ABSTRACT
OBJECTIVE: The S.I.G.N (Surgical Implant Generation Network Inc.) solid intramedullary nail is originally designed for tibial shaft fractures and is currently being used for femoral shaft fractures as an extended use. The nail is used in developing nations such as the Philippines, as an alternative for those who could not afford the commercially available nails. The main objective of the study is to determine whether there is a difference in clinical outcomes of patients with isolated femoral shaft fractures in Philippine General Hospital, treated with S.I.G.N intramedullary nails versus Cannulated intramedullary nails, from year 2007 to 2012. POPULATION: A total of 175 patients fulfilled the inclusion criteria based from reviews of censuses, in-patient and OPD charts of the trauma section of the Department of Orthopedics, Philippine General Hospital. The Surgical Implant Generation Network (S.I.G.N) Fracture Care On-line Database was also screened for patients to be included in the study. A total of 68 patients were able to follow-up, with 48 patients in the S.I.G.N group and 20 patients for the Cannulated group. MAIN OUTCOME MEASURES: The dependent variables of the study are radiographic and clinical union, knee range of motion, weight bearing status, and complications. RESULTS: The subjects were divided into patients operated with S.I.G.N nails and with Cannulated Interlock Intramedullary nails. For the S.I.G.N group, the mean age is 32.1 years and mean follow-up is 40.75 weeks post-op. The Cannulated group has a mean age of 27.9 years and mean follow-up of 35.85 weeks post-op. Radiographic union rate for the S.I.G.N group is 68.8% while for the Cannulated group is 80%. Clinical union and full weight bearing status of patients are 100% in both groups. There is no significant difference with the number of patients with full range of motion in both groups: (S.I.G.N: 85%; Cannulated: 90%). Complication rates are also non-significant (S.I.G.N: 12.5%; Cannulated: 5%). CONCLUSIONS: There is no significant difference between patients with isolated femoral shaft fractures treated with S.I.G.N. Interlock Intramedullary nail versus Cannulated Interlock Intramedullary nail in terms of Clinical and radiographic union, weight bearing, knee range of motion and complication rate.
ABSTRACT
INTRODUCTION. Discussions on road safety are both timely and relevant. From its sixth place place in 1995, death from road accidents rose to fourth in 2004, and is expected to become the second leading cause of death worldwide by 2020. lt is notable that road accidents specifically motorcycle accidents are increasingly more common among developing countries such as the Philippines. OBJECTIVES. Because of this growing public concern, this cross-sectional descriptive study aims to determine the profile of motorcycle accidents in Metro Manila, the prevalence of musculoskeletal injuries resulting from such accidents, and to propose recommendations for its prevention. METHODS. Charts and clinical records of road accident victims from three major institutions namely, the Philippine General Hospital, Philippine Orthopedic Center and East Avenue Medical Center were selected. The profile of these patients and the incidence of musculoskeletal injuries were gathered. RESULTS. Males were found to be more involved in these accidents with an average age in the range of 21 to 35 years. The most common time of fatal vehicular accidents was at 9 p.m. while nonfatal injuries occurred most commonly around 4 a.m. Motorcycles rank as the leading cause of injuries to motorists, both fatal and nonfatal. There was a 16.3% increase in the incidence of motorcycle-related musculoskeletal injuries from 2007 to 2008. The lower extremity was involved in half of cases with the rest occurring in the spine and upper extremity. The most commonly involved segment was the tibia (25%), followed by the femur (20%) and the forearm (12.5%). SUMMARY AND RECOMMENDATIONS. It is apparent that the increase in vehicular crash causing fatal accidents is due to an increased number of motorcycles and cars, and these commonly involve the pedestrian and drivers. It is understandable that in order to improve road safety, education should be enhanced among motorists and students alike as a form of prevention, and primary trauma centers should be determined to facilitate identifying which centers can adequately manage these injured motorists.
