RESUMEN
Fractures around proximal humerus are common injuries occurring in predominantly elderly female population associated with osteoporosis. Elderly age group associated with comorbidity gives good outcome with minimal intervention with external stabilization of the fracture avoiding major surgical procedure on proximal humerus. Objective:to study the outcomes of fixation of proximal humerus fracture by external stabilizing system in elderly, osteoporotic and comorbid patients. Methodology:we did study of 30 Neers type 3 and type 4 fracture patients in span of 12 months from fracture in which 17 were female and 13 were male patients. The age group was 50 to 75. The results external fixation of fracture was evaluated as per Neers criteria. Results:all 30 patients were followed till fracture got union. In Neers type 3 fracture 13 (81.25%) patients got good results while in type 4 fractures 09 (64.28%) patients got good results. Conclusion: external stabilization of Neers type 3 and 4 proximal humerus fracture patients who are elderly, osteoporotic and comorbid shows excellent outcome with this minimally invasive stabilizing system.
RESUMEN
Aim: To study the cost-effectiveness of clinical screen with ultrasonography (USG) of hip for diagnosing developmental dysplasia of the hip (DDH) in new borns. Methodology: Prospective study was conducted in DVVPF's Medical College and Hospital, Ahmednagar over a period of two years. Term new borns had (i) target scan at 6 weeks—family history of DDH or breech presentation—and (ii) early scan—abnormal clinical screen. Results: In all, 58 babies had USG scan. Five early scans (Graf's classification; three Type IIA, one Type IIC and one Type IIIB] and 15 target scans (Type IIA) were reported abnormal. All Type IIADDH had subsequent 12 weeks' scans normal. Babies with Type IIIB and IIC had hip reduction surgery at 6 and 16 months of age, respectively. At cost Rs. 200 INR/- scan, total Rs. 1,47,200/- INR was incurred against two possible hip replacements prevented. Conclusion: Universal clinical screen with USG of hip can aid in early diagnosis of DDH in newborns. Large population-based studies from developing countries need to look in its cost-effectiveness.