ABSTRACT
Introduction: Anterior cruciate ligament (ACL) injury is associated with various degrees of rotational deformity. About 15% have a positive pivot shift test after accurate ACL reconstruction. Unrepaired lateral collateral ligament (LCL) tear can lead to increase load on reconstructed ACL and lead to ligament failure. Case Report: We present a case of combined ACL with LCL tear treated arthroscopically using a single femoral tunnel and asymmetric combined semitendinosus and gracilis (STG) graft. The patient had full range of motion at the knee joint and was able to squat and sit cross-legged and was able to carry out activities of daily living at 8 months of follow-up. Conclusion: Our technique provides orthopedic surgeons with an alternative for combined ACL and LCL reconstruction with a single combined STG graft, thereby limiting additionally graft site morbidity and avoiding the need for allograft and preserving adequate femoral bone stock by preparing only a single femoral tunnel and thus limiting the cost to the patient using single implant for femur.
ABSTRACT
INTRODUCTION: Pertrochanteric fractures are most frequent factures of the proximal femur, accounts for nearly 50% of all proximal femur fractures and are most devastating and also a major cause of disability in elderly. The aim and objective of this study was to evaluate the role of proximal femoral locking compression plate in unstable proximal femur fractures. MATERIAL AND METHOD: A total of 20 cases were included in our study (M:F - 16:4), who suffered proximal femur fracture due to various modalities and all of them were operated using proximal femoral locking compression plate. This proximal femoral fractures included unstable - intertrochanteric with subtrochanteric extension and subtrochanteric with intertrochanteric extensions as well as one case with intertrochanteric, subtrochanteric and neck of femur fracture. Patients were followed up regularly and minimum follow-up period was 12 months. Patients were given physiotherapy and partial weight bearing was started after 6 weeks postoperatively or after union was achieved. The outcome was evaluated as per Harris Hip Score and radiological union. RESULT: Among 20 cases with average age of 55.3 ± 17.9 years, treated with PF-LCP, the average time of union 18.75 ± 3.67 weeks was achieved. We got 10 excellent, 3 good, 3 fair and 4 poor result with average Harris Hip Score of 80.2 ± 28.54 with 65% good to excellent result with average Post-operative Neck Shaft Angle of 124.150 ± 17.880 and with 45% rate of complication which included four cases of superficial infection and two cases of deep infection and late complications like four cases of non-union, deformity - three cases of coxa vara and 2 cases of coxa valga, with patients having more than one complication in them. CONCLUSION: PF-LCP is not recommended as a definitive implant but can be used as an alternative for the treatment of unstable proximal femoral fractures when there is no option available for other routinely used implants. Despite of its complications, PF-LCP is used where all implants fail.
