Fixation of intertrochanteric intertrochanteric femoral fractures femoral fractures by dynamic hip screw

Objective: Aim of the study was to evaluate the results of DHS fixation union rate, complications and functional outcome

Study Design: Experimental / clinical trial study

Place and Duration of Study: This study was carried out at Bolan Medical Complex Hospital Quetta from January 2014 to December 2015

Materials and Methods: 45 patients were surgically treated with use of dynamic hip screw [DHS] to stabilize the intertrochanteric fractures. Out of total 45 patients 35 [74%] were males and 10[14%] females. Age ranged between 25 -71 years average 63.9 years. Most common mode of injury was mixed in 28 patients. All the cases were classified according to Jensen's classification. All the cases were performed under image use of 135' angle plate with hip screw

Results: Out of 45 patients 03 patients died, two in the hospital and I at home. It was observed that patients from rural areas arrived late [19.8 days] after their injuries and these from urban areas reached within two days and thus affected the reduction and operation time

Time lapse between the injury and operation was 11.7 days. Overall union time was 20.02 weeks

No nonunion was seen

Complications were seen in 12 patients

Conclusion: Excellent to good results were achieved in 96% of cases which concludes that DHS is bio-mechanically stronger and better implant for fixation of intertrochanteric fractures

Management of developmental dysplasia of hip in older children by triple procedure

Objective: To review the presentation and evaluate the radiographic and functional outcome of developmental dysplasia of hip [DDH] in older children treated by triple procedure surgery, consisted of open reduction, Salter Innominate Osteotomy [SIO], femoral shortening and derotation Osteotomy

Study Design: Observational / descriptive study

Place and Duration of Study: This study was conducted at the BMC Hospital Quetta from January 2013 to December 2015

Materials and Methods: We assess the efficacy and safety of underwent triple procedure treatment of DDH in older children. The study series comprising 22 patients [25 hips].Patients were classified pre-operatively according to the Tonnis Classification, and post-operative functional evaluation was performed using modified Mackay's scoring system, while radiographic assessment considered Severin scoring method

Results: The average age at presentation was 5.60 years and the male to female ratio was 2:46 months. While the average follow-up were 16.4 months. The final outcome was successful in 19 hips [76%] in 16 patients. Patients younger than 5-6 years of age had a better radiological and clinical outcome as compared to older children. Although in the outcome of clinical and radiological assessment there were no significant different between group-I and group-II

Conclusions: Late presentation of DDH is still common in Quetta, Balochistan, which necessitates Triple procedure operative management given frequent occurrences of best result in younger children. Early diagnosis and surgical interventions is therefore imperative in the successful treatment of patients suffering from DDH

Application of an external fixator to the open diaphyseal fractures of femur

The study on 30 cases of open diaphyseal femoral fractures has been done between January 2008 to November 2008 on patients coming to Orthopaedics Department at Bolan Medical complex Hospital Quetta attached to Bolan Medical College, Quetta. It is a prospective study, which includes 30 patients with open diaphyseal fractures of femur. They were operated after stabilization of general condition using external fixator. It is a valuable clinical treatment option, providing surgeons with the spatial relationship of tissues both statically and dynamically via minimally, technique. The study shows union occurred in 24, 80% cases. There was an established non-union in 06 [20%] cases. All were Type III-A and III-B. The average time of union was from 8-20 weeks. The overall incidence of deep infection was 38% and was limited to type III-A and III-B. Pin crack infection was seen in 36% and was controlled with standard management. The average hospital stat was 15 days On the basis of this study it is evident that treatment by external fixator is very satisfactory, cost effective and there are no major complications and can be used with full confidence. Above all good results can be achieved by aggressive and repeated debridement, irrigation and early soft tissue coverage of the-bone

Fixation of distal femoral fractures in adults by dynamic condylar screw

To analyze the role of Dynamic Condylar Screw and the early functional outcome and complications associated with surgical management of Distal Femoral Fractures in Adult using DCS in our circumstances. This descriptive study was carried out in Orthopaedics Department Bolan Medical Complex Hospital Quetta from March 2007 to April 2008. The study included management of 25 cases of Distal Femoral Fractures treated by Dynamic Condylar Screw. These fracture are complex injuries, which are often unstable and comminuted. Despite advances in surgical Technique and improvement in implant, treatment of Distal Femoral Fractures remains a challenge in many situation, if not treated correctly may lead to permanent disability. There were 25 cases selected, 23 males and 2 females with in average age of 32.2 years, ranging from 20 years to 60 years. The cause of injury was high-energy trauma in majority of cases. These were of A1, A2, A3, and C1 and C2 type fractures. 21 out of 25 cases gained knee flexion more than 90°. The limb shortening of 2cm was noted in 03 cases, in 20 patients fractures united in 10-12 weeks. Bone graft was used in 05 cases. The average follow up was about 10 months. At the end of the study results shows that DCS is a good method of treating closed type, A1, A2, A3, C1 and C2 fractures. DCS provides rigid fixation and good purchase in Osteoporotic bone. Early mobilization prevents knee stiffness