RESUMO
Objectives: the purpose of present study is: 1. To know the results of surgical intervention of Garland type III fracture Humerus in children.2. To know the early and late complication of surgical intervention
Study Design: prospective interventional study
Setting: department of Orthopedic Unit-II, Civil Hospital Karachi
Period: February 2010 to January 2012
Methods: 200 male and female patients with Gartland type III supracondylar fracture of humerus presenting within 24 hour of injury, with age limit varying between 1- 12 years were included in our study. The anteroposterior and lateral view X-rays were taken and evaluated for displacement and angulation, medial/ lateral displacement and angulation and rotation of distal fragment. After all aseptic measures, patient under general anesthesia, through posterior approach skin was incised, subcutaneous tissue dissected along the line of incision. Triceps apponeurosis was splitted and interposed soft tissue was released and fracture reduced and fixed with K-wire on both medial and lateral sides parallel to the long axis of humerus in lateral view and an angle of 30 degree - 40 degree in A/P view. Wound closed in layers, aseptic dressing applied and well-padded back slab with elbow in appropriate angle of flexion was applied and pulses were checked. Postoperatively the hand was held elevated. Plaster of parries black slab was removed after four weeks; the wires were removed after six weeks. The follow-up ranged from 3 to 6 months. All the Data regarding patient were entered on well-designed proforma. The criteria for assessing the results were based on healing period, anatomical appearance, function and radiographic appearance
Results: excellent results according to Mitchell-Adam's criteria were observed in 60%. [120/200] cases, good results were observed in 27% [54/200] cases. Overall excellent to good results were observed in 87% of cases
Conclusion: it is concluded that outcome of surgical treatment of supracondylar fractures of humerus [Gartland type III] fixed with medial and lateral placement of k- wires were excellent to good and it achieves stable fixation. As both wires were placed under vision so risk of ulnar nerve and radial nerve injuries were decreased as compared to closed reduction and percutaneous k-wiring. As this method is techinically easy, less demanding and effective for stabilization and can be applied for patients with these fractures
RESUMO
To find out the prevalence of Vitamin-D deficiency in conditions other than osteomalcia and rickets in our part of the world. Prospective and observational study from Feb. 2005 to Dec. 2006. Multi-centric including Civil Hospital and Abbasi Shaheed Hospital, Karachi. Only those patients were included who had any structural or biochemical changes in the body. Serum Vitamin-D level of all patients was sent for estimation from a single reputable laboratory, apart from serum calcium, phosphorus, alkaline phosphatase and routine blood investigations. All data was collected and processed on SPSS Version 10. Of the total 79 patients, 58[73%] were females and 21[27%] males. Minimum age was one year and maximum 90 years, with a mean age of 41.91 and standard deviation of 19.1. Majority of the patients were seen in the 4th, 5th and 6th decades of life, and most of them were house wives. The serum Vitamin-D level was found low in 73[92%] patients and the most severe form of deficiency was seen in patients with tuberculosis. Vitamin-D deficiency was seen in 92% of our patients, belonging to all age groups and suffering from different diseases