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Background: Fracture neck femur (FNF) is important due to its high incidence in general population. In younger patients, trauma is the major cause of fracture neck femur. Displaced fractures are usually treated by fixation with partially threaded cannulated screws (PTS) placed in a parallel pattern. In the present study, we have explored the use of fully threaded cannulated screws (FTS) for fixation of fracture neck of femur. Aim and Objectives: The aim of our study was to analyze and compare the clinical and functional outcomes of fracture neck femur treated in both groups. Materials and Methods: A prospective randomized control analysis was conducted in the Department of Orthopedics of Rajindra Hospital and Government Medical College, Patiala, Punjab between June 2019 and December 2021 on 30 patients who were admitted with neck femur fracture in the age group between 15 and 60 years. Fifteen patients were treated with FTS and 15 were treated with PTS. Subsequent hip radiographs were taken postoperatively and analyzed for various parameters such as fracture fixation, fracture union, and reduction. Regular follow-up was done by clinical examination along with the radiological examination monthly for 3 months, then at 6th month, and 9th month. The functional outcomes of fracture neck femur treated with PTS and FTS were compared in terms of blood loss, radiological union, weight bearing, functional outcomes (in terms of Harris hip score), and post-operative complications. Results: Hip function on the operated side was evaluated and compared with the normal side as per Harris hip score. About 73.3% of patients with FTS group in this study had excellent results compared to 26.6% in PTS group, fair results were found in 13.3% in both groups, 6.6% of patients had good results with FTS group as compared to 13.3% of PTS group, and 6.6% had poor outcome with FTS group as compared to 46.6% with PTS group. In our study, mean Harris hip score was 76.6 in PTS group and 85.5 in FTS group (P = 0.044). The present study indicated that there were statistically significant differences between FTS and PTS in terms of functional outcomes and complication rates such as femoral neck shortening (P < 0.05). However, no significant differences in terms of blood loss, weight bearing, and fracture union time were observed between two groups (P > 0.05). Conclusions: FNF treated with FTS is superior than PTS in terms of functional outcomes and complication rates. Both FTS and PTS are equivalent in terms of average blood loss, weight bearing, and fracture union time.
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PURPOSE: To introduce the technique of reducing displaced or comminuted clavicle shaft fracture using composite wiring and report the clinical results. MATERIALS AND METHODS: Between March 2006 and December 2013, 31 consecutive displaced clavicle fractures (Edinburgh classification 2B) treated by anatomic reduction and internal fixation using composite wiring and plates were retrospectively evaluated. The fracture fragments were anatomically reduced and fixed with composite-wiring. An additional plate was applied. Radiographic assessments for the numbers of fragments, size of each fragment and amount of shortening and displacement were performed. The duration for fracture union and complications were investigated retrospectively. The mean fallow-up duration was 15.9 months. RESULTS: The mean number of fragments was 1.7 (1-3) and the mean width of fracture fragment was 7.1 mm (4.5-10.6 mm). The mean shortening of the clavicle was 20.5 mm (10.3-36.2 mm). The mean number of composite wires used in fixation was 1.9 (1-3). Radiographic union was achieved in all patients with a mean time to union of 11.6 weeks. There were no complications including metal failure, pin migration, nonunion, or infection. CONCLUSION: The composite wiring was suitable for fixation of small fracture fragment and did not interfere with the union, indicating that it is useful for treatment of clavicle shaft fracture.
Subject(s)
Humans , Classification , Clavicle , Fractures, Comminuted , Retrospective StudiesABSTRACT
Background: Intertrochanteric fracture of femur is one of the most common fractures seen in general population. Till date various fixation devices are used for fixation of this fracture that includes both extra medullary and intramedullary implants. Ender and Simon Weidner popularised the condylocephelic intramedullary nailing for this fracture. But it is seen that fracture treated by ender nailing alone resulted in varus malunion. Aims & Objective: Along with ender nail we added the cannulated cancellous screw which results in controlled collapse of the fracture with union in anatomic position. Material and Methods: We studied 50 patients of intertrochanteric fracture treated by ender nail and cannulated cancellous screw between year 2009 to 2011. Follow up assessment was done by Harris hip score. Results: The union achieved in mean time of 7 weeks. In study of 50 patients we obtained 86% excellent to good results. 14% patient had fair to poor results. Conclusion: We found that use of Ender nail and cannulated cancellous screw results in fracture union in more anatomical position with better patient compliance and early mobilization.
