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$Research paper thumbnail of A study of hip arthroplasty using bipolar endo-prothesis for fracture neck of femur$

International Journal of Research in Medical Sciences, 2016

Fracture neck of femur remains an unsolved fracture to Orthopedic surgeon as far as treatment and... more Fracture neck of femur remains an unsolved fracture to Orthopedic surgeon as far as treatment and results are concerned. There is still a dilemma over either internal fixation or arthroplasty in the treatment of fracture neck of femur in middle age group. The first efforts on treating hip fractures concentrated on alignment of fracture fragments by traction and closed reduction. The reduction was maintained by long term traction, spica casts or internal fixation. However, despite the most accurate anatomic alignment and most rigid fragment fixation, many patients failed to regain normal use of their hips. Non-union of the femoral neck, avascular necrosis of the femoral head and the degree of fracture commination affected results in many. Non-anatomic reduction and inadequate fixation cause prolonged disability, pain, immobility and repeated surgical procedures. It is because of these inherent problems, replacement of femoral head and neck became the treatment of choice of many Orthopedic surgeons in elderly people to avoid complications of recumbence. A conventional Austin Moore and Thompson device has been routinely deployed, however in long term follow-up, unsatisfactory results remained high due to femoral stem loosening, acetabular erosion, intrusion of prosthesis into the pelvis and difficulties with total hip revisions. These factors led to the development of bipolar prosthesis. In 1974, Dr James Ennis Bateman an Orthopedician and Averill, a bio-engineer devised bipolar prosthesis, which

$Research paper thumbnail of Analysis of displaced supracondylar fractures in children treated with closed reduction and percutaneous pinning$

International Journal of Research in Medical Sciences, 2016

Background: Closed reduction is difficult not only to achieve but also to maintain because of the... more Background: Closed reduction is difficult not only to achieve but also to maintain because of the thinness of bone of the distal humerus between the coronoid and olecranon where most supracondylar fractures occurs. For this reason percutaneous pinning techniques have become the treatment of choice for most supracondylar fractures. By this procedure even the displaced and rotated fracture can be treated successfully with minimal incidence of complications. The purpose of this study is to determine the efficacy of management of displaced supracondylar fractures using closed reduction with percutaneous K-wire pinning and to analyze the results, loss of carrying angle, and loss of motion with incidence of complications. Methods: 35 Cases of displaced supracondylar fractures in children aged between 3 and 13 years were treated by closed reduction and percutaneous pinning and were studied prospectively for functional outcome.30 cases were treated with crossed pinning. 5 cases were treated with lateral pinning. Results: 31(88.6%) of the patients observed satisfactory results. 4 (11.4%) of the patients observed poor results. Of the cases treated by crossed pinning 26 (86.5%) had good results and 4 (13.3%) had poor results. All the patients treated with lateral pinning had excellent results. The difference in the functional outcome between the two groups were statistically significant. Conclusion: The results obtained in this study shows that anatomical reduction by closed method and stabilization with K-wire fixation is the first treatment of choice for displaced supracondylar fractures.

Journal of Evidence Based Medicine and Healthcare, Sep 19, 2015

BACKGROUND/AIM: ACL repair using Hamstring tendon autograft is very well known. Our study aims to... more BACKGROUND/AIM: ACL repair using Hamstring tendon autograft is very well known. Our study aims to find the outcome of ACL injuries treated in our unit arthroscopically with anatomic 4 strand hamstring autograft fixed with RCI screw. SETTINGS AND DESIGN: Prospective/case series. MATERIALS AND METHODS: First 20 patients out of 88 cases (operated between 2008 and 2010) were taken for the study. Patients with isolated ACL injuries were included. Patients with bony ACL avulsion/other associated fractures/ ligamentous / meniscal injuries were excluded from our study. The final outcome was done using IKDC subjective scoring and Lysholm knee scoring systems at the end of 24 months of follow up. The preferred method of fixation was RCI screw as it provides aperture fixation. STATISTICAL ANALYSIS: Kruskaal wall is test, linear regression. RESULTS: In our study groups of 20 cases of Arthroscopic ACL reconstruction, Majority of the patients (12 cases) were in the age group between 21-30 years-indicates that young and active people were most often involved. Males were injured more commonly than females. Sports injuries were the common cause of ACL injury closely followed by RTA. Right knee was found to be involved more than Left. CONCLUSION: ACL reconstruction by using four strand hamstring tendon autograft is highly successful with very few complications when proper graft, harvest preparation and anatomical tunnel placement and secure fixation are achieved.

Journal of Evidence Based Medicine and Healthcare, 2015

Aim of this study is to assess and compare the outcomes of posterior lumbar interbody fusion (PLI... more Aim of this study is to assess and compare the outcomes of posterior lumbar interbody fusion (PLIF) and posterolateral fusion (PLF) in adult isthmic spondylosthesis. BACKGROUND: Posterolateral fusion has been considered the best method and widely been used for surgical treatment of adult spondylolisthesis.Superior results have subsequently been reported with interbody fusion with cages and posterior instrumentation MATERIALS AND METHODS: Thirty six patients with isthmic spondylolisthesis were operated. One group (20 patients) had decompression and posterolateral fusion (PLF) with a pedicle screw system; other group (16 patients) was treated by decompression, posterior lumbar interbody fusion (PLIF) and a Pedicle screw system. In both groups adequate decompression was done RESULTS: Seventy seven percent of the patients had a good result with (PLIF) and 68 percent with posterolateral fusion (PLF). However there was no statistical difference in cases with low grade slipping, whereas the difference was significant for cases with high grade slipping. Fusion rate was 93% with (PLIF) and 68% with (PLF), but without any significant incidence in the functional outcome. 78% has relief of sciatica and neurogenic claudication. CONCLUSION: Based on these findings we found that for high grade spondylolisthesis which requires reduction or if the disc space is still high posterior lumbar inter body fusion is preferable. For low grade spondylolisthesis or if the disc space is narrow posterolateral fusion is preferable. A successful result of fusion operation depends on adequate decompression which relieves radicular symptoms.