Fixation of extra articular distal radial fractures with non bridging external fixator.

Severely comminuted fractures of distal radius often lead to impairment of wrist function. A prospective study was performed on 30 patients aged between 35-65 years of extra-articular fractures of distal radius. All patients were treated with closed manipulation of the fracture an application of non-bridging (radio radial) external fixator under radiological control. At six months after the injury functional results were good with near normal movements of the wrist and hand. Radiological fracture alignment was satisfactory with no significant shortening of the radius. There were no re-displacements and none of the patients required a second operation. Superficial pin site infection occurred in two patients without pin loosening. We recommend non bridging external fixator as a good method of treatment of extra articular fractures of the distal radius in younger patients.

Treatment of recurrent anterior dislocations of shoulder by Laterjet-Bristow operation: an experience.

Shoulder dislocation is common problem in orthopaedics. Management of recurrent shoulder dislocation is painstaking with different surgical procedures having varying outcomes. Laterjet-Bristow procedure provides stability and good functional outcome in Rowe scale and long term patient satisfaction. This is an observational prospective study carried out at two different tertiary care centers at Nepal and Pakistan using the same protocol. Habitual and pathological recurrent dislocations were excluded and all the recurrent dislocation of shoulder following initial traumatic anterior dislocation was included in this study. Standard Laterjet-Bristow operation was done and followed up for average of 27 months. Functional evaluation was done using Rowe score and graded as excellent, good, fair and poor. There were 12 men and 9 women with the mean ages of 23.4 years. At 12 months, 11 patients had fair result and seven patients had good result. At two years only three had fair result, 15 had good result and three patients had excellent result. Only three patients had poor result at one year while none had poor result at two year. The mean loss of external rotation in operated shoulder at one year was 24.33 degrees which decreased to 21.2 degrees at the end of second year. There was no restriction of external rotation in three patients at both yearly follow-ups while 18 patients had restriction in the range 10-30 degrees. Laterjet-Bristow can be the procedure of choice for surgical treatment of recurrent traumatic anterior dislocation and also as a salvage surgery for failed cases from other types of procedures. The only shortcoming of this procedure was some limitation in external rotation and minor loss in muscle power of that shoulder.