients [80%] achieved excellent results, two patients [13%] had good results and only one patient [7%] had fair results. The overall final scores for all patients were twelve patients [80%] had excellent results, two patients [13%] had good results and only one patient [7%] had fair results. Patient with a fair result had a deformity and swelling of the hand on using it in heavy work. Internal fixation of distal radial fractures by volar T plate using an extended volar approach is a good technique and early motion increases the efficacy of functional results

Early functional results of total knee replacement in degenerative arthritis

This work was conducted to evaluate the early functional results of total knee replacement [TKR] in degenerative arthritis. Twenty knees of 19 patients [5 males and 14 females] with severe osteoarthritis were included. The average age was 61 years [range 55-74 years]. The right side was operated upon in 13 knees. Only one patient had the procedure done bilaterally. All the patients were evaluated preoperatively both clinically and radiologically. The patients were also evaluated according to the clinical rating system described by the Knee Society. The patients were followed up for an average period of 39 months with a minimum of 26 months and a maximum of 65 months. The clinical rating system improved from a mean preoperative of 35 +/- 14 points [range 30-65 points] to 82 +/- 9 points [range 60-95 points] at the latest evaluation. There were no serious complications or reoperations at the time of the latest review, except one patient who had a lateral release procedure two months after the TKR

Intramedullary hip screw versus compression hip screw for the treatment of trochanteric fractures

The intramedullary hip screw has been introduced recently with design features that may influence the clinical results and complication rates of the trochanteric fracture Sixty four patients suffering from trochanteric fractures were included in this study. There were 37 males and 27 females They were divided into two groups of 32 patients each Group I was treated by the intramedullary hip screw and group II was treated by the compression hip screw. The patients were considered in two subgroups as regards fracture stability as stable and unstable fractures The results of the two groups were comparable as regards operative time quality of reduction position of the implant within the femoral head, hospital stay, and time to union. The intramedullary hip screw required shorter incision and had less blood loss with less limb length discrepancy On the other hand, the intramedullary hip screw required more radiological exposure and had a prolonged learning curve. The intramedullary hip screw offers almost a percutaneous fixation of the trochanteric fractures. It cannot he recommended for the routine treatment of trochanteric fractures but it seems to be a promising alternative to the compression hip screw especially in the unstable and comminuted fractures

Transpedicular screw fixation of unstable thoracolumbar spinal fractures

Spinal immobilization and restoration of canal diameter may be associated with improvement in neurological function for partial neural deficit. Because transpedicular screws are placed close to the injured vertebra, the possibility for anatomic reduction should be better. The present study was conducted to evaluate the capability of transpedicular screw fixation to achieve reduction and stability of thoracolumbar fractures. Twenty four patients with unstable thoracolumbar fractures were included in this study and were followed for an average of 19.3 months. All patients with partial neural damage had improved at least one Frankel grade during the follow up period. The mean angle of kyphosis and the canal compromise improved markedly after the operation. Fusion occurred in all patients. There were no neurological complications related to the pedicle screw placement reported in this series. The technique demanding and meticulous and needs thorough knowledge of the anatomy and biomechanics of the spine. It is a highly reliable method for reduction and stabilization of unstable thoracolumbar fractures

Volar inlay bone graft and K-wire fixation in stable scaphoid non-union

Stable undisplaced non-united fracture of scaphoid showed an increasedincidence of displacement and angulation with subsequent radioscaphoidarthritis over longer duration of non-union. 16 patients with stable scaphoidnon-union were treated by volar inlay graft and k-wire fixation. For clinicalassessment, the wrist score of Coony et al was applied pre and postoperatively. Bone healing was obtained in 15 out of the 16 patients. Thepostoperative wrist score was significantly improved even in the 2 patientswith satisfactory preoperative assessment. The stable ununited scaphoidfractures, even with mild or no symptoms, should be treated precisely to improvethe functional status of wrist and to decrease the incidence of radioscaphoidarthritis