Retrospective analysis of open reduction and internal fixation of coronal plane fractures of the capitellum and trochlea using the anterolateral approach.

INTRODUCTION: Coronal plane distal humeral injuries are relatively rare. Numerous classification systems have been proposed as the complexity of these fractures has been realized. We in the present series of ten patients describe the surgical technique of Open Reduction and Internal Fixation of Coronal plane fractures of the distal humerus with headless compression screws performed using the anterolateral approach. MATERIAL AND METHOD: It was a retrospective study, the data collected from March 2010 to 2015 was analysed and the final outcome was assessed using the DASH score. Out of a total of 13 patients with distal humerus coronal plane fractures, 10 patients were available for follow up. The X-rays and CT scans were reviewed and the fractures were classified according to Dubberley and Bryan and Morrey classification. Radiographic were evaluated for presence of union or nonunion, avascular necrosis, joint line step-off (none/1-mm/>1-mm), hardware failure and instability. RESULTS: The average age was 41 years. The average DASH score in our study was around 24. The time to union ranged between 8-12 weeks with the average time being around 10 weeks. One patient had post traumatic Arthritis radiologically classified as Broberg and Morrey Type 2 and one patient had Heterotrophic ossification Brooker Grade 1. CONCLUSION: Open reduction and internal fixation of coronal shear fractures of capitellum and trochlea using headless screw compression via the antero-lateral approach is a reliable treatment modality and results in stable fixation with restoration of a functional arc of motion. LEVEL OF EVIDENCE: IV.

Intra-articular hyaluronic acid is superior to steroids in knee osteoarthritis: A comparative, randomized study.

BACKGROUND: To compare the short and mid-term results of intraarticular triamcinolone hexacetonide and hyaluronic acid (HA) in knee osteoarthritis. METHODS: A prospective randomized study including 40 patients in steroid and 42 patients in HA group. The outcome was evaluated with Knee Society Score (KSS) and Visual Analog Scale (VAS). RESULT: On KSS function and VAS score, there was no difference till four weeks. On KSS pain there was no difference till 12 weeks (P > 0.05) after that score of steroid group deteriorated rapidly. At six months HA was significantly better than a steroid. CONCLUSION: The HA seems to be better for pain relief and functionality in the short and mid-term periods.

Retrospective analysis of extra-articular distal humerus shaft fractures treated with the use of pre-contoured lateral column metaphyseal LCP by triceps-sparing posterolateral approach.

Management of extra-articular distal humerus fractures presents a challenge to the treating surgeon due to the complex anatomy of the distal part of the humerus and complicated fracture morphology. Although surgical treatment has shown to provide a more stable reduction and alignment and predictable return to function, it has been associated with complications like iatrogenic radial nerve palsy, infection, non-union and Implant failure. We in the present series retrospectively analysed 20 patients with extra-articular distal humerus shaft fractures surgically treated using the extra-articular distal humeral locking plate approached by the triceps-sparing posterolateral approach. The outcome was assessed using the DASH score, range of motion at the elbow and the time to union. The mean time to radiographic fracture union was 12 weeks.