RESUMO
Background: Fracture neck femur (FNF) is important due to its high incidence in general population. In younger patients, trauma is the major cause of fracture neck femur. Displaced fractures are usually treated by fixation with partially threaded cannulated screws (PTS) placed in a parallel pattern. In the present study, we have explored the use of fully threaded cannulated screws (FTS) for fixation of fracture neck of femur. Aim and Objectives: The aim of our study was to analyze and compare the clinical and functional outcomes of fracture neck femur treated in both groups. Materials and Methods: A prospective randomized control analysis was conducted in the Department of Orthopedics of Rajindra Hospital and Government Medical College, Patiala, Punjab between June 2019 and December 2021 on 30 patients who were admitted with neck femur fracture in the age group between 15 and 60 years. Fifteen patients were treated with FTS and 15 were treated with PTS. Subsequent hip radiographs were taken postoperatively and analyzed for various parameters such as fracture fixation, fracture union, and reduction. Regular follow-up was done by clinical examination along with the radiological examination monthly for 3 months, then at 6th month, and 9th month. The functional outcomes of fracture neck femur treated with PTS and FTS were compared in terms of blood loss, radiological union, weight bearing, functional outcomes (in terms of Harris hip score), and post-operative complications. Results: Hip function on the operated side was evaluated and compared with the normal side as per Harris hip score. About 73.3% of patients with FTS group in this study had excellent results compared to 26.6% in PTS group, fair results were found in 13.3% in both groups, 6.6% of patients had good results with FTS group as compared to 13.3% of PTS group, and 6.6% had poor outcome with FTS group as compared to 46.6% with PTS group. In our study, mean Harris hip score was 76.6 in PTS group and 85.5 in FTS group (P = 0.044). The present study indicated that there were statistically significant differences between FTS and PTS in terms of functional outcomes and complication rates such as femoral neck shortening (P < 0.05). However, no significant differences in terms of blood loss, weight bearing, and fracture union time were observed between two groups (P > 0.05). Conclusions: FNF treated with FTS is superior than PTS in terms of functional outcomes and complication rates. Both FTS and PTS are equivalent in terms of average blood loss, weight bearing, and fracture union time.
RESUMO
Background: Continuous passive motion (CPM) is a common strategy for early post-operative rehabilitation of patients who have undergone knee surgery. During an early recovery time following primary total knee replacement (TKR), the efficiency of the CPM approach was evaluated in this study. Aim and Objective: To determine the effectiveness of using a CPM device for individuals with poor ROM after a TKR as compared with non CPM device users. Materials and Methods: Fifty-four TKR patients were distributed into two groups. CPM and exercises were given to the study group, while exercises were given to the control group only. All individuals were assessed for mean active range of motion (AROM), mean Knee Society Score (KSS), and the Western Ontario and MacMaster Universities Osteoarthritis Index before and after surgery (WOMAC). Results: The study group’s mean AROM was 81.7 ± 15.1, while the control group’s was 75.4 ± 21.8. The Study group had a mean KSS score of 135.7 ± 19.7 points, while the control group had a score of 134.2 ± 15.7. Between the two groups, there were no statistical differences. The Study group’s KSS functional score was 64.6 ± 8.4, compared to 61.1 ± 7.5 for the control group, yet there was a statistically significant difference between the groups at hospital discharge (P = 0.008). A statistically significant difference in pain level, joint stiffness, and function was also found between the two groups (37.1 ± 12.3 points for the CPM group and 23 ± 14.1 points for the control). Conclusions: From these findings it suggests that CPM has no effect on improving clinical measures. The subjective assessment of pain level, joint stiffness, and functional ability, on the other hand, showed a substantial positive effect.
RESUMO
Background: Low back pain with radicular symptoms is one of the most prevalent musculoskeletal disorders and leading cause of disability. Radicular back pain can be defined as a diffuse process affecting more than one underlying nerve root that causes pain and depending on the severity of symptoms may cause loss of sensation and motor function. Quality of life (QOL) is a multidimensional patient-based outcome criterion which can be used to describe the impact of health condition on the patient as well as the effects of the treatment. Low back pain interferes with QOL and work performance. Aim and Objectives: To analyze the QOL in patients of low back pain with radiculopathy. Materials and Methods: This descriptive-analytical study was carried out on 364 low back pain patients and healthy people in Government medical college, Patiala, India, from January 2021 to June 2021. We used SF-36 questionnaire to assess QOL, which allows calculating eight different scores (on a scale of 0–100), a physical component scale (PCS), and a mental component scale (MCS) summary. Mean Mental (MCS) and Physical (PCS) component summary scores were assessed and compared with healthy people involved in the study. Overall, a higher PCS and MCS score indicates better QOL. Results: Out of 364 patients enrolled, 311 patients with mean age of 49.1 ± 11.9 years were included for the study. SF-36 was administered and assessed. The result from this questionnaire showed that mean PCS and mean MCS were significantly lower in the low back pain patients compared to the normative population and were statistically significant. Conclusion: Patients of low back pain with radiculopathy have poor QOL compared to normative individuals. Lower QOL in patients necessitates getting early treatment, educating the patient, and rehabilitation. It is vital to give more attention to the QOL of the patient as it is an untouched domain.
RESUMO
Background: Rheumatoid arthritis (RA) is an autoimmune disease that causes pain, stiffness, swelling, loss of joint function, and a rise in acute-phase reactant levels. Pain causes much discomfort in patients with RA. Disease-Modifying Antirheumatic Drugs, Non-Steroidal Anti-Inflammatory Drugs, and Glucocorticoids are commonly used to treat RA, but these medications alleviate the inflammatory process to improve short- and long-term goals of treatment. Vitamin D has immunomodulatory properties that may be effective in RA patients, suggesting that Vitamin D may have a remedial effect in these patients. Aims and Objectives: The aim of this study was to evaluate the effectiveness of vitamin D in controlling the inflammatory response thus controlling pain in patients with RA. Materials and Methods: The study analyzed 96 diagnosed cases of RA presenting to our tertiary care center. The subjects were allocated into two groups one in which Vitamin D was supplemented and other in which placebo was given. Their disease activity was measured and VAS score was analyzed at presentation and 1 month and 3 months of follow-up. Results: At presentation levels of Vitamin D were inversely correlated with disease activity. Mean VAS score decreased subsequently during the follow up from 3.2 ± 1.7 at presentation to 2.25 ± 1.12 in Vitamin D group and from 4.38 ± 1.79 at presentation to 2.67 ± 1.19 at 3 months follow-up in placebo group, respectively. Conclusion: Vitamin D supplementation did not statistically significantly improved the VAS score thus requiring the need for further research for the evaluation of Vitamin D supplementation in the treatment of RA.