Short term results of concomitant intranasal administration of salmon calcitonin in intertrochanteric femur fractures operated upon using dynamic hip screw

To evaluate the effect of nasal calcitonin spray in union of the intertrochanteric fractures of elderly female patients. Fifty female patients aged above 60 years [mean age = 73.9 years] old with Intertrochanteric fracture were operated from Sept 2005 to August 2006 by dynamic hip screw. In a randomized controlled trial, patients were divided into two groups A and B. Each group had 25 patients. After hospitalization 200 IU of salmon calcitonin as a single dose nasal spray was administered to patients of group A, daily for 3 months and a placebo spray was used in patients of group B. serum level of alkaline phosphatase and time of appearance of a bone callus in a plain radiograph were compared in the two groups twice weekly for 8 weeks. About 72% of patients in group A showed signs of union as the appearing of bone callus in radiograph in the 3rd week, compared to 40% in group B. Twenty of patients in group A [80%] and 20% of the group B had an increase in serum alkaline phosphatase from the 15th day after injury [P<0.005]. Meanwhile alkaline phosphatase levels in group A was 185 IU on 15 the day compared to 140 IU on group B. and values were 443 IU and 210 IU on 90th day respectively. As regards the time of appearance of the union signs in a plain bone radiograph, 72% of patients in group A have shown signs of appearance of a bone callus in the 3rd week after surgery, while the rate has been 40% in group B. Using nasal spray of calcitonin in old females with intertrochanteric fracture is effective for earlier and increased rate of bone union

Antley-Bixler syndrome: a case report and result of radiohumeral synostosis resection

Antley-Bixler syndrome [ABS] is a rare congenital disorder with multiple skeletal and cartilaginous anomalies that demand orthopedic management. In this report we address the diagnostic features and associated malformations of this syndrome and describe the functional outcome of resection of radio humeral synostosis in a 9 month old girl with Antley-Bixler Syndrome

Short term outcome of treatment of femoral shaft fractures in children by two methods: Traction plus casting, versus intramedullary pin fixation - A comparative study

There is no consensus on treatment of closed femoral shaft fractures in children 6-12 years old .The aim of this study was to evaluate and compare the short term results of pediatric femoral shaft fractures at above ages with two different methods of treatment: skeletal traction followed by a hip spica cast and surgical treatment by intramedullary pin fixation and to determine which of these methods results in earlier union of fracture and independent ambulation of the patients. This study was performed prospectively at two hospitals during a period of 32 months from 2003 through 2006. Sixty six children with closed fractures of the femoral shaft were treated and followed at least through the time of fracture healing, spica cast removal and onset of unprotected walking in two separate groups: [A] skeletal traction by 90 - 90 technique followed by spica cast [n=30], [B] open reduction and internal fixation with intramedullary pin and cast [n=36]. The length of hospital stay, casting period, union of fractures, time to start walking and the rate of complications was evaluated and compared using Chi-Squar test. Mean age of all patients was 7.4 years old. Average follow-up was 6 months. Healing of the fractures was observed in all cases of both groups between 8 and 12 weeks. The length of immobilization was longer in traction versus surgery group. Average treatment duration from admission to hospital till independent walking was 75.3 days for the traction and 61.2 days for surgery group. Limb shortening and malrotation were more in traction versus intramedullary pin patients. Both methods of traction plus spica casting and intramedullary pinning can be used to treat femoral shaft fractures in 6-11 years old children. Intramedullary pin due to its less hospital stay, earlier walking and less complication rates can be used as the first choice in treatment of this fracture at school aged children

Anterior cruciate ligament reconstruction using patellar tendon and quadriceps tendon: a comparative study

The goal of this study was to compare the results of knee anterior cruciate ligament reconstruction with the use of patellar tendon and quadriceps tendon. In this study 30 patients with rupture of anterior cruciate Ligament of knee were compared in two 15-person group with the use of patellar tendon and quadriceps tendon. After precise rehabilitation program for six month, patients were compared according to scoring system. Variables of this system included: Knee extension, knee flexion, anterior drawer test, quadriceps muscle weakness, patellofemoral symptoms, infrapatellar symptoms, effusion, giving way symptoms, and radiographic changes of degenerative arthritis. Each variable was given scores [0,5.10] depending to symptoms, and sum of scores was recorded and compared for each person in each group. The use of quadriceps tendon had lesser infrapatellar symptoms as compared with patellar tendon [p<0.04]. This difference was significant. Average of total score for group PT was 78.6 and group QT was 81; both of them were in the excellent range and there was no significant difference between these two groups. In reconstruction of anterior cruciate Ligament of knee, using quadriceps tendon was more appropriate for conditions in which patients require longtime kneeling [knee flexion] and will result in patient's earlier return to activity and more satisfaction