ABSTRACT
BACKGROUND: Bicondylar tibial plateau fractures are complex injuries and treatment is challenging. Ideal method is still controversial with risk of unsatisfactory results if not treated properly. Many different techniques of internal and external fixation are used. This study compares the clinical results in single locked plating versus dual plating (DP) using two incision approaches. Our hypothesis was that DP leads to less collapse and change in alignment at final followup compared with single plating. MATERIALS AND METHODS: 61 cases of Type C tibial plateau fractures operated between January 2007 and June 2011 were included in this prospective study. All cases were operated either by single lateral locked plate by anterolateral approach or double plating through double incision. All cases were followed for a minimum of 24 months radiologically and clinically. The statistical analysis was performed using software SPSS 10.0 to analyze the data. RESULTS: Twenty nine patients in a single lateral locked plate and 32 patients in a double plating group were followed for minimum 2 years. All fractures healed, however there was a significant incidence of malalignment in the single lateral plating group. Though there was a significant increase in soft tissue issues with the double plating group; however, there was only 3.12% incidence of deep infection. There was no significant difference in Hospital for special surgery score at 2 years followup. CONCLUSION: Double plating through two incisions resulted in a better limb alignment and joint reduction with an acceptable soft tissue complication rate.
ABSTRACT
INTRODUCTION: Injuries around the elbow are common in pediatric population. Amongst them, most common is fractures of the supracondylar part of humerus, followed by condylar fractures. Fractures of the neck of the radius account for five-ten percent of the total injuries. Various techniques for closed reduction of the fracture have been described in literature. Open reduction and fixation is indicated when closed reduction fails to provide satisfactory results and the angulation remains more than 45-60 degrees. CASE REPORT: We present two cases of severely displaced radial neck fractures treated with closed reduction and intramedullary fixation using titanium elastic nails. The distal bent tip of the nail is used to maneuver the proximal rotated fragment and to reduce it back in its place. CONCLUSION: It is an indirect closed reduction technique and associated with minimal intra and post-operative complications and gives encouraging results. It gives stable fixation and also prevents re-displacement after nail removal.
ABSTRACT
Tuberculosis (TB) continues to be a public health problem in both developing and industrialized countries. TB of the skeletal muscle is very rare. We present a case of the simultaneous involvement of skeletal muscles in multiple sites in an 11-year-old immune-competent female patient. All physicians should have adequate knowledge of TB and awareness of its atypical presentations to ensure the proper management of such patients.
Subject(s)
Antitubercular Agents/therapeutic use , Muscle, Skeletal/microbiology , Muscular Diseases/microbiology , Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Miliary/diagnosis , Tuberculosis, Miliary/drug therapy , Biopsy, Needle , Child , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Immunohistochemistry , India , Muscular Diseases/diagnosis , Muscular Diseases/drug therapy , Risk Assessment , Severity of Illness Index , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
We report a case of irreducible dorsal dislocation of all the lesser metatarsophalangeal joints of the foot following injury at sport. Plantar plate prevented reduction at all the joints, which necessitated an open reduction and stabilization with K-wire. This report highlights the necessity of prompt open reduction and reviews the mechanism of injury and complex anatomy at metatarsophalangeal joint.
