BACKGROUNDWith mechanized farming in India and industrialization, both bone forearm fractures have become common. If the fractures are treated inadequately, it may result in severe loss of function. So, in order to restore function, anatomical reduction and internal fixation is necessary. Union may be achieved with any of the methods available; however, severe loss of function may be the end result unless adequately treated with proper technique and implants. With the development of compression plate osteosynthesis which provides a good treatment option and predictable outcome, there is an important change in the treatment of forearm fractures. This method helps in perfect reduction of fracture fragments in anatomical position by rigid fixation and early mobilization, the normal functions of the hand can be achieved at the earliest. MATERIALS AND METHODSIn this study, 30 patients with forearm fractures, were treated by open reduction and internal fixation with 3.5 mm dynamic compression plate (DCP) and screws in patients with displaced fractures of the shaft of forearm bones. This study was conducted from RESULTSOn an average, follow up period of these patients was 12 months. The results were correlated under Anderson et al, scoring system. There were 23 (76.66%) patients with excellent results, 5 (16.66%) patients with satisfactory results and 1 (3.33%) patient with unsatisfactory result and 1 (3.33%) patient had failure. Unsatisfactory result was due to comminution of fracture (prolonged immobilisation) and patient non-cooperation for instructions. CONCLUSIONPost operatively, with DCP fixation, additional supportive measures may not be required after soft tissue healing and shoulder elbow and wrist movements can be started early. This helps prevent muscle atrophy and joint stiffness. It is very much possible in intelligent and cooperative patients. However, all patients should be curtailed from lifting heavy weights till union of fracture. Almost all fractures in our study united by 4-6 months. The AO principles of internal fixation namely (1) anatomical fixation, (2) preservation of vascularity, (3) mechanically stable fixation, (4) rapid mobilization of joints in proximity, can be achieved with compression plating system. With rigid/anatomical internal fixation, dynamic compression plate is a good fixation for displaced diaphyseal fractures of the forearm bones. Adherence to AO principles, strict asepsis, proper post-operative rehabilitation and patient education are more important to obtain excellent results. Also, external immobilization was not necessary in intelligent and co-operative patients. Therefore, internal fixation with dynamic compression plate appears to be the gold standard for fractures of forearm. HOW TO CITE THIS ARTICLE:Babu APK, Kumar MR, Reddy BS, et al. A clinical study on internal fixation of diaphyseal fractures of both bones forearm with dynamic compression plate.
BACKGROUND Fractures of the patella are common and constitute almost 1% of all skeletal injuries. The patella is important for the extension of the knee joint. Several methods of internally fixing the fractured patella have been advocated. This study is directed towards the clinical evaluation of the modified tension band wiring technique for the fractured patella. MATERIALS AND METHODS The present study consists of 15 cases with fracture patella treated with modified tension band wiring during the period from October 2014 to October 2016 at govt. general hospital, Kurnool. RESULTS All cases were operated using a midline anterior vertical skin incision, 80% had excellent results, with normal squatting, grade-V quadriceps power and complete range of movement at knee joint.20% of cases had difficulty in squatting, grade-IV quadriceps power and limitation of flexion. Minimal quadriceps wasting seen in 20% of cases. CONCLUSION From the analysis of the present study modified tension band wiring is the gold standard technique in management of transverse fracture patella.
BACKGROUNDBack pain, the ancient curse is now appearing as a modern epidemic. Humans have been plagued by back and leg pain since the beginning of recorded history. Lumbar discs are responsible for well over 90% of all organic symptoms attributable to low backache. Clearly lumbar disc herniation is a significant medical and social problem. What is less clear is the efficacy of treatment and type of treatment to choose. In 1934, Mixter and Barr published their study and concluded that laminectomy with decompression and extraction of herniated lumbar disc could improve suffering caused by sciatic pain. Since then increasing number of patients have been operated upon for this disorder. Open discectomy is now the "gold standard" for operative intervention in patients with herniated lumber discs whose conservative treatment has failed. However, the outcome studies of lumbar disc surgery document a success rate of 51 to 89% in spite of advances in investigations, operative technique and postoperative care. Therefore, appropriately presenting and reviewing this subject is important.
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