Résumé
Background: With increasing number of motor vehicles and population, trauma patients are increasing day by day. Motorcycle accidents are one of the major causes of disabilities and deaths in young males
Objectives: To determine the pattern of orthopaedic injuries and outcome of its treatment in patients presented to Allied Hospital Faisalabad after motorcycle accidents and to provide the baseline data to policy makers and other stakeholders who want to undertake necessary measures to improve road safety in the country
Study design: Descriptive cross sectional
Setting: Accident and Emergency [A and E] and orthopaedic department of Allied Hospital Faisalabad
Duration of study: January 2012 to December 2012
Method: All patients were admitted through Accident and Emergency department. The data was collected in retrospective way and was analyzed using SPSS version 17
Results: Total 1003 patients were included in this study. 859 were male [85.6%] and 144 were female [14.4%]. The patient ages ranged from 3 to 90 years with peak frequency of 21-30 years 318 [31.7%]. Businessmen290 [28.9%], employee/public workers 224 [22.3%] and students 216 [21.5%] were the majority of victims. Collision of motorcycle with vehicles was the most common mechanism of injury 31.4% and Motorcycle riders 613 [61.1%] were the usual victims. Frequency of non-helmet use was 93.4% and of head injuries along with orthopaedic injuries were 33.1%. Most common orthopaedic injury pattern in motorcycle accidents was fracture of tibia and fibula 43.4%. Mean duration of hospitalization was 9.1days
Conclusion: Road traffic accidents constitute one of most important public health problem in our society. Disabilities and deaths in motorcycle crash are increasing day by day. Preventive programs must be launched by policy makers of concerned departments and stakeholder at national level as solely a medical approach is insufficient to save precious lives of many people
Résumé
Background: There has been a trend toward operative management of pediatric Diaphyseal Forearm Fractures [DFFx]. We studied our experience with surgical management of these injuries to assess outcome and complications
Objective: The purpose of this study was to assess outcome and complications associated with open reduction and intramedullaryKirschner-wire fixation for fracture shaft radius ulna in children
Design: Prospective study
Setting: Orthopedic surgery departments of Independent Medical College, Punjab Medical College and University Medical College Faisalabad
Study Period: Between March 2009 and February 2011
Method: The study group included 32 boys and 12 girls aged 6-15 years with unstable displaced fractures shaft radius, ulna or both. Relevant history and x-rays of the forearm were taken. We followed the inclusion and exclusion criteria. All the cases were treated with open reduction and retrograde Kirchner wire fixation. The cases were followed for at least 6 months. Patients were assessed functionally and radiologically and results were graded according to the system described by Price et al as excellent, good, fair and poor
Results: This prospective study was completed on 44 patients 32 were male and 12 were female. All fractures were united in acceptable alignment. At final assessment there were 30 [68.18%] excellent, 8 [18.18%] good, 3 [06.82%] fair and 3 [06.82%] poor results. The fair or poor clinical outcome was higher in children above 10 years of age. Delayed union after IM intramedullary fixation occurred in 3 children over 10 years of age
Conclusion: This technique can provide precise fracture reduction, maintains stabilization for fracture healing, results in minimal cosmetic deformity, cost effective and facilitates easy removal of implants after treatment
Résumé
Background: Well-reduced unstable distal radius fractures have the potential to undergo late displacement and/or collapse due to musculotendinous forces. To over come this there is controversy as to which is the preferred treatment - minimally invasive like external fixation or invasive like open reduction and plating
Objective: To determine the outcome of augmented external fixation of unstable distal radius fractures
Design: Prospective study
Setting: Orthopedic surgery department of Independent Medical College, Punjab Medical College and University Medical College Faisalabad
Period: Between January 2009 and December 2010
Methods: In this case series study 46 patients with unstable distal radius fractures were followed for 1 year after operation using the technique of application of common 3.5mm AO external fixator using principle of ligamentotaxis for reduction and restoring length with addition of k-wires plus bone graft if needed. All patients were evaluated according to the sum of demerit points system [Saito, 1983]
Results: There were 20 male [43.48%] and 26 females [56.52%] with mean age 48.54+16.36. According to the sum of demerit points [Saito, 1983], the latest follow-up functional end results were 'Excellent' in 45.66%, Good in 34.78%, Fair in 10.87% and Poor in 08.69%. As for the anatomical results at follow-up, the radial shortening <2mm in 37 [70.44%], from 2- 4mm in 5 patients [10.87%] and >4mm in 4[08.69%]. The average radial tilt was 22°and palmar tilt was 6°
