Comparative study between conventional and 4 mm manual small-incision cataract surgery

Purpose: Comparative study of intraoperative and postoperative complications, visual outcomes, and cost?effectiveness between conventional and 4?mm manual small?incision cataract surgery with MVR blade. Methods: In total, 600 patients having nuclear sclerosis grade I朓V were operated under peribulbar anesthesia and were divided into two groups of 300 each. In group A (300), conventional small?incision cataract surgery was done, whereas in group B (300), 4?mm manual small?incision cataract surgery was performed through a 4?mm sclerocorneal tunnel. A wire vectis was passed through the 4?mm incision below the nucleus to stabilize it, and a 20?G MVR blade was introduced from 11o抍lock limbus and nucleus was bisected into two halves, which were removed through main incision. Cortical wash was given, and foldable IOL was implanted. Intraoperative and postoperative complications between the two groups were compared. Postoperative visual outcome and surgically induced astigmatism between the two groups was studied. Results: The most common intraoperative complication was hyphema (11.33%) and irido?dialysis (8.00%), whereas postoperatively, striate keratopathy (36.33%) and hyphema (19.33%) were common. Short?term complications such as striate keratopathy, hyphema, and irido?dialysis were significantly more in group B, and long?term results in terms of visual outcome and surgically induced astigmatism were significantly less in group B. Conclusion: Although intraoperative and short?term postoperative complications were observed more in 4?mm manual small?incision cataract surgery, it was found to be more effective in terms of surgically induced astigmatism and final visual outcome. In addition, it is cost?effective as compared to phacoemulsification.

The Surgical Outcome of Unstable Distal Clavicle Fractures Treated with 2.4 mm Volar Distal Radius Locking Plate

PURPOSE: This study evaluated the surgical outcomes of unstable distal clavicular fractures treated with a 2.4 mm volar distal radius locking plate. MATERIALS AND METHODS: From August 2009 to August 2012, 16 patients with distal clavicle fractures underwent surgical treatment. Mean age was 36 years (18-62 years) and mean follow-up period was 12.9 months (6-32 months). Two cases were Neer type I, six cases IIa, three cases IIb, three cases III, and two cases V. For the radiologic assessment, union time and metal failure were evaluated, and coracoidiologic assessment, union time and metal failure were evaluatethe acromioclavicular joint. The clinical results were evaluated by range of motion, postoperative complication, and University of California at Los Angeles (UCLA) score. RESULTS: Mean time to fracture union was 7.4 weeks (6-14 weeks) in all cases. No statistical difference in coracoid-clavicle distance was observed between immediate post-operation group and contra-lateral group (p=0.6), but an increase of 2.1 mm was observed in the last follow up group compared with the contra-lateral group (p<0.01). The UCLA scoring system showed excellent results in 15 cases and good results in one case. Acromial-clavicle instability occurred in one case so that metal removal and distal clavicle resection were performed. CONCLUSION: A 2.4 mm volar distal radius locking plate can provide rigid fixation through several screw fixation in the short distal fragment and lead to satisfactory clinical outcomes in unstable distal clavicular fractures.

2.4 mm Volar Locking Compression Plate for Treatment of Unstable Distal Radius Fractures

PURPOSE: To evaluate outcomes 2.4 mm volar locking compression plate for treatment of unstable distal radius fractures. MATERIALS AND METHODS: We retrospectively analyzed the results in 22 cases, which were treated by 2.4 mm volar locking compression plate. We evaluated the clinical results according to the Mayo wrist performance scoring system and radiographic results. RESULTS: All cases had bony union. The mean Mayo wrist performance score was 85.23. Between preoperative and immediate postoperative radiographic measurements, the mean radial length was improved from 6.04 mm to 9.68 mm, radial inclination from 15.61degrees to 19.61degrees, volar tilt from -13.73degrees to 7.66degrees and intraarticular step-off from 0.79 mm to 0.33 mm (p0.05). Postoperative complication included that flexor pollicis longus and 2nd flexor digitorum profundus were ruptured in 1 case. CONCLUSION: Treatment of unstable distal radius fractures using a 2.4 mm volar locking compression plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.

Short Term Results of Operative Management with 2.4 mm Volar Locking Compression Plates in Distal Radius Fractures

PURPOSE: To evaluate the short term outcome of internal fixation using 2.4 mm volar locking compression plate for the treatment of unstable distal radius fractures. MATERIALS AND METHODS: We retrospectively analyzed the results in 22 cases, which were treated with 2.4 mm volar locking compression plate. We evaluated the radiologic results and the clinical results according to Disabilities of the Arm, Shoulder and Hand (DASH) score and visual analogue scale. RESULTS: At final follow up, the mean VAS was 1.2 and mean DASH score was 10. Average loss of reduction from initial postoperative to final follow up radiographs was 0.36 mm of radial length, 0.2degrees of radial inclination, 0.6degrees of volar tilt. CONCLUSION: Fixation of unstable dorsally displaced distal radius fractures with a 2.4 mm volar locking compression plate provides sufficient stability with minimal loss of reduction and good enough clinical outcomes with less complications.