Background:Femoral fractures are common in children aged between 2 and 12 yearsand 75% of the lesions affect the femoral shaft. Traction followed by a plaster cast is universally accepted as a conservative treatment. We compared primary hip spica or traction followed by hip spica with closed reduction and fixation with retrogradely passed crossed Rush pins for diaphyseal femur fracture in 25 children of the age group 3-12 years, randomly distributed in each group.Materials and Methods:Fifty children (age: 3-13 years, mean; 9 years) with femoral fractures were evaluated; 25 of them underwent the conservative treatment using immediate hip spica (group A) and 25 underwent treatment with crossed retrograde Rush pins (group B).Results:Mean duration of fracture union was within 15 weeks in group A and 12 weeks in group B. Mean duration of weight bearing was 14weeks in group A and 7 weeks in group A. Mean hospital stay were 4 days in group A and 8days in group B. The man follow-up period was 16 months in group A and 17 months in group B. Complications like angulation, shortening and infection were compared. Bursitis and penetration of pins at the site of Rush pin insertion is a complication associated with this method of treatment.Conclusion:Closed reduction and internal fixation with crossed Rush pins was a superior treatment method in terms of early weight bearing and restoration of normal anatomy.

Introduction: Displaced fracture shaft of both bone forearms in children can still managed with close reduction and cast application. If, it has failed or remain inadequately reduced after closed reduction require intramedullary fixation to achieve functional outcome. This study assesses the functional outcome of treating displaced fracture shaft of both bone forearm in children with intramedullary flexible titanium elastic nailing.Method: 79 children aged 3 to 15 years with displaced fracture of shaft of both bone forearm underwent flexible titanium elastic nail. The patients were followed up for a period of 12 months. Results: Close reduction followed by nailing was possible in 71 patients, while 8 patients required open reduction through mini incision of both the radius and ulna fracture prior to nailing. 74 patients had excellent results and 5 patients had good results. 13 patients had minor complications including skin irritations over prominent hardware, superficial nail insertion site infection were noted in our study. 2 patients had a restriction of 20° of pronation and 10° of supination, 2 patients restriction of 15° of pronation and 1 patient had 8° volar angulation at the radial bone with limitation of 5° supination. All fractures were united in acceptable alignment by an average 9 weeks and nails were removed at an average of 6 months. Conclusion:Flexible nailing leads to more versatile and efficient application of internal fixation for fracture shaft of both bone forearm, which permits early mobilization and return to the normal activities of the patients, with very low complication rate.

Background:Femoral fractures are common in children between 2 and 12 years of age and 75% of the lesions affect the femoral shaft. Traction followed by a plaster cast is universally accepted as conservative treatment. We compared primary hip spica with closed reduction and fixation with retrogradely passed crossed Rush pins for diaphyseal femur fracture in children. The hypothesis was that Rush pin might provide better treatment with good clinical results in comparison with primary hip spica.Materials and Methods:Fifty children with femoral fractures were evaluated; 25 of them underwent conservative treatment using immediate hip spica (group A) and 25 were treated with crossed retrograde Rush pins (group B). The patients ages ranged from 3 to 13 years (mean of 9 years).Results:Mean duration of fracture union was 15 weeks in group A and 12 weeks in group B. Mean duration of weight bearing 14 weeks in group and 7 weeks in group B. Mean hospital stay was 4 days in group A and 8 days in group B. Mean followup period in group A was 16 months and group B was 17 months. Complications such as angulation, shortening, infection were compared.Conclusions:Closed reduction and internal fixation with crossed Rush pins was superior in terms of early weight bearing and restoration of normal anatomy.

Introduction: Displaced fracture shaft of both bone forearms in children can still managed with close reduction and cast application. If, it has failed or remain inadequately reduced after closed reduction require intramedullary fixation to achieve functional outcome. This study assesses the functional outcome of treating displaced fracture shaft of both bone forearm in children with intramedullary flexible titanium elastic nailing.Method: 79 children aged 3 to 15 years with displaced fracture of shaft of both bone forearm underwent flexible titanium elastic nail. The patients were followed up for a period of 12 months. Results: Close reduction followed by nailing was possible in 71 patients, while 8 patients required open reduction through mini incision of both the radius and ulna fracture prior to nailing. 74 patients had excellent results and 5 patients had good results. 13 patients had minor complications including skin irritations over prominent hardware, superficial nail insertion site infection were noted in our study. 2 patients had a restriction of 20° of pronation and 10° of supination, 2 patients restriction of 15° of pronation and 1 patient had 8° volar angulation at the radial bone with limitation of 5° supination. All fractures were united in acceptable alignment by an average 9 weeks and nails were removed at an average of 6 months. Conclusion:Flexible nailing leads to more versatile and efficient application of internal fixation for fracture shaft of both bone forearm, which permits early mobilization and return to the normal activities of the patients, with very low complication rate.

Pressure sore is a complication in paraplegic/quadriplegic patients. Despite advances in reconstruction techniques, sacral pressure sores are still a challenge to the orthopaedic surgeon, because of long hospital stay resulting into the situation where pressure sores are in evitable for ambulatory patients too. Development of pressure sores makes treatment/rehabilitation difficult and delays treatment options. Additionally, untreated sores cause complications, e.g. death and recurrence after surgery. Attention has been focused on aggressive dressing of the deep sores with use of sugar paste. Once granulation tissue had filled a sore cavity, a surgical closure using V-Y flaps were considered a method providing better treatment results. This study was conducted on 14 patients (10 males and 4 females) with sacral pressure sores in age group of 35 to 80 years. After initial debridement and removal of tissues of doubtful viability, culture and sensitivity were done in all cases. Wounds were packed with sugar paste for 5 to 14 days or till cavity is filled by granulation tissue. Bilateral V-Y myocutaneous flaps were used in 13 cases. Wound gaping occurred in 1 due to failure of a unilateral rotational flap and secondary bilateral V-Y myocutaneous flaps were needed. Suction drains retained for 7 to 10 days and pressure bearing on sores sites was avoided till complete healing. Superficial infection occurred in 3 cases which responded to suction and dressings. In our experience, the use of sugar paste dressing as a preprocedure to V-Y flap covering operation is a reliable options in management of infected deep sacral pressure sore.