RESUMO
Background Plate osteosynthesis is the gold standard treatment for the management of humeral shaft fractures. In the present study, we performed plate osteosynthesis on the anteromedial and anterolateral surfaces using the anterolateral approach to compare the functional outcomes. Aims and objectives To study and compare the functional outcome, time to achieve union and associated complications of anteromedial and anterolateral plating in humerus shaft fracture by anterolateral approach. Methods This prospective, randomised control study was performed at Dr Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India. This study had 46 patients in total, who were divided into two equal groups at random. All of the fractures in group A were treated using a limited contact dynamic compression plate (LCDCP) on the anterolateral surface using an anterolateral approach, while all of the fractures in group B were corrected using an anteromedial surface using an anterolateral approach using LCDCP. All the patients were followed for six months at regular intervals. At each follow-up, patients were assessed radiologically with X-rays and clinically by Rodriguez-Merchan criteria (RM criteria). Results and conclusions The union was achieved in the majority of the cases of the anteromedial plating group within 12 weeks (78.3%) with a mean union time of 11.7±1.5 weeks than the anterolateral group (56.5%) with a mean union time of 12.3±1.8 weeks. Based on functional assessment according to RM criteria, the excellent outcome was achieved in 69.6% and 65.2% of the anterolateral and anteromedial plating groups, respectively. There was no case of non-union and radial nerve palsy in anteromedial plating cases whereas in anterolateral cases one patient did not achieve union and two (8.7%) had radial nerve injury, which recovered completely by the end of the study. An anterolateral approach with anteromedial surface plating on the flat medial aspect of the humerus is a good technique for fixing humeral fractures.
RESUMO
Introduction: Among all the phalanges, most fractured is the proximal phalanx. Frequently encountered complications are malunion, stiffness, and soft-tissue injury which invariably increase the disability. The aim of fracture reduction, therefore, comprises acceptable alignment and the gliding of the flexor and extensor tendons are maintained. Factors affecting management are fracture location, type of fracture, soft-tissue injury, and fracture stability. Case Report: A 26-year-gentlemen, right hand dominant, a clerk by occupation, came to emergency with right-hand index finger pain, swelling, and unable to move the right index finger treated with debridement, wound wash, and external fixator frame made with K wire and needle cap. Fracture united in 6 weeks with good hand function and the full range of motion of the hand. Conclusion: Mini fixator for phalanx fracture is a cheap and reasonably effective procedure. A needle cap fixator is a good alternative in difficult situations, it helps in correcting the deformity as well as keeps the joint surface distracted.
