Lag screw with DHS (LSD) for vertical angle femoral neck fractures in young adults.

Vertical Pauwels Type III fractures of the neck of femur in young patients are difficult fractures to treat. These are usually as a result of high energy trauma which are associated with a significant degree of fracture comminution in the neck of femur. This makes the fracture reduction and fixation difficult. Many fixation methods and implants have been described for use in these fractures but are not without reported complications such as non-union and varus collapse. In this article, we highlight the incidence of fracture comminution in both the anterior and posterior cortices of the femoral neck, better visualised with axial computed tomography scanning and describe a simple technique utilizing lag screws and a DHS implant to adequately address these fractures.

Anatomy of clavicle in the Indian population and its applicability in pre-contoured plating.

BACKGROUND: Fractures of the clavicle are traditionally treated non-operatively, but with the increase of high-energy trauma, there has been an increase in the operative management of these fractures. Controversy exists on the type of fixation for middle third clavicle fractures. The anatomically pre-contoured plates are low-profile mechanically sound plates which do not cause much soft tissue irritation. METHODS: To characterise the clavicular morphology through computerised tomography and determine the applicability of pre-contoured plates for our population. RESULTS: In this study, the mean total length was 145.31 mm and the apex of superior clavicle bow was located 38.15 mm from the acromial end, thereby giving a zone of 107.16 mm for plating. In the 107.16 mm of platable zone, the zone of ideal fracture location was 43.16 mm. Superior anterior plates had a good fit in 89.3% of the CT subset, whereas superior plates had a good fit in only 71.6% of the population. CONCLUSION: Superior anterior pre-contoured clavicle plates have approximately 98% good to fair compatibility for clavicles in the South Indian population without any need for further intra-operative moulding.