ABSTRACT
Objective: To document the presentation of tibial infected non-union and analyze the management outcome with Ilizarov technique in terms of bone results, functional outcome, bone transport time, external fixation time, external fixation index and any complications
Methods: This case series was conducted at the Departments of Orthopedic Surgery, National Institute of Rehabilitation Medicine [NIRM], Islamabad and Civil hospital, Quetta over a period of 3-years
Results: There were 56 patients with 53[94.64%] males and 3[5.35%] females. The age range was 16-50 years with a mean of 32.58+/-9.98 years. According to ASAMI criteria, bone results were excellent in 37[66%], good in 10[17.85%], fair in 6[10.71%] and poor in 3[5.35%]. The functional results were excellent in 37[66%], good in 9[16%], fair in 7[12.5%] and poor in 3[5.35%]. The bone union rate was 98.21%
Conclusion: Ilizarov method beautifully addresses the formidable issue of infected non union of tibia with good outcome in terms of bone healing and infection eradication. The treatment period is relatively lengthy and hence patience on part of patient as well as the surgical team is imperative for achieving favourable outcomes
ABSTRACT
Objective: To document the clinical presentation of neglected DDH and evaluate the outcome of triple procedure
Methods: It was a descriptive case series study, conducted at the Department of Orthopedic Surgery, National Institute of Rehabilitation Medicine [NIRM], Islamabad over a period of 8-years. It included children aged >1 and <9 years who underwent the triple procedure of open reduction, femoral shortening and Salter's osteotomy. Clinical evaluation was performed using McKay's criteria. Tonnis classification and Severin's scoring system were employed for the radiological evaluation
Results: There were 193 children with 213 DDH affected hips. The mean age was 3.31+/-1.6 years. The preoperative severity of the femoral head dislocation per Tonnis classification was Grade-I in 7.98%[n=17], Grade-II in 48.35%[n=103] and Grade-III in 43.66% [n=93] hips. The postoperative MacKay criteria was 'Good' to 'Excellent' in 193[90.61%] hips. The postoperative Severin's class was I in 113[53%] hips, II in 48[22.53%] hips, III in 43[20.18%] and IV in 9[4.22%] hips. The preoperative acetabular index ranged from 39 degree to 51 degree with a mean of 43.91+/-3.69 degree. The mean postoperative AI was 18.42+/-2.99 degree. The postoperative centre edge angle ranged from 21 degree to 26 degree with a mean 23.18 +/-1.35 degree
Conclusions: The single stage triple procedure offers the surgical remedy of choice with favourable results for managing neglected and late diagnosed DDH among children aged 1-8 years