Pattern of adult limbs fractures at Shaikh Zayed hospital, Lahore

Road traffic accidents leading to musculoskeletal injuries are increasing in trauma centers and becoming public health emergency. Experties of commonly presenting fractures pattern will help in planning and management of these injuries. This study done at Accident and Emergency Department, Shaikh Zayed Hospital, Lahore, was aimed at different fracture pattern of musculoskeletal injuries in 1 year period from February 2013 to January 2014 a total 1090 patients with Road Traffic Injuries were included in the study. 1840 adult patients who presented to the Accident and Emergency Department, Shaikh Zayed Hospital Lahore, 1090 [59.23%] of patients were due to Road Traffic Injuries. Amongst the Road Traffic Accidents [RTA] 853 [78.23%] of the patients had accidents of Motorbike QingQui Rikshaw and 897 [82.28%] of the patients were from 16-45 years age group. Highest frequency of fracture occurred in the Femur 368[33.76%], followed by Tibia/Fibula 260 [23.85%], Humerus 178 [16.33%] and Radius/Ulna 146 [13.39%]. out of 1090 fractures, Complete fractures were 1005 [92.20%]. Leading Fractures were Transverse 632 [57.98%] followed by Oblique 208 [19.08%] and then comminuted Fractures 175 [16.05%]. Causes were Road Traffic Injuries followed by Fall and Machine injuries

frequency of nonunion and avascular necrosis in fracture neck of femur in young adults, treated with cannulated screws

Objectives:- The objective of the study was to document frequency of nonunion and avascular necrosis in fracture neck of femur [NOF] in the young adults, treated with cannulated screws

Methodology: It is a descriptive case series study, carried out at Department of Orthopaedic Surgery Sheikh Zayed Hospital [PGMI] Lahore. Forty patients were included in this study, reported within two weeks of injury. All patients with Garden type I, II, III and IV fractures neck of femur, aged from 18 to 55 years, from May 2012 to November 2012 were included with the consent to undergo osteosynthesis with cannulated screws

Results: KOFU [Japan] hip scoring system was used to evaluate results. Total 34 fractures [85%] achieved radiological union on an average of 3 months. Out of these 34 patients, 11 patients were with Garden type I, 10 patients Garden type II, 8 patients with Garden type III and 5 patients with garden type IV fractures had union of fracture. Total 6 patients [15.0%] had complications. Out of these total 6 patients, 2 patients were Garden type III and 4 patients were Garden type IV. All these 6 patients [15%] had nonunion, and 2[5%] patients ended in avascular necrosis of head of femur also but in 4 patients head of femur remained viable. There was no case reported with implant loosening in our all treated cases

Conclusion: With cannulated screw fixation all garden type I and II fractures achieved union and garden type III fractures have minimal frequency of nonunion and garden type IV fractures have variable frequency of nonunion. So cannulated screw fixation is best method of treatment in fracture neck of femur in young adults

Fixation of thoracolumbar fractures by fixator internae

Study included 20 patients with instable burst fractures presented in Accident and Emergency Department, Shaikh Zayed Hospital, Lahore. Twelve patients were male and eight patients were female. Age ranges from 15 to 29 years. Ten patients were without neurological loss, five were partial neurological involvement and 5 were complete neurological cases. All these patients were operated and stabilized with posterior interpedicular system called fixator internae developed by AO. This instruments allows stable fixation limited only two adjacent spinal segments. With fixator internae it is possible to add distraction or compression to the involved segments. It is able to reduce effectively the middle column by ligamentotaxis. All patients in this series had a minimum follow up of one year. Most patients in this series had a near anatomical reduction of all three columns in the involved segments. It was also possible to reestablished the normal Lordosis of the lumbar spine. AO International Classification of thoracolumbar fractures were followed. 10 patients without neurological loss were mobile after 2 weeks. Five patients with partial neurological loss recovered fully and 3 patients complete neurological loss, one patient recovered partially and but 2 patients remained paraplegic and bed ridden. Results were satisfactory and cost effective

Osteosarcoma: review and diversity of cases

Osteosarcoma is the most common primary malignant tumour of bone in adolescents and young adults. It accounts for approximately 15% of all primary bone tumors confirmed at biopsy. There are numerous types of primary osteosarcoma, including are intramedullary osteosarcoma, juxtacortical [surface] osteosarcoma, and extra skeletal osteosarcoma. Osteosarcoma may also occur as a secondary lesion in association with underlying benign conditions. The identification of neoplastic osteoid matrix formation and aggressive characteristics are necessary for histological diagnosis of osteosarcoma. In all bone tumors, differential diagnosis is best assessed with radiographs, whereas staging is performed with computed tomography or magnetic resonance imaging. Beside literature review, we are going to discuss 26 cases of primary osteosarcomas of bone [majority are of conventional type] and 03 cases of extra- skeletal ostcosarcomas