Intra-articular distal radius fractures; functional outcome of percutaneous kirschner wire fixation and short arm cast in patients of 20-70 years

To determine functional outcome of percutaneous Kirschner wire fixation and short arm cast in intra-articular distal radius fractures in patients of 20-70 years. Descriptive case series. Department of Orthopedic Surgery, Dow University of Health Sciences / Civil Hospital Karachi. 1[st] April, 2013 to 30[th] September, 2013. A total of 62 patients with closed type III distal fractures according to Frykman classification were included in this study. Patient lying in supine position and after general anesthesia, closed reduction was done with the forearm in prone position, aiming to restore normal anatomical position. Two Kirschner wires were inserted from radial styloid process in parallel and oblique fashion to the medial cortex of the radius and one transversely from lateral to medial for intra-articular fragments. Final functional outcome was assessed after 12 weeks of surgery and recorded on pre-designed Proforma. Acceptable functional outcome of percutaneous Kirschner wire fixation and short arm cast in intra-articular distal radius fractures was observed in 80.65% [50/62] cases. It is concluded that functional outcome of percutaneous Kirschner wire fixation and short arm cast procedure is satisfactory in intra-articular distal radius fractures and it appears to be an easy, technically less demanding and effective method for stabilization, so this procedure can be applied for patients with these fractures

Successful reductions of anterior shoulder dislocations using intra articular lidocaine injection

To find out the frequency of successful reductions in acute anterior shoulder dislocations after the use of intra-articular lidocaine injection. This study [case series] was conducted in Emergency Department of Civil Hospital Karachi from July 2009 to January 2010. Patients with acute anterior shoulder dislocation [diagnosed with examination and X-Rays] were reduced in emergency department by Hippocratic method after infiltration of 1% Lidocaine in the affected shoulder joint. Reduction was confirmed by post reduction shoulder X-Rays. Frequency of successful reduction and complications were recorded. Majority of the patients [34.3%] were between 18-30 years of age group with mean age of 40.14 [ +/- 15.14] years. Males were affected more than females with male to female ratio being 2.9:1. They commonly had predominant right shoulder dislocation [71.4%]. Successful reduction was achieved in 32 [91.4%] patients after infiltration of 1% lidocaine injection. No complication was recorded. Use of intra-articular lidocaine for reduction of shoulder joint appears to be a safe and effective method and associated with successful reduction in majority of cases

Radiological outcome of type ii open diaphyseal fractures of tibia with interlocking intramedullary nailing

To determine the fracture healing [callus formation] with the use of interlocking intramedullary nailing in type II open diaphyseal fractures of tibia. Forty patients with open type II tibial diaphyseal fracture of tibia were included in this case series study conducted in Orthopaedic Unit-1 of Civil Hospital Karachi from August 15, 2008 to August 14, 2009. All patients underwent fracture stabilization by reamed locking intramedullary nail within three days of injury. The main outcome measure was fracture healing [i.e. adequate callus formation] on X-ray at twenty four weeks. The SPSS version 13 was used to analyze data for descriptive statistics. Majority of the patients [42.5%] were between 18-30 years of age group with mean + SD age was 36.50 [12.89] years. Males were affected more than females with male to female ratio being 4:1. Adequate callus formation was achieved in 35 [87.5%] patients radiographically at the end of six-months. Intramedullary interlocking nail can be safe and effective in management of open type II diaphyseal fracture of tibia as it is associated with satisfactory healing