RESUMEN
Isolated capitellar fractures are uncommon. Authors continue to differ about the preferred method of treatments and it's results on the post operative outcome. Of This study: Is to evaluate the clinical and functional out come of operatively treated capitellar fracture with K.Wire, and furthermore to define the impact of fracture type on the out come. A retrospective study carried out on 15 patients Sustaind closed capitellar fracture, 11 females, 4 males. The main age [16 - 58 years]. the Operative treatment performed at a mean of 10 days, by open reduction through relatively limited lateral approach and internal fixation with k. wires. The evaluation of the functional outcome was by clinical and radiographic examination . The range of motion [ROM] by using of Mayo Elbow Performance Index [MEPI], and The American Shoulder and Elbow Surgeons [ASES] scales, and self assessment questionnaires form. Eight patients type I, one type II, four type III, two type IV ,and three patients had ipsilateral radial head fracture,. two in association with type III, and one with type IV. All fractures healed, with no significant clinical instability or weakness. The mean ulno-humeral motion [UHM] was [95o-132o] . All patients had full forearm rotation, average flexion contracture was 15o [range [8o-35o]. [P=0.05]. The mean [MEPI] was [90 +/- 10] points, with seven excellent results and six good, and the mean [ASES] was 36 +/- 3 [30 to 40 points] in seven patients. Ipsilateral radial head fracture had no significant effect on the functional outcome. Good to excellent outcome with functional ulnohumeral motion [UHM] can be achieved following open reduction and minimal fixation with k. wires in the treatment of capitellar fractures
RESUMEN
Tibia is the most commonly fractured long bone in the body, because its particular blood supply and high complications rate we always try to find out the best method to manage such fracture with minimal disturbance to its blood supply and early mobilizations. The fracture brace is one of the best methods of treatment of fractures regarding safety and early mobilization. We used the brace in closed and compound [Gustillo I and II] in adult, and shows its advantage over other methods regarding safety, mobility, and low complication rate. Nineteen patient with tibial shaft fracture was investigated during the treatment with tibial castbrace Fractures were classified according to AO/ASIF classification. Patients were treated primarily by back slab followed by plaster application from toes to above the knee Fracture brace was applied after the pain and swelling had subsided. Serial x-ray films were taken regularly in a fixed dates to observe and prevent any unacceptable misalignment cast brace was discarded after union, when it found safe to walk independently. The average time needed for application of the cast after injury was [4.8] weeks for closed fractures and [6.1] weeks for open Fractures. Union occurred in an average of [17.2] weeks for type A1 [AO/ASIF], [16.2] weeks for A2, and the longest healing time [22.2] weeks was obtained in type C. Neither a significant shortening was obtained with a range of [8.6-13.4 mm.] nor an angulations range of [1-7.5[°]] if compared with the acceptable figures. Functional bracing is another method in accomplishing the goal of early introduction of function after bone union. It does not replace other methods of treatment which have its specific indications. Functional bracing is successful in type A, and can be used in type B and C of AO/ASIF classification .The misalignments obtained are mostly within acceptable range if compared with the standard figures