Background: The stability of the joint is highly dependent on its supporting ligamentous structures, therefore injuries of ligaments and menisci are extremely common. Objective: To categorize discrepancies in findings of menisci and cruciate ligament between arthroscopy and MRI. Methodology: This prospective, comparative observational study was conducted at Ramkrishna Care Hospital, Raipur, Chhattisgarh. Informed consent was taken from all patients undergoing this study. We prospectively studied 67 patients with complaints of knee pain or instability/locking/giving away sensation with history of knee injury between the age group of 15-60 years over a period of 24 months starting from November 2014 to October 2016. Results: MRI showed 100% sensitivity and negative predictive value for ACL tear while specificity was 66.67% and accuracy of 95.52% with positive predictive value of 95.08%. MRI showed 100% positive predictive value for PCL tear while negative predictive value was 98.48%, alongwith sensitivity of 50% with specificity of 100% and accuracy of 98.51%. MRI showed positive predictive value of 57.58% for MM tear while negative predictive value was 88.24%, alongwith sensitivity of 82.61%, specificity of 68.18% and accuracy of 73.13%. MRI showed 75% positive predictive value for LM tear with a negative predictive value of 93.62%, alongwith sensitivity of 83.33%, specificity of 89.80% and accuracy of 88.06%. Conclusion: It was concluded MRI has high accuracy in diagnosing both meniscal and cruciate ligament injuries. The sensitivity for ACL tear is higher as compared to PCL while that of meniscal tear are almost equal.
Background: Subtrochanteric fractures have a tremendous impact on both the health care system and society in general. Accurate reduction and internal fixation by DHS is the ideal choice. Methodology: This is a prospective study of 20 cases of Subtrochanteric fracture admitted to Kims. Hubli between Nov 2008 to Aug 2010 treated with L.Proximal femoral nail by open method. Cases were taken according to inclusion and exclusion criteria, i.e fresh subtrochanteric fracture in adults. Pathologic fractures, multiple fractures, fractures in children, old neglected fractures were excluded from the study. Objectives of study was to study subtrochanteric fractures and to determine effectiveness of L.PFN in tretment of subtrochanteric fractures by ORIF. Results: Our study constituted 20 subtrochanteric fractures of which, 40% were Russell and Taylor type IA, 35% were type IB, and 25% type IIA. Mean duration of hospital stay was 24 days and mean time for full weight bearing was 14 weeks. Good to excellent results were seen in 85% of subtrochanteric fractures. Even though Proximal Femoral nailing is associated with Technical and mechanical complications, it were mostly related to the operative technique and the type of fracture and preoperative reduction of the fracture. Results of Proximal femoral nail fixation for subtrochanteric femur fractures are promising if a carefully pre-meditated operative plan is made. Conclusion: Most of the complications of proximal femoral nailing are surgeon and instruments related which can be cut down by proper patient selection and good preoperative planning and restoring the anatomical alignment.
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