Outcome of intramedullary kirschner wire fixation in children

To know the functional outcome of Intramedullary Kirschner Wire fixation of unstable Radius-Ulna fractures in children. Descriptive study. 27/03/2009 to 26/03/2010. Department of Orthopedic and Trauma, Khyber Teaching Hospital, Peshawar. All patients were admitted from OPD. Children less than 16 years with Unstable Radius-Ulna fractures were included in the study. Patients with open fractures and adults with polytrauma were excluded from the study. Unstable Radius-Ulna fractures were treated by Intramedullary Kirschner Wire fixation under general anesthesia and tourniquet control. Follow up till radiological and clinical union was done. K-wires were removed after healing of fractures. Patients were assessed functionally and radiologically and results were graded according to Price et al Criteria. A total of 64 children with unstable radius and ulna fractures were included in the study. The age range was 6 to 15 years with average age of 10.41 years. 47 were male and 17 were female. The average time of radiological union was 7 weeks and K-wires were removed at 8 weeks time. At final assessment there were 47 Excellent, 10 Good and 7 Fair results. Excellent results can be achieved by Intramedullary K-Wires fixation. In children with unstable Radius-Ulna fractures. It should be the method of choice for treating these fractures

Intertrochanteric fracture of femur; outcome of dynamic HIP screw in elderly patients

Intertrochanteric [IT] fracture is common in elderly population. The dynamic hip screw is widely accepted in the treatment of IT fractures of the proximal femur. To determine the outcome of dynamic hip screw in intertrochanteric fracture of femur in elderly patients. A descriptive observational study Department of Orthopaedic Khyber Teaching Hospital, Peshawar. Period: From 7[th] Jan 2008 to 7[th] Jan 2009. 113 consecutive patients with intertrochanteric fracture of the femur treated with dynamic hip screw. All patients were investigated and optimized for surgery. An accurate close reduction was done under fluoroscopic control. A dynamic hip screw [DHS] was inserted by a standard technique. Patients were reviewed clinically and radiographically on 2nd, 6th, 12th and 24th weeks. We studied 113 Patients of intertrochanteric [IT] fracture, 13 patients were lost to follow up and the study was completed on 100 patients. Forty seven [47.0%] patients were male and 53 [53.0%] were female. Postoperatively seven patients [7%] suffered from infections, 3 [3.0%] patients suffered from restricted hip joint movements. There was shortening of lower limb in 3 [3.0%] patients, 2 [2.0%] patients developed non union of the fracture site, 1 [1.0%] patient develop varus deformity. Seven [7.0%] patients had implant failure, 3 of which have lag screw cut-out through superior cortex, 3 patients have broken leg screw at barrel shaft junction and 1 patient has broken leg screw at 3 sites. 77 [77.0%] healed without complications. It is concluded that the Dynamic Hip Screw is safe, suitable and reliable method of fixation for Boyd and Griffin type I and type II intertrochanteric fracture of femur

Management of displaced supracondylar fracture of humerus in children by side arm traction

This study was conducted to evaluate the outcome of Displaced Supracondylar Fractures of Humerus in children treated by side arm traction. Descriptive study from January 2003 to December 2005. Department of Orthopaedics and Traumatology at Khyber Teaching Hospital, Peshawar 30 children with displaced supracondylar fractures of humerus who were treated with side arm traction and were available for at least six months follow-up. The technique of side arm traction was initially used in those children who presented with huge swelling and blister formation but later on it was used more frequently. The patients were put on side arm traction with commercially available adhesive straps and about 1.5 kg weight was applied to the cord over a pulley. The traction was continued for a period of about 2-3 weeks and after radiological assessment of reduction the children were put in a cast for another 2-3 weeks. Then at each follow-up the patients were assessed clinically for carrying angle, and the range of motion and the outcome was graded. Among the total 30 children that were treated, 18 were males and 12 were females. Their ages ranged from 2-12 years, with a mean age of 6.2 years. All patients had displaced Gart land Type III fractures. The average hospital stay was 21 days. There were no neurovascular injuries. The outcome according to Flynn criteria was graded as excellent in 63.3%, good in 23.3%,fair in 10% and poor in 3.3% cases. We conclude that side arm traction is a safe and effective method of treating displaced supracondylar fractures of humerus in children