ABSTRACT
PURPOSE: The purpose of the study was to evaluate the effectiveness of debridement and application of Ilizarov ring fixator (IRF) in the management of infected tibial non-unions. PATIENTS AND METHODS: Twenty six patients with infected non-unions of tibia were managed by debridement and resection of infected portion ± partial fibulectomy and stabilization by Ilizarov ring fixator. Bone segment transport was done in 18 patients who had greater than 2.5 cm bone defect after debridement. Bone grafting was required in three patients to augment union. RESULTS: All fractures united and infection eradicated completely. There were 13 excellent, nine good, and four fair results. Functional results were excellent in nine, good in 11, fair in five and poor in one. Pin site inflammation was the most common problem and occurred in 23 (88%) patients. There were no major complications or neurovascular complications. CONCLUSION: We conclude that debridement combined with Ilizarov ring fixator with or without partial fibulectomy is a reliable method of treatment of infected non-unions of tibia.
ABSTRACT
BACKGROUND: Fall from height is one of the important causes of musculoskeletal injuries. Fall from walnut trees constitutes an important entity that leads to a significant mortality and morbidity amongst those engaged in fruit collection. The present study aimed to determine the prevalence of different musculoskeletal injuries in these victims and to highlight the importance of recognizing this incident as an occupational injury. METHODS: A retrospective study of all patients admitted to the Orthopedic Department of the Sher-i-Kashmir Institute of Medical Sciences (SKIMS) Medical College from January 2003 to December 2007 was conducted. The medical records were studied for the different types of bony injuries, associated injuries and delay in the referral of patients. RESULTS: 94% of falls occurred from August to October. Of the 115 patients, 63 (54.7%) had associated non-orthopedic injuries. Head injury was the most common associated injury, presenting in 34 patients (29.5%). Thoracolumbar (16.5%), calcaneum (10.5%) and distal radius (8.7%) fractures constituted the common fractures encountered in the victims. CONCLUSION: Walnut tree injuries mostly involve young males who form the productive group of the population. Being a seasonal injury, it puts a considerable load on the health resources of the region over a small period of time.
