An experimental study of open pedicle grafts of ileum for the repair of large duodenal defects is presented. All the grafts survived and functioned well. No shrinkage occurred. The results are extremely encouraging for the clinical application of this technique.

Introduction:Incidence of open fractures of the long bones is increasing due to the increase in road traffic accidents (RTA) which leads to an increased incidence of complex non-unions of long bones. Patients are usually operated many times for fracture fixation (and healing) or to eradicate infection, which causes soft tissue scarring and devitalization of any surviving bone. Objective: In this study, we assess the outcome of the Limb reconstruction system in tibial infected nonunion and open tibial diaphyseal fracture with bone loss. Method: It is a prospective study conducted on 15 patients and patients included in this study having compound fractures of shaft tibia with bone loss classified by Gustilo-Anderson open fracture classification. With the defect in the distal tibia, proximal corticotomy 1.5 cm distal to the last screw in the proximal clamp and proximal to distal transports were done and vice versa. All patients were evaluated with the ASAMI scoring system into bone results and functional results. Results: In the majority of patients, the injury was caused by road traffic accidents 80% of cases. Out of 15 cases, 2 belong to the upper 3rd, 9 cases belong to the middle 3rd and 4 cases belong to the lower 3rd of shaft tibia. The union time ranges from 4 to 11 months but the maximum union was achieved in 7e9 months in 8 (53.33%). Pin tract infection was reported in two (13.33%) patients who became better with regular dressing. Ankle stiffness was present in one case (6.67%), most probably due to improper physiotherapy. According to ASAMI Criteria excellent radiological results were present in 11 (73.33%) cases, good results were found in 4 (26.67) cases and excellent functional results were observed in 7 cases (46.67%) and good results were found in 8 (53.33%) cases. Infection was cured in all patients and did not recur till the last follow-up. Conclusions: Advantages of rail fixator include less invasive surgery, early weight-bearing, less infection, less blood loss, prevention of diffuse osteoporosis and atrophy, preservation of limb function, no need for bone grafting, correction of deformity during the process of healing, thus no need for a second surgery. Non-union, bone defect, and deformity can be corrected simultaneously. Hence, we recommend the use of this system (rail fixator) especially for infected non-union of long bones and compound fractures with bone loss.

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Background: Fracture of distal radius usually occurs as a result of high energy trauma in younger individual with good bone density and is associated with substantial articular and periarticular tissue injury. The fracture of distal radius was previously known for being common in elderly with low function demand who sustained a low energy trauma. Purpose of study was to compare the functional and radiological outcomes between percutaneous K-wiring and close reduction with below elbow cast application in treatment of distal end radius fracture. Methodology: 30 cases of closed reduction and casting and 30 cases of percutaneous K-wire fixation were included in the study. The data obtained from the two groups was analysed by using unpaired student’s t-test for continuous variables. All cases were followed up after 2 weeks, 4 weeks, and 6 weeks and were functionally and radiologically assessed for re-displacement. Results: There was no statistically significant difference in the range of movement outcomes between the two groups. The unpaired student’s t-test on the values obtained from both groups yielded a P-value of 0.9816. Conclusion: Closed reduction with percutaneous K-wiring and below elbow cast application is a simple, minimally invasive technique that provides additional stability and better radiological outcome in the treatment of extra-articular distal radius fracture as compared to closed reduction and below elbow cast application.

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