INTRODUCTIONIntertrochanteric and subtrochanteric fractures account for 50% of all fractures of the proximal femur. Early surgical intervention is advocated in majority of these patients to reduce the complications associated with longterm immobilization like deep vein thrombosis, thrombophlebitis, pulmonary embolism, urinary and lung infections, cubitus ulcers. Various extramedullary and intramedullary implants are being used for these fractures. Comminution of the lateral trochanteric wall, postero-medial communition, reverse oblique fractures etc. are unstable fractures which have had poor results with the regular methods of fixation. Proximal femur locking plate is an fixed angle stable construct, with locking cancellous screws at 90, 125 and 130 degrees, which can be used as open reduction internal fixation as well as minimally invasive per cutaneous plate osteoporosis (MIPPO) technique. Our aim in this study is to evaluate radiological and functional outcome at the end ABSTRACT Background: Comminution of the lateral trochanteric wall, postero-medial communition, reverse oblique fractures, fractures involving communition of greater trochanter are unstable fractures which had poor results with the regular methods of fixation. Our aim in this study is to evaluate radiological and functional outcome at the end of one year following proximal femur locking plate fixation for certain group of unstable intertrochanteric fractures. Methods: 20 patients (14 male and 6 female patients) with per trochanteric fractures underwent proximal femur locking plate fixation in Sri Ramachandra Medical College hospital. Intertrochanteric fractures were classified according to Boyd and Griffin. Mean age of the patients was 55.2 years (26-82 years). The Schatzker & Lambert Criteria used to evaluate the functional outcome at the end of one year. Minimum follow up period was six months and maximum follow up was one year. Results: The functional outcome was assessed by Schatzker and Lambert criteria and was excellent in 8 patients; good in 6, Fair in 4 and Poor in 2.The average time to bear weight fully and walk was 6.5 weeks. Conclusions: Union was achieved in unstable, comminuted trochanteric fractures without significant complications and neck shaft angle was maintained in majority of the cases following proximal femur locking plate fixation.One of the major drawbacks of using proximal femur locking plate is that weight bearing is to be controlled and done only after radiological evidence of callus formation.
Purpose: Purpose of this article is to assess the outcome of total hip replacement in the management of selected Acetabular fractures in specific cases within 3 weeks after injury. Methods: Prospective study of twenty patients who underwent primary total hip arthroplasty for acute Acetabular fractures. The study was done in Sri Ramachandra Medical College during the period Jan 2010 to Jan 2014. The inclusion criteria were acetabulum fractures associated with femoral neck fracture, neglected dislocation of the hip, marked impaction of femoral head or acetabulum and severe comminution of femoral head. The mean age was 61 years (range 50 to 71 years) and mean duration between injury and presentation was 6 days. The mean duration between injury and surgery was 12 days (range 2 to 21 days). Patients were followed up by serial X-rays and Harris Hip Score. Results: In our series of primary total hip replacement for acute acetabular fractures we had 75% excellent/good results, 20% fair resulta and 5% poor results. Mean Harris Hip Score-81 (Range 68 to 92) Conclusion: Primary total hip replacement is a reasonable method of treatment of selected acetabular fractures in the acute phase in specific cases. Outcomes may not be as good as total hip replacement done for other conditions.
The existing scoring system like American Orthopaedic Foot and Ankle Society (AOFAS)-ankle hindfoot scale, Leppilahti et al scoring system, Achilles tendon total rupture score, foot and ankle outcome score, the physical activity scale (PAS) questionnaire and Tegner activity score were not designed to evaluate all the parameters following surgical treatment of Achilles tendon rupture. Hence, we developed a comprehensive score called the comprehensive Sri Ramachandra Medical College (SRMC) scoring system. We compared the results of 60 patients who were surgically treated for acute Achilles tendon rupture using our comprehensive SRMC scoring system with the most commonly used AOFAS-ankle hindfoot scale. Results We found that there was 6.7% poor results using our scoring system, whereas no poor results using AOFAS scoring system mainly because our scoring system also assesses quality of life, patient satisfaction and tendon strength. Similarly, there was 10% fair results in our scoring system compared to 3.3% in AOFAS scale indicating that our scoring system is more sensitive. Comprehensive SRMC scoring system was found to be reliable statistically as per alpha method (α = 0.7787) and was statistically significant at p < 0.001. Conclusion Comprehensive SRMC scoring system was found to be superior to AOFAS scale specifically for analyzing Achilles tendon repair. Poor results are likely to be picked up by our scoring system which has been shown in our results. How to cite this article Nageswaran J, Ram GG, Bedford SC. Ankle Hindfoot Scale vs Comprehensive Srmc Scoring System in Acute Achilles Tendon Rupture. J Foot Ankle Surg (Asia- Pacific) 2015;2(2):77-79.
<p class="abstract"><strong>Background:</strong> The tibia is the most commonly fractured long bone and because of its location and the tenuous soft tissue coverage, its more prone for open fractures tibia than any other long bone. The ideal management of such fractures still remains controversial. We have evaluated the healing of fractures and functional outcomes in patients with open tibial fractures treated with an Ilizarov ring fixator.</p><p class="abstract"><strong>Methods:</strong> 32 patients who had open fractures of the tibia (II, IIIA or IIIB) who were treated with an Ilizarov fixator were included in the study. The patients were followed up for a minimum period of 1 year after removal of the fixator. Functional and radiological results were analysed using association for the study of applications of methods of Ilizarov scoring.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 20 cases of type IIIB, 7 cases of type IIIA, 5 cases of type II fractures. Union was achieved in all patients. Mean time for union was 25.2 weeks, with faster union times in type II, type IIIA fractures. Six cases of type IIIB needed flap cover. Limb discrepancy was seen in 3 cases. 17 cases of pin tract infections were seen, most of which were grade 3 and were managed with antibiotics. Two cases had delayed union, of which one was treated with bone marrow aspirate injection and the other one with bone grafting. At one year, 21 (65.6%) had excellent results, six (18.7%) had good results, four (12.5%) had fair outcomes and one (3.2%) had a poor result.</p><p class="abstract"><strong>Conclusions:</strong> Despite the associated complications, Ilizarov fixator is the ideal treatment for compound tibial fractures.</p>
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