RESUMEN
Objective: to compare the short-term functional outcome between resection and reconstruction in Mason Type II and Type III radial head fractures using Broberg and Morrey score
Methods: a prospective cohort study was conducted in the Department of Orthopedic Surgery of SMS Medical College and attached Hospitals. A total of 29 patients [15 in resection group, 14 in reconstruction group] between the age group of 20-60 years with Mason Type II and Type III fresh closed radial head fractures were included in the study. The functional outcome including the range of motion, extension lag and Broberg Morrey score were determined and compared between two groups
Results: the mean age of resection group was 44.5+/-6.6 years and mean age of reconstruction group was 37.1+/-6.2 years. The baseline characteristics . At 12-months follow-up, in Mason type II fracture, radial head reconstruction group with mean extension lag of 9.4+/-4.1 and mean Broberg Morrey score of 94.9+/-5.1 showed better results compared to radial head resection group with mean extension lag of 15.7+/-4.1 [p=0.022] and mean Broberg Morrey score of 88.3+/-5.1 [p=0.045] respectively. In Mason type III fractures, radial head resection with mean supination of 79.4+/-4.7, mean pronation of 74.4+/-4.1 and mean Broberg Morrey score of 89.8+/-6 showed better results when compared with radial head reconstruction group with mean supination of 64.2+/-4 [p<0.001], mean pronation of 59.2+/-8.4 [p=0.003] and mean Broberg Morrey score of 81.9+/-5 [p=0.031]
Conclusion: the procedure suggested in Mason type II, is reconstruction of radial head. In Mason type III due to difficulty in achieving anatomical reduction results were not good with reconstruction when compared with resection. We recommend radial head excision in Mason type III fractures where anatomical and stable fixation is not possible
RESUMEN
Objective: To compare the effect of adding two different doses of dexmedetomidine to ropivacaine, on onset and duration of analgesia for supraclavicular brachial plexus block in patients scheduled for upper limb orthopedic surgery
Methodology: This prospective randomized double blind comparative study was conducted at our institution. After ethical committee approval and informed patient consents, 50 patients of ASA I, II and aged 21-60 years, who were scheduled for elective upper limb surgery and were enrolled in the study and randomly divided into two equal groups. They received either 30 ml of 0.75% ropivacaine plus dexmedetomidine [1 micro g/kg] diluted with normal saline up to 5 ml [total volume = 35 ml] in Group 1 or 30 ml of 0.75% ropivacaine plus dexmedetomidine [2 micro g/kg] diluted with normal saline up to 5 ml [total volume = 35 ml] in Group 2. The onset and duration of sensory and motor block, duration of analgesia, hemodynamic parameters, sedation score, VAS and side effects were recorded
Results: Onset time of sensory and motor block were earlier in Group 2 than in Group 1 [p < 0.001]. Duration of sensory and motor block and duration of analgesia were longer in Group 2 than in Group 1 [p < 0.001]. There was no significant difference in the incidence of hypotension and bradycardia between both the groups [p > 0.05]. There was a statistically significant reduction in number of rescue analgesic doses and total dose consumption in 24 hours in Group 2 than in Group 1. Quantitative data are represented as arithmetic mean and standard deviation and analyzed using Student's t test or ANOVA as per need. Qualitative data are represented as number [proportion or percentage] and analyzed using Chi square test. The levels of significance and alpha-error were kept 95% and 5% respectively for all statistical analyses. P values < 0.05 were considered significant