Prosthesis dislocation following total hip arthroplasty; a comparison of posterior and lateral surgical approach

Introduction: Joint function and integrity can be restored by various techniques and the surgical approach which is used for this restoration is called as arthroplasty. Principal methods for Total Hip Arthroplasty are Direct and Posterior lateral approaches. The most convenient to perform is posterior approach however, dislocation have been reported in most of cases. The rates of hip dislocation may be decreased by direct lateral approach as it provides cup positioning in better way. Direct lateral approach may be considered widely in future if the results of this study show relative benefits

Objectives: To compare posterior surgical approach with direct lateral approach in patients undergoing total hip arthroplasty in terms of prosthesis dislocation

Subjects and Methods: This prospective study was performed at [Punjab Medical College] PMC and various hospitals for 3 years from 1-07-2014 to 30-06-2017.A total of 46 patients with Hip Osteoarthritis were included in the study. All patients were diagnosed clinically and confirmed with radiographic findings. 23 patients underwent Hip Arthroplasty with posterior approach and lateral approach was used in 23 patients. Outcome in terms of prosthesis dislocation was compared in both the groups

Results: In group A, mean age was 55.19 [years] with a standard deviation [Std dev] of 6.705. In group B it was 53.72 +/- 8.541 in terms of age. Prosthesis dislocation in group A was 34.7% and 13.4% in group B. P value was 0.001

Conclusion: Outcome of Direct lateral surgical approach is better than Posterior surgical approach in terms of prosthesis dislocation in patients undergoing Total Hip Arthroplasty

Outcome of dynamic compression plating in fracture shaft of humerus

Background: Fracture shaft of humerus is a common orthopedic problem and represents roughly 3% of all fractures, usually managed non-operatively. The usual operative modalities used for fixation of humerus fractures are the kuntscher nails, dynamic compression plate [DCP], external fixator and intramedullary nail [IMN]. Plating of fracture shaft of humerus is the more common surgical treatment option. There is a higher rate of excellent and good results and tendency for earlier union with the plating of fracture shaft of humerus

Methods: This study was conducted at Orthopedic Department of Allied and DHQ Hospital Faisalabad from November 2011 to November 2012. All patients with fracture shaft of humerus were included and treated with dynamic compression plating

Results: 91 patients with mean age of 37.24 including 70 [76.9%] males and 21 [23.1%] females falling in inclusion criteria were operated by same orthopaedic surgeons team with same implant i.e. DCP. At 1ST postoperative day, 87 patients [95.60%] had no neurological deficit while 4 patients [4.40%] had neurological deficit. At 12th postoperative day only 9 patients [9.9%] had superficial wound infection while 82 patients [90.1%] have no wound infection

Conclusion: Humeral shaft fracture is one of the commonest fractures among the working community and elderly. Fixation of fracture with Dynamic Compression Plate is the treatment of choice. Postoperative radial nerve injury is an important complication and few patients in this study developed neurological deficit

Supracondylar humerus fractures outcome of open reduction and percutaneous crossed pin fixation

Displaced Supracondylar fractures of the humerus in children are common injuries treated by orthopaedic surgeons. To evaluate the role of open reduction and percutaneous crossed pin fixation in displayed supracondylar fractures and to design a simple and effective protocol for the treatment of these fractures. Prospective. Independent Medical College Independent University Hospital Faisalabad. From January 2009 to June 2010. Fifty six cases with grade II and grade III Gartland Supracondylar humeral fractures were treated with open reduction through postereomedial approach and percutaneous crossed pin fixation with Kirschner wire and followed up for a minimum period of 1 year. Patients were assessed on the basis of Flynn's criteria there were 41 Excellent and12 good results It is concluded that open reduction and percutaneous crossed pin fixation is a sound and effective treatment for displayed supracondylar fractures with several advantages but requires careful judgment on the part of surgeon to avoid complications

Comminuted fractures of shaft of femur; bridge plate versus interlocking nail in low velocity gun shot injuries

Comminuted fracture shaft of the femur is a common entity faced by orthopaedic surgeon. Road traffic accidents are the major cause of these comminuted fractures. But with increase in violence, gun shots are also causing these fractures frequently. To see and compare the result of intrameduliary interlocking nailing and biological plating in terms of infection rate, union rate and to assess the other complications. Prospective study. Department of Orthopedic Surgery Allied Hospital Faisalabad. From Sept 2001 to Sept 2003. Forty comminuted fractures of femur were managed .twenty by bridge plating and twenty by interlocking nailing. Results were compared with reference to healing time, infection rate, operating time and hospital stay and was comparable to other studies. Closed interlocked intra-medullary nailing is an excellent method for treating comminuted femoral shaft fracture. But requires expensive equipment and more expertise. Bridge plating require no special instrumentations and can be done at periphery with less facilities available