ABSTRACT
The biomechanical characteristics of midshaft clavicular fractures treated with titanium elastic nail is not well studied. This study aimed to present a analysis of titanium elastic nail fixation and reconstruction plate fixation for midshaft clavicular fractures. Methods: Forty-four patients between 18 and 65 years of age were included in this study. They were randomized in two groups to be treated with either elastic intramedullary nail (ESIN) or plate. Clinical and radiological assessments were performed at regular intervals. Outcomes and complications of both groups over 2 years of follow-up time were compared. Results: Length of incision, operation time, blood loss and duration of hospital stay were significantly less for the ESIN group. American Shoulder and Elbow Surgeons (ASES) and Constant Shoulder scores were significantly higher (p\0.05) in the plating group than the EIN group for the first 2 months but there was no significant difference found between the two groups regarding functional and radiological outcome at the 2-year follow-up. Conclusion: ESIN is minimally invasive surgical technique with a lower complication rate, faster return to daily activities, excellent cosmetic and comparable functional results, and can be used as an equally effective alternative to plate fixation in displaced midshaft clavicle fractures.
ABSTRACT
The distal end of the radius is one of the common sites of involvement in giant cell tumors (GCTs) with increased chance of recurrence. The objective of the present analysis was to study the modalities of management of the different types of distal end radius GCTs so as to reduce the recurrence rates and retain adequate function. Methods: A prospective study of 24 patients of GCT of distal end of radius treated by various procedures in our institute and followed upto 24 months to analyse complications and functional outcome based on The Musculo Skeletal Tumour Society Score. Results: In our series of 24 patients of GCT distal radius, 7 cases treated with curettage and bone graft 4cases were presented with recurrence, 1 with stiffness, and 2 with superficial infection. Out of14 cases treated with Wide Resection and reconstruction with nonvascularized proximal fibula 4 cases appeared with recurrence,2 showed non-union and 1 delayed union , 3 with wrist deformity,7with stiffness, 4 with carpal subluxation & 2 with donor site morbidity. In 3 patients treated with centralisation of ulna 2 case presented recurrence. Conclusion: A careful clinical and radiological assessment of distal radius GCT and judicious treatment plan is the key for successful outcome.