Background: Subtrochanteric fractures account for approximately 10-30% of all hip fractures, affecting persons of all ages and should be internally fixed to reduce the morbidity and mortality by early rehabilitation and mobilization. A dynamic condylar screw (DCS) and a 95° angle blade plate (BP) provide a good choice for fixation of subtrochanteric fractures so it is a matter of debate that which one is the best fixation in such fractures. Objective: To evaluate the surgical treatment of subtrochanteric fracture of femur using DCS versus a 95° BP. Methods: Prospective comparative study of 40 patients conducted in Al-Imamein Al-Kadhimein Medical City from November 2015 to November 2017. Twenty patients treated with open reduction and internal fixation by using DCS and other twenty patients treated with open reduction and internal fixation by using a 95° BP. The mode of injury, site and type of fracture, age of patients, operating time, and blood loss, union rate, complication of implants, functional results were compared between the groups. Results: Out of 40 patients, there were 26 (65%) male, right side affected in 24 (60%) patients. Mechanism of injury was trivial trauma observed in 28 (70%) patients. According to a Russell-Taylors classification, majority of fractures are type IB that observed in 16 (40%) patients. Majority of the patients, 27 (67.5%), started full weight bearing at 14 weeks. There was no significant mean age difference between the two groups (p=0.7). The mean operation time of DCS (83±4.3 min) was lower significantly than of 95° BP (p<0.001). Mean blood loss from DCS variety (365±63 cc) was lower significantly than of 95° BP (p=0007). Infection occurred less frequently significantly in patients who treated by DCS than those treated by 95° BP (p=0.03). There was no association between types of open reduction and internal fixation treatment variety and functional result according to the modified Harris hip score (p=0.52). Conclusion: DCS better than 95ᵒ BP because of its technically easier, possibility to correct reduction even after insertion, less perioperative complication and earlier weight bearing. Keywords: Subtrochanteric fractures of femur, dynamic condylar screw, 95ᵒ BP Citation: Joda AI, Chhaily ZA, Abd Ali AS, Rahee LS. Is dynamic condylar screw better than (95°) blade plate in management of subtrochanteric fracture of femur? Iraqi JMS. 2020; 18(2): 123-129. doi: 10.22578/IJMS.18.2.6
Background: Pelvic osteotomy is a major procedure required for lately presented with developmental dysplasia of hip (DDH) patients; one of the needed osteotomies of the pelvis in such patients is Pemberton osteotomy (P.O.). Objective: To evaluate the clinical and radiological results of the P.O. for delayed presentation of Iraqi DDH patients. Methods: The study was conducted at Al-Imamein Al-Kadhimein Medical City from 2014-2020. We did the osteotomy for 32 hips of 25 patients (no one of them have neuromuscular disease). Of them 28 hips were Tönnis stage IV, 4 stage III, and 2 stage II. Results: The clinical status of all patients has improved according to modified McKay criteria, 26 of them have excellent score, 4 have good score, 2 with fair results, but no one has bad results. Radiologically, we score Severin’s classification as 62.5% with excellent, 28.1% with good, 9.4% with fair stage, and zero for bad stage. The average acetabular index corrected from 41.34⁰ into 16.17⁰. The center edge angle of wiberg reached 32.34⁰. The VCA of Lequesne became 29.66⁰. And the ACM angle became 43.33⁰. Avascular necrosis was reported as 1 hip was class I and 1 hip as class II according to Kalamchi McOwen classification. Conclusion: Although Salter R.B. when published his article about his osteotomy discussed the P.O. as one option for pelvic osteotomies meanwhile Pemberton P.A. still not publishing his article until after 4 years even it was practiced well before that time! We found that P.O. is very useful and dependable for clinical improvement and for correcting the radiological parameters to normal values yet it is simple, safe, practical, and effective osteotomy. Keywords: Pemberton osteotomy, delayed DDH, Tonnis classification, Severin’s classification, modified McKay classification, Kalamchi McOwen classification Citation: Chhaily ZA, Joda AI, Hafith AA, Abbood WH. Radiological and clinical results of Pemberton osteotomy for delayed presentation of Iraqi DDH patients. Iraqi JMS. 2021; 19(2): 182-188. doi: 10.22578/IJMS.19.2.7
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.