Background: Out of 10-20 million people in the world with post-polio sequelae, around 6.5 million of them are in India. Due to its eradication, survivors have lived through their life and crossed 40-50 years of age. Falls and subsequent fractures are common in these patients, which are difficult to manage and cause considerable morbidity. We conducted this study to analyze the various strategies used in the management of fractures in a post-polio limb. Methods: This is a retrospective study analyzing a total of 10 adult patients with post-polio sequelae complicating the fractured limb which was managed with varied treatment options such as locking compression plate, dynamic hip screw, and hemiarthroplasty. The functional status of the patient was evaluated with Vignos grade of disability. Results: All the patients (mean age of 34 ±12 years ) were treated with extramedullary internal fixation devices such as locking compression plating in 6 patients, dynamic hip screw fixation in 1 patient, cancellous screw fixation in 2 patients, and total hip replacement in one patient. Of the 10 cases, 8 were fresh fractures, and 2 presented with a failed fixation for repeated fracture sustained later on. The mean follow-up period was 37.8 ±16.4 months. Bony union was attained at a mean duration of 3.5 ±1.4 months in all the patients undergoing fracture fixation. None of the included had secondary implant failure or other complications. Conclusion: Patients with limbs involving post-polio sequelae are more prone to fractures and are difficult to manage using the standard treatment protocols. Extramedullary internal fixation device provides effective stability for bony union and optimal functional results without major complications in these small, deformed, osteoporotic, and hypo-vascularized femurs.

Background:We conducted this study to compare the functional outcome of patients who underwent posterolateral fusion for the management of grade 1,2 degenerative spondylolisthesis with patients who underwent interbody fusion for the same condition. Studies on either of the treatment methods demonstrated significant improvement but the latter is implant driven while the former is not. Although radiological outcomes were found to be better in the interbody fusion we aimed to compare and analyze the functional outcome in these two groups of patients. Methods: This is a retrospective cohort study analyzing 44 patients undergoing posterolateral fusion and 46 patients undergoing interbody fusion for grade 1,2 degenerative spondylolisthesis with a minimum 5year follow-up were reviewed. Patient demographics, the functional outcome with Oswestry Disability Index (ODI), and complications were analyzed. Results: Although we noted significant improvement in the ODI scores (p<0.001) compared to the preoperative status, we did not find any significant difference in the ODI scores at 5-year follow-up between the cohorts (p=0.96). We did not find any significant difference in the complication rate (p=0.54) or reoperation rates (p=0.93) between the two groups. Conclusion:The method of fusion did not have a significant role in improving the functional outcome in the management of grade1,2 degenerative spondylolisthesis. There was also no significant difference between the two methods of fusion concerning the dural tear rates, reoperation rate, or infection.