No abstract

<p class="abstract"><strong>Background:</strong> Open fractures are surgical emergencies; incidence of open fractures is increasing with more high-energy road traffic accidents. The tibia is exposed to frequent injury because of its location. The need for aggressive debridement, adequate fracture fixation, and early flap coverage in reducing the morbidity cannot be over emphasized.</p><p class="abstract"><strong>Methods:</strong> Treatment of open fracture by immediate debridement and anatomical fracture reduction using external fixator device. Gastrocnemius muscle flap done in upper 1/3 open fractures (type IIIB) with larger defects along with split thickness skin graft (STSG). In middle and lower 1/3 open fractures (type IIIB), fasciocutaneous and soleus muscle flaps done with relatively smaller soft tissue defects and exposed bone with STSG.<strong></strong></p><p class="abstract"><strong>Results:</strong> The study included 15 patients with open tibia fracture Gustillo Anderson type IIIB classified after the initial debridement. Excellent flap takes up was seen in all cases. 11 cases (73.3%) achieved union at the end of 6 months follow-up while 4 cases (26.7%) showed delayed union which required additional procedures like BMI or bone graft.</p><p class="abstract"><strong>Conclusions:</strong> Soft tissue coverage techniques like fascicutaneous flap, gastrocnemius and soleus muscle flap had a definitive role in the management of open fractures of tibia (type IIIB).</p>

CRIF with K-wire fixation is the treatment of choice in fractures suprracondylar humerus in children. The study was done in thirty patient to evaluate the outcome of percutaneous lateral pinning using k wire. Thirty case of displaced fracture supracondylar in children managed with CRIF with percutaneous lateral pinning using k- wire. The average age group of children was 7.4 year (minimum 5year of age and maximun-13year year). The fracture was immobilised for three weeks. Follow up was done at 3, 6, 9.12.24 week and all the complication were recorded. Evaluation was done on the basis of Flynn’s criteria by measuring loss of elbow motion and carrying angle.Out of 30 patient 26 patients had excellent results, 2 patient had good results, 1 patient had fair result and 1 patient had poor result according to Flynn’s criteria. CRIF with k –wire by percutaneous lateral pinning in displaced fracture supracondylar humerus in children is an excellent modality of treatment with good functional outcome and minimum complication.

OBJECTIVE: Adhesive capsulitis or frozen shoulder is a common condition that presents with pain and progressive limitation of both active and passive shoulder movements. In this study, we investigate the efcacy of intraarticular steroid injection in case of frozen shoulder. Material & Methods: Study is done on 32 patients of frozen shoulder attended Orthopedic OPD at Jhalawar Medical college, Jhalawar from July 2018 to June 2019. Intra-articular injection of steroid (methyl prednisolone acetate 80 mg) given & results analyzed. RESULTS: Patient follow up done every 2 weeks after giving Intraarticular steroid & advised to exercise of shoulder. Improvement in shoulder pain & movement of shoulder analyzed & recorded up to 12 – 24 weeks. CONCLUSION: Intraarticular injection for frozen shoulder is good, safe & efcient method. For better result corticosteroid injection is given in the early stages when pain is the predominant presentation.

Background: The posterior cruciate ligament (PCL) presents commonly as avulsion fractures from the tibial attachment site. Isolated tears of the PCL can be caused by a fall on the flexed knee or dashboard injury in road traffic accident. Such a mechanism (the upper tibia driven posteriorly with the knee flexed) may produce PCL disruption as the only clinically detectable instability. For the PCL avulsion fractures fixation, there are various methods available like closed reduction and internal fixation (CRIF), open reduction and internal fixation (ORIF), and arthroscopic fixation. This study was performed to assess the result of PCL avulsion fracture managed with ORIF with cannulated cancellous screw. Methods: We performed ORIF using cannulated cancellous screws with the posterior approach in 11 patients with isolated PCL tibial avulsion injuries. The minimum follow-up period was 6 months. The results were assessed radiologically and clinically. The spectrum of outcomes following PCL tibial avulsion fracture were measure using the Lysholm knee scoring system and range of motion (ROM) of the knee joint. Results: 63.6, 27.3, and 9.1 percent of the cases had excellent, good, and moderate fracture healing, respectively. Conclusion: PCL tibial avulsion fractures managed with open reduction with cannulated cancellous screw fixation yields good functional outcome with less complications.