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PURPOSE: A technique of cerclage wire fixation in comminuted fracture of the clavicle shaft is thought to interfere the fracture healing, so authors studied radiographically and clinically about the cases of cerclage wiring of the fracture fragments with the plate and screws fixation in the comminuted fracture of the shaft of the clavicle. MATERIALS AND METHODS: According to following inclusion criteria, total 18 patients (male: 15, female: 3) were investigated; Patients who visited hospital due to clavicle shaft comminuted fracture from February 2005 to April 2009, who underwent surgery utilizing more than 2 cerclage wire fixation for the fragments when open reduction and plate fixation were operated and who could be follow-up over one year. The duration for fracture union, functional outcome and complications were investigated retrospectively. RESULTS: Radiological bone union was accomplished in average 13.3 weeks (12~16 weeks) and there was no complication such as nonunion, delayed union or infection. Range of motion of ipsilateral shoulder joint was recovered in all patients except one at the final follow-up. CONCLUSION: The clinical and radiographical results of the plate and screws fixation with cerclage wiring of the fragments in comminuted clavicle shaft fracture showed that the cerclage wiring does not interfere the fracture healing, so authors think that this method is a good alternative operation if it is performed carefully to minimize soft tissue dissection.
Subject(s)
Humans , Clavicle , Follow-Up Studies , Fracture Healing , Fractures, Comminuted , Range of Motion, Articular , Shoulder JointABSTRACT
[Objective]To observe the curative effect of ectogenic bone inductive factor in treating osteoporotic frature,and provide feasibility pathway and method for clinical treatment.[Method]Sixty cases of osteoporotic fracture from Febuary 2002 to May 2005 were randomly divided into experimental group(30 cases) and control group(30 cases).The experimental group were given 4 ml osteotide a day by intramuscular injection,and 15 days were a course of treatment.The second course of treatment went on after 15 days later when the first course ended.At the same time,no any medicine was given to the control group.The biochemical indicators were detected 2 months later.And after 2,4 and 6 months the union of fracture was observed through radiology.[Result]Four months after operation,radiology examination showed that the rate of union of fracture was 93% and 67% respectively.There was significant difference between the two groups(P
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Objective To study the effects of Zhishang Sanfang (ZS) in promoting the union of radius fracture. Methods Twenty-eight rabbit models with fr acture were randomly allocated to ZS group (Group A) and control group (Group B).His tological, histochemical and histomorphological quantitative detection was used to observe the morphological features of the frature end in the 14th and 28th da y after operation. Results The formation of blood capillaries and bone trab eculae in Group A was superior to those in Group B. The scores of the four callu s and th e depth of the lateral callus in Group A were higher than those in Group B. Con clusion ZS has obvious effect in promoting the union of fracture.
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Recently, the incidence of open fracture of tibial shaft has risen as a result of rapid increase in automobile and industrial accidents. The open fracture of tibial shaft is extremely difficult to treat and has a greater incidence of osteomyelitis, delayed union and nonunion. One hundred and forty two patients (146 cases) of the open fractures of tibial shaft were treated and managed at the Department of Orthopedic Surgery, Hanyang University Hospital from May, 1972 to May, 1984. The results were as follows; 1. In 43.2% of all cases, ordinary culture test for open wound was positive and staphylococcus was predominant. 2. A relatively same rate of fracture union was shown in any portion of tibial shaft. 3. A better prognosis of the fracture type was shown in the oblique, transverse and spiral fracture than in the comminuted and segmental fracture. 4. According to the classification of Ellis, the higher delayed and nonunion rate was shown in major severity group than moderate and minor ones. 5. In minor and moderate severity group, the relatively same rate of fracture union was shown in conservative or operative treatment, but in major severity group, conservative treatment was better than operative treatment. 6. In upper 1/3 and middle 1/3 of the tibia, the relatively same delayed and nonunion rate was shown in conservative or operative treatment and lower 1/3 of the tibia, the high delayed and non-union rate was shown in operative treatment. 7. In comminuted, oblique and transverse fracture, the high delayed and nonunion rate was shown in operative treatment, but in other type of fracture, the relatively same delayed and nonunion rate was shown.