Intramedullary nailing; gunshot comminuted femur fractures, experience in a tertiary care hospital at Karachi

Gunshot comminuted fractures of femoral shaft are complicated fractures to treat in orthopedic practice, resulting in prolonged morbidity and extensive disability. Intramedullary interlocking nail is a well-established operative procedure for the management of this entity. The objective of this study is to find out the healing of gunshot comminuted fracture of shaft of femur treated by interlocking nails. This study was conducted at Civil Hospital Karachi during July 2009 to December 2009.Forty three patients sustaining gunshot comminuted fracture of shaft of femur were selected. All patients then underwent fracture stabilization by locking intramedullary nail. The main outcome measure was fracture healing [i.e. callus formation] on X-ray at six months of follow-up. The SPSS version 13 was applied to the data. Majority of the patients [46.5%] were between 18-30 years of age group with mean age of 36.05[+12.53] years. Males were affected more than females with male to female ratio being 4.3:1. Healing [i.e. callus formation] was achieved in 39[90.7%] patients radiographically at the end of six-months. Intramedullary interlocking nail is safe and effective procedure in the management of gunshot comminuted fractures of femur shaft as it is associated with good healing

Successful reductions of anterior shoulder dislocations using intra articular lidocaine injection

To find out the frequency of successful reductions in acute anterior shoulder dislocations after the use of intra-articular lidocaine injection. This study [case series] was conducted in Emergency Department of Civil Hospital Karachi from July 2009 to January 2010. Patients with acute anterior shoulder dislocation [diagnosed with examination and X-Rays] were reduced in emergency department by Hippocratic method after infiltration of 1% Lidocaine in the affected shoulder joint. Reduction was confirmed by post reduction shoulder X-Rays. Frequency of successful reduction and complications were recorded. Majority of the patients [34.3%] were between 18-30 years of age group with mean age of 40.14 [ +/- 15.14] years. Males were affected more than females with male to female ratio being 2.9:1. They commonly had predominant right shoulder dislocation [71.4%]. Successful reduction was achieved in 32 [91.4%] patients after infiltration of 1% lidocaine injection. No complication was recorded. Use of intra-articular lidocaine for reduction of shoulder joint appears to be a safe and effective method and associated with successful reduction in majority of cases