ESIs are perhaps the most commonly used conservative interventional treatment for lumbosacral radiculopathy and have been shown to reduce pain and improve function in well-selected patients, often for months. ESIs play an integral role as part of a multimodal treatment strategy to treat lumbar radicular pain and theoretically present fewer risks than surgical interventions. Numerous studies over the past 50 years have demonstrated efficacy and safety leading to high utilization in treating lumbosacral radiculopathy. Overall, complication rates are low, with pain at the injection site being the most common. Systemic side effects such as elevated blood glucose may also occur. According to our study, the use of ESI is more effective for alleviating lumbosacral radicular pain than conservative treatments in terms of short-term and intermediate-term and hence proving our use of ESI for pain managemen.

Introduction: Most frequent bone injuries seen in orthopaedic practice is distal end radius fractures.[1] It occurs most frequently in adult patients after the fourth decade of life and comprises around 10% to 20% of all the fractures attended as emergencies.[2] The causes of the injury are fall on outstretched hand/work related accidents/car accidents/sports injuries. The importance of fixation of the distal radius (DR) fractures have evolved over the past two decades. Cast immobilization was the initial method, followed by K-wire fixation and then internal fixation with a variety of plates.[4] After using a variety of the available volar locking plates to fix intra-articular fractures, a significant improvement in wrist function was observed. In addition, surgical technique has improved, resulting in less disfigurement. The purpose of this study was to evaluate the outcome of a fracture of the distal radius (DR) treated surgically by ORIF (open reduction and internal fixation) with a volar plate, and to prospectively follow the degree of recovery of wrist range of motion and patient functional outcomes. Result: The present study was conducted on patients presenting with fracture of the distal end of radius, who were treated with open reduction and internal fixation with volar plating. The results of the study are summarized as below: ? Majority of the patients were in age group 21-30 and 31-40 years with a mean age of 35.90 ± 12.21 years. The youngest patient was 18 years old and oldest one was 58 years old. ? Majority of the patients were males. ? In majority of the patients, left side involvement was seen in comparison to right side involvement. ? Coronary artery disease, diabetes mellitus type-2 and hypertension were seen in 1 patient each in our study. Rest of the patients had no comorbidities. The reason for not having significant comorbidities was that majority of the patients in our study were young. ? All these patients underwent open reduction and internal fixation with volar plating. Majority of the patients (77.4%) achieved fracture union within 1-2 months, while 19.4% achieved it within 3 months. 1 patient (3.2%) was able to achieve the union within a month of surgical intervention. The fracture union was achieved in a short time. The wrist function was assessed using Gartland and Werley score. The mean Gartland and Werley score showed significant improvement from 1 month to 6 months in all the patients. ? At 6 months, 87.1% patients had excellent outcome and 12.9% patients had good outcome. ? Complications were seen in 4 patients. Of them 1 patient complained of complex regional pain syndrome and 3 patients complained of wrist stiffness Conclusion: We found that open reduction and internal fixation with volar plating provided excellent to good wrist outcome in patients with distal end radius fractures with minimal complications. Volar plating provides stable fixation for early mobilization, leading to early resumption to pre-trauma functional level. Although we obtained excellent to good results with open reduction and internal fixation with volar plating in distal end radius fractures, the results cannot be extrapolated to the general population as the sample size was small. Hence, we recommend that large multi- centric studies be performed before generalizing the results.

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