ABSTRACT
Background: This study was done for the analysis of the functional outcomes of distal humerus fractures managed by open reduction internal fixation by reviewing 24 cases of fractures of distal humerus which were surgically managed by olecranon osteotomy approach during December 2012 to September 2016. Methods: 16 male patients and 8 female patients with a mean age of 38.12±15.06 years were included in this study. A mean follow up time of 10.2months (range 3-18 months) was done. Flexion, extension, range of motion,mayo elbow performance score (MEPS),disability of shoulder arm and hand score (DASH SCORE), duration of surgery and blood loss were used to assess the functional outcome of fractures of distal humerus managed by open reduction internal fixation using the olecranon osteotomy approach. Results: According to AO foundation (AO) Classification there were no cases of type A or type B , 5 cases of type C1 , 6 cases of type C2 and 13 cases of type C3 fractures.Out of 24 patients9(37.5%), 9(37.5%), 6(25%) obtained Excellent , Good , Fair MEP score respectively. Conclusion:No patient fell under poor category of MEP score.
ABSTRACT
Background: The Aim of the study was to analyze the functional outcome of limb length discrepancy after total hip replacement. . Methods: It is a Prospective study on 21 patients who underwent total hip replacement with different hip pathology between November 2015 and October 2017. Results: 13 males and 8 females patients with a mean age of 35.31±7.42 (21-50) were followed up for a time of 12months. Limb length discrepancy and hip function of 21 patients who underwent primary total hip arthroplasty were assessed before surgery and 1month, 3 month and 12 month after surgery. Limb length discrepancy was evaluated before and after surgery by clinical and radiological method, Functional outcome assessed by using the Oxford hip score (OHS) and Harris hip score(HHS). Preoperatively all patients had shorter limb length as compared to contra lateral side. Postoperatively in 42.9% (9/21) the limb operated on was longer, in 19 %( 4/21) of cases limb operated on was shorter and in 31 %( 8/21) postoperative limb length were equal. Postoperatively limb length discrepancy was present in 61.9 %( 13/21) & was perceived by 53.8 %( 7/13 of cases) when either shortening or lengthening exceeded 10mm. Oxford hip score (OHS) and Harris hip score (HHS) were significantly increased at subsequent follow up (at 1, 3 and 12 months). Functional scores (OHS and HHS) were excellent in patients with equal limb length as compared to those having shorter or longer limb length. Conclusion: Patient with limb length discrepancy had negative influence in relation to limping and pain. Patients should be counseled preoperatively about possible limb length differences and associated symptoms.
ABSTRACT
Background: The aim of this analysis was to study various clinical presentation, epidemiological prevalence, various diagnostic tools applied and basic management of low back pain in special reference with sacroiliitis. Methods: We reviewed 360 patients with low back pain. Patients were evaluated and diagnosed by proper history, clinical, radiological and haematological examination. Conservative treatment trial was given to all. Results were evaluated by JOA score in the form of recovery rate at one month and at three month. Results: Mean age group affected is 40.59 years and most common cause is musculoskeletal strain. Males are more commonly affected. Among total patients of low back pain 16.38 % were suffering from sacroiliitis. On conservative treatment after 3 months, 41.67 % had GOOD recovery rate and 12.5 % had excellent recovery rate.Conclusion: Prevalence of low back pain is maximum in 4th decade of life. Males are affected more commonly (55 %). Most patients had sedentary life style. Onset of low back pain is mostly gradual (96.39 %) and most common cause is musculoskeletal strain (36.67 %). Sacroiliitis consisting 16.37 % of the total patients with low back pain. Among the special tests, FABER's test is most commonly positive in all patients, but STORK's test is most commonly positive in patient with sacroiliitis. After 3 months of conservative trial 41.67 % patients had GOOD recovery rate, and 12.5 % had excellent recovery rate.
ABSTRACT
Background: Osteoarthritis is more common in females. It is because osteoarthritis in post-menopausal women is associated with higher body weight, higher subcutaneous fat, calcium deficiency and weaker muscles linked to hormonal changes. The purpose of this study was to evaluate the role of high tibial osteotomy fixed with angle stable plate in treatment of osteoarthritis of knee. Methods: In our study 10 cases were operated by modified coventry technique , 10 cases were operated by open wedge osteotomy with non locking plates and bone graft and 104 cases were operated by medial open wedge osteotomy and iliac graft secured by locking plate. In these cases full weight bearing was allowed at 8 week, 6 week and 3rd post operative day respectively. Radiographical analysis include post operatively change in tibio-femoral angle. Mean follow up of these cases was 2 year. Results: In our study thee knee pain and function score were significantly improved (p value <0.001). The average pain score preoperatively was 1 8± 7(the maximum pain score for pain is 50) and post-operatively was 44±5. According to the grading used for functional assessment in knee scores there was definite improvement in the function of cases 122 (98.38%) at 2 yrs. The preoperatively mean functional knee score in of 110 cases (88.7%) cases was 28.86 (the maximum functional knee score is 100) and postoperatively was 70.45. There is correction in tibiofemoral angle (mean preoperative and postoperative tibiofemoral angle was 5.2±1.5 degrees varus and 5.8±1.3 degrees valgus respectively). Conclusion: There was definite improvement in the pain and function of the knee after the correction of the deformity (P value <0.001). The results of high tibial osteotomy in 88.23 percentage knees were rated as excellent. 104 out of these 124 cases were fix by locking plates. 2 cases had poor results due to excessive over correction and associated comorbidities. There is a definite correlation between the postoperative valgus obtained and relief in the pain.