Résumé
Distal radius fractures are one of the common injuries for which orthopedic consultations are sought. These injuries make up to 10-15% of all bony injuries in adult population. High energy trauma as seen in road traffic accidents is common cause of these injuries. Noncomminuted extra-articular fractures of distal radius are common in adult males following vehicular accidents. Majority of the patients with distal radial fractures are managed by closed reduction and immobilization. Poor functional outcome and complications such as malunion has made many researchers to look for alternative methods of managing these patients. An attractive alternative for managing these cases consist of Percutaneous pinning followed by immobilization of the fracture for 3 weeks. This method is simple and affordable and reported to have excellent functional outcome.Methods:This was a prospective cohort study conducted in the department of orthopedics of a tertiary care medical college situated in an urban area. 40 adult patients with Noncomminuted extraarticular fractures of distal radius were included in this study on the basis of a predefined inclusion and exclusion criteria. All patients were treated by closed reduction followed by percutaneous pinning using K-wires. Below elbow plaster cast was given for 3 weeks after which plaster was removed and physiotherapy was started. Follow up X-rays were taken at 3 and 6 weeks. Functional outcome was assessed by Quick DASH scores. SSPE 21.0 was used for statistical analysis and p value less than 0.05 was taken as statistically significant.Results: Out of the 40 studied cases there were 34 (85%) males and 6 (15%) females a M:F ratio of 1:0.17. The most common affected age group was found to be <30 years (55%) and most common mechanism of injury was motor vehicular accidents (65%). All patients were treated by closed reduction followed by percutaneous pinning using K-wires. Excellent or good functional outcome was seen in 34 (85%) patients. 4 (10%) patients were found to have fair functional outcome and remaining 2 (5%) patients were found to have poor functional outcome as assessed by Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.Conclusion:Percutaneous pinning followed by immobilization of the fracture is an effective treatment for Non-comminuted extra-articular fractures of distal radius having excellent functional outcome.
Résumé
Background: Scapular fractures can be seen following road traffic accidents, falls or following assaults. While nondisplaced scapular fractures can be managed conservatively displaced and comminuted fractures needs surgical intervention. Open reduction and internal fixation is associated with excellent functional outcome and acceptable complication rates. Methods: This was a prospective cohort study comprising of patients presenting with scapular fractures and treated by surgical interventions were included in this study depending upon a predefined inclusion criteria. Any patient having any exclusion criteria was excluded from the study. Demographic details, mechanism of injury and imaging finding were noted. All patients underwent surgical interventions in the form of open reduction and internal fixation. Post operatively patients were assessed for functional outcome and complications Results: Out of 25 studied cases there were 16 (64%) males and 9 (36%) females with a M: F ratio of 1: 0.6. The most common age group affected was 18-30 years (44%) and most common mechanism of injury was road traffic accidents (60%). Majority of the patients had fractures of body of scapula (48%) followed by fractures of glenoid cavity (32%), coracoid process (12%) and acromion process (8%). Mean preoperative and postoperative quick DASH scores were found to 42.12 +/- 10.13 and 10.76 +/- 4.54. Mean VAS score at presentation and 48 hours postoperatively was 8.14 and 5.20 respectively. Minor complications were seen in 6 (24%) cases. Conclusion:Displaced or comminuted scapular fractures treated by surgical interventions are found to have excellent functional outcome and acceptable complication rate
Résumé
Background: Navicular fractures are usually caused by high velocity trauma, sudden twisting forces (sports injury) and repeated minor trauma (as seen in military recruits or athletes). The patients usually present with pain and swelling. Stress fractures usually present with vague symptoms and the diagnosis is delayed leading to complications. The diagnosis is usually done on the basis of imaging. The undisplaced fractures are managed conservatively while displaced fractures need surgical intervention. Usual complication in surgically treated patients may include prolonged pain, stiffness, arthritis and avascular necrosis. Aims and Objectives: To study the mechanism of injury, presenting complaints, management and outcome of patients with navicular fractures. Methods: This was a retrospective study conducted in the department of orthopedics of a tertiary care medical college situated in an urban area. 30 patients diagnosed to be having navicular fractures and treated either by conservative or surgical methods were included in this study on the basis of a predefined inclusion and exclusion criteria. The etiology, type of fractures, management and outcome were studied in this study on the basis of patient records. Follow up record of at least 2 years after surgery was reviewed in all the cases. Results: Out of the 30 studied cases there were 22 males and 8 females with a M:F ratio of 1:0.28. Most common affected age group was found to be 21-30 years. Mean age of male and female patients was found to be 28.77+/- 7.90 and 29.12 +/- 8.58 respectively. Right navicular bone was affected in majority of the cases and most common type of injury was found to be road traffic accidents. Simple undisplaced fractures were seen in majority of the cases. Conservative management was done in 19 patients while 11 patients were treated by surgical interventions. complications like sudeks atrophy, wound infection and long term pain and stiffness were seen in 7 patients. Conclusion: Navicular fractures are commonly seen in young athletes. The management is either conservative or surgical depending upon type of fracture. Early diagnosis and proper treatment in crucial as delay in management is associated with complications.