Conclusions: The application of common 3.5mm AO external fixator with addition of k-wires is simple, cost effective, quick, minimally invasive and prevents redisplacement of fracture fragments adequately. The risk of infection is small and there is little damage to the surrounding tissues
Résumé
Lateral condyle fractures in children are the second most common fracture about the elbow. The problem arises in those cases which are difficult to treat by pop cast or by close reduction with percutaneous pin fixation. Late presentation is another challenge. We selected surgical treatment for such cases up to 12 weeks to evaluate our results. To study the usefulness of open reduction and K-wire fixation of displaced, unstable with or without rotation of fractures lateral condyle of the humerus in children presenting up to 12 weeks post injury Prospective. Three teaching orthopaedic units Independent Medical College / Punjab Medical College, and University Medical College Faisalabad. From January 2008 to December 2010. In this prospective study a series of 22 patients were treated using technique of open reduction and internal fixation with k-wires. The results were assessed by criteria of Agarwal et al with little modification after follow-up for 1 year. Excellent to good results were observed in all the12 patients presenting at 1-4 weeks post injury. In 5 patients presenting at 5-8 weeks, the results were excellent in one, good in 2, fair in1 and poor in one patient. In 5 patients presenting at 9-12 weeks good in 1 fair in 2 and poor in 2 patients. Open reduction and internal fixation is an effective treatment in all cases of displaced fractures of the lateral condyle of the humerus presenting up to 12 weeks post injury on the basis of low surgical complications and high union rate
Résumé
Objectives: The aim of this study was to compare the outcome of solid versus cannulated interlocking nails as a method of internal fixation in closed femoral shaft fractures in adults
Study Design: Quasi Experimental
Place and Duration of Study: Orthopaedic Department Allied Hospital, Faisalabad a teaching hospital affiliated with Punjab medical college, Faisalabad. Duration of study was from Jan 2007 to Dec 2008
Patient and Methods: The study was based on sixty cases. Thirty cases were included in either group of solid and cannulated intramedullary interlocking nails. The solid interlocking nailing group was designated as group A, the cannulated as group B. The most common cases were road traffic accidents. The average hospital stay was 6 days. The follow up time was 9 months
Results: In group A we have union time within 3 months in 26[86.66%] patients, delayed union in 3[10%] patients and non union in one patient[3.33°%].Three patients in group B[10%] went into non union, one due to deep infection, one due to implant failure and breakage of nail and one with no apparent cause. Regarding infection we had superficial infection in one patient of group A and two patients of group B which was corrected with appropriate antibiotics. No case of deep infection occurred in group A but one in group B which went into non union. Regarding implant failure, we had no implant failure in group A and four cases of implant failure in group B with one nail breakage, two distal locking screw breakage and one proximal locking screw breakage
Conclusion: The most common cause of femoral shaft fractures is road traffic accident with male adult population affected the most. There was no statistical difference in union and infection in both groups. [p value >0.05].There was significant difference in implant failure in both groups with no patient in group A and four in group B [p value <0.05]. So solid interlocking nail is stronger than cannulated one
Résumé
To evaluate the results of union in unstable pertrochanteric fracture of femur in nonanatomical reduction and fixation. A descriptive study conducted at Department of Orthopaedic surgery Bahawal Victoria Hospital Bahawalpur. In the present study, we had 30 patients with unstable intertrochanteric fractures of either sex. Patients were treated by nonanatomic reduction, either by Dimon Houghsten or Sarmiento osteotomy depending upon fracture geometry, and fixed by dynamic hip screw. Out of thirty patients, 21[70%] were male and 9 [30%] were female. The average age of male patients was 74.9 years and that of female was 61.2 years. We included patients with Jensen's type IV fractures having osteoporotic grade of four to six according to Singh's index. Patients were followed up for minimum period of 20 weeks and evaluated for radiological union and functional outcome using Sikorski and Barrington's pain and mobility scale. Out of thirty patients, only 25 completed the follow up. Four patients had limb length discrepancy. 88% of the patients had excellent to good functional outcome. Anatomical reduction must be tried in all cases. However, to avoid the complications of implant failure and loss of reduction with varus union in unstable fractures, non anatomical reduction should be considered
Résumé
Tuberous Sclerosis is an autosomal dominant disorder. It occurs with frequency of 1:5800-30000. It present as cutaneous and systemic manifestations. We report here a case of Tuberous sclerosis in a 10 month old infant who presented with infantile spasms and ash leaf lesions. Treatment with steroids showed good response