Maxillofacial Fractures in Pondicherry, India: An Eight?Year Single Centre Retrospective Study

Background: The purpose of the present study was to analyze the etiology, incidence, pattern, and treatment modalities of patients with maxillofacial fractures treated at the Department of Dentistry of a medical college in Pondicherry during the period between June 2011 and June 2019. Materials and Methods: A retrospective epidemiological study of 277 patients treated for maxillofacial fractures between June 2011 and June 2019 was performed. Data regarding age, gender, etiology, site of the fracture, time of injury, presence of associated injuries, treatment modalities, and complications were recorded. Results: A total of 491 maxillofacial fractures were seen in 277 patients. These were 261 males (94.2%) and 16 females (5.8%) with a male to female ratio of 16.3:1. Most of the patients 79.8% were in the age group of 11 to 40 years. Most common cause of injury was Road Traffic Collisions (RTCs; 62.1%), followed by fall (20.2%), assault (14.4%) and others (3.3%). Fractures of the mandible (52.3%) and zygomatic complex (18.9%) were the most common maxillofacial fractures reported in our study. 196 patients sustained associated injuries with a prevalence of soft tissue injury (61.2%). Majority of fractures were treated with open reduction and internal fixation (ORIF; 71.9%) of patients followed by closed reduction (17.7%) and observation only (10.4%). Postoperative complications were presented in 16.8% of the patients in the study. Conclusion: RTC is the commonest cause of maxillofacial injury with a male predominance in our study. Mandibular and zygomatic complex fractures were the most common. ORIF remains the preferred method of treatment.

A CASE REPORT ON SALVAGE OF FAILED INTERNAL FIXATION OF PROXIMAL HUMRUS FRACTURE USING FIBULAR STRUT GRAFT.

Proximal humerus fractures are common problems plaguing in geriatric population. Approximately half of all proximal humeral fractures occur due to fall usually at ground level. (Low velocity trauma). In younger individuals fractures occurring because of higher-energy trauma such as a fall from a height, motor vehicle accidents, sports, or assaults. The proximal humerus fracture because of three loading modes: compressive loading of the glenoid onto the humeral head, bending forces at the surgical neck, and tension forces of the rotator cuff at the greater and lesser tuberosities. Most proximal humeral fractures are treated nonoperatively. However, surgical treatment is becoming more popular, with development of modern implant (PHILOS plate). Implant failure is common complication occur due to improper fixation, osteoporotic bone, early mobilization, non-union and varus malalignment. Various modality available for its management i.e., Hemiarthroplasty, reverse shoulder arthroplasty and ORIF + bone graft. IN this case report 60-year male patient with right side proximal humerus fracture treated with PHILOS plating. At 6 week follow up radiograph suggest implant failure. Patient was posted for revision surgery ORIF + platting and fibular strut graft was done.

Operative Management of Calcaneal Fractures using Mippo Technique

Introduction: Calcaneal fractures continues to be a topic ofcontroversy in terms of the optimal management modality.Current study aimed to access the sinus tarsi approach forthe fixation of calcaneal fractures in terms of radiological andfunctional results.Material and Methods: Study was conducted on 30 patientsof both genders aged between 20 and 60 years with both jointdepression and tongue type fractures, Sanders type 2 and type3 fractures.Results: In our study, as per AOFAS Scale at 3 months, 19(63.33%) calcaneum cases fell into the excellent group, 9 (30%)into good and 2(6.66%) into poor result group. The Mean ±SDAOFAS scale was 78.43±7.17 (range 55-85). At 6 months, theresult as per AOFAS scale showed further improvement with 28(93.33%) calcaneum cases falling into the excellent group and 2(6.66%) falling into the good result group. None of them fell inpoor group at 6 months follow up. The Mean ±SD AOFAS scalewas 90.03±5.24 (range 74-95).Conclusion: Fixation with plate using MIPPO techniquethrough sinus tarsi approach is an effective and safe methodwith good clinical and radiological results, for the treatmentof calcaneal fractures; to achieve anatomical restoration undervision, stable fixation and early mobilization with minimal softtissue complications.

Comparative Study Of Effectiveness Of Dexamethasone Injection After Orif In Mandible

Aims & objectives The purpose of this study was to compare the effects of 4mgm inj dexamethasone IV intra operatively after ORIF on post operative oedema, pain & trismus in fracture mandible. Material & Method. THis prospective study included 162 cases of fracture mandible. Patients were divided into two groups randomly. Patients who received IV injection of 4 mgm Dexamethasone intraoperatively were study group (Group 1) & those who didn’t receive injections of Dexamethasone were categorised as controlled group (Group 11) with 81 patients each. Clinically mouth opening, swelling, infection pain, post operative discomfort were assessed on 2nd, 4th 7th, 10 day Th day followed by 4, 8 & 12 weeks time Result Pain ,Mouth Post operative oedema & other postoperative discomfort was significantly less in study group as compared to controlled group

A Clinical Study of Comminuted Fractures of the Tibial Shaft Treated by Open Reduction and Internal Fixation with D.C.P / 대한정형외과학회잡지

The tibia is the most commonly fractured bone of all the long bones. In this age of vehicular accidents, the tibia is frequently subjected to high energy trauma. Anatomically the tibia has poor soft tissue coverage and poor blood supply. Therefore severe injury on the tibia can lead to severe complication and major disability. 41 adult patients with comminuted fracture of the tibial shaft were treated by OR/IF with D.C.P. and bone graft at the Department of Orthopedic Surgery, Kyungpook University Hospital from January 1978 to June 1986. These were analysed according to mechanism of injury, degree of comminution, timing of operation, soft tissue injury and operation time. Bone union and end results of treatment were reviewed. The results were as follows Of 41 cases, causes of injury were vehicular accident in 32 cases. 34 cases had associated injury on other part of body and average injury per case was 1.7 injuries. Based on the classification of Johner and Wruhs, the B group with butterfly fragment was 27 cases and C group was 14 cases. Among the B group, B2 was most common as 14 cases. Average union time was 18 weeks and delayed union and nonunion were 6 cases. Degree of comminution of fracture might be important fractor to bone union. According to the end result of Johner and Wruhs, excellent and good were 31, fair and poor were 10. Of the 41 cases, 10 cases had permanent disability. 4 cases had angular and rotational deformity alone and 1 case had shortening of tibia more than 1 cm, 1 case had both of them. Limited R.O.M. of ankle joint (>50%) occured in 4 cases. The post-operative infection occured in 6 cases, 3 were superficial infection but 3 cases were osteomyelitis. OR/IF with D.C.P. on comminuted tibial shaft fracture was a risk operation. Therefore proper method of treatment should be selected according to degree of comminution, timing of operation, presence or abscence of open wound and associated injury.