A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Chinmoy, Das
- Immediate Unreamed Nailing Versus Delayed Nailing in Compound Tibial Shaft Fracture
Authors
1 Tezpur Medical College and Hospital, Tezpur, IN
2 Dept. of Orthopaedics, ESIPGIMSER, 54 Baghmari Road, Manicktala, Kolkata, IN
Source
International Journal of Health Research and Medico Legal Practice, Vol 3, No 2 (2017), Pagination: 53-56Abstract
Introduction: Tibia is largely covered with thin soft tissue envelope, hence high chance of open fracture and exposure of bone.
Method: We conducted a prospective, randomized control trial study on 52 patients of open grade IIIA and IIIB (Gustilo and Anderson classification) fractures regarding immediate unreamed interlocking nail in 26 patients and external fixation followed by interlocking nail (delayed nailing) in remaining half of the patients distributed as par randomisation plan and the outcome was measured.
Results: In open Type IIIA fractures, union occurred after 18.09 and 26.5 weeks after immediate and delayed nailing group respectively while in IIIB union was achieved at 24.7week and 47.2weeks respectively. We obtained excellent results in 73.07% patients after immediate nailing and 53.84% after delayed nailing.
Conclusion: Un-reamed solid intramedullary interlocked nailing provides excellent results in function as well as union, especially in GA Type II fracture. Immediate nailing led to earlier union in this study. Statistically significant differences were found in case of union rate and full weight bearing in favour of immediate nailing. Overall, the results were better in the immediate nailing group.
Keywords
Interlocking Nailing, External Fixation, Compound Fracture.- Clinical and Functional Outcomes of Open Reduction and Internal Fixation in Fresh Displaced Pilon Fractures
Authors
1 Tezpur Medical College and Hospital, Tezpur, IN
2 Gauhati Medical College and Hospital, Guwahati, IN
Source
International Journal of Health Research and Medico Legal Practice, Vol 3, No 2 (2017), Pagination: 77-80Abstract
Introduction: There are several methods for treatment of pilon fracture. We propose to evaluate the clinical and functional outcome in terms of union of the fracture, mobilisation, weight bearing, infections and wound coverage after open reduction and internal fixation in closed fresh displaced pilon fracture with the help of distal tibial locking compression plate. Even though we have conducted this study to compare our results with the various national and International studies.
Method: We have conducted a prospective study for 40 cases of Fresh displaced tibial pilon fractures in patients aged between 18yrs - 65yrs attending the OPD and Emergency department of Orthopaedics, Gauhati Medical College & Hospital, Guwahati who met the inclusion criteria outlined below. Patients were treated by open reduction and internal fixation of the fractures with Distal Tibial lock plate with or without Fibula plating.
Results: Patient were followed up for two years evaluated by AOFAS score and compared with standard study. From our study we have obtained 21(52.5%) of patients have Excellent result, 10(25%) of patients have Good, 7(17.5%) patients have Fair and 2(5%) have poor result.
Conclusion: Restoration of length, articular reduction, articular congruity, axial and rotational alignment with better soft tissue handling are key to excellent functional results following fractures of tibial pilon. Final outcome depends upon chondral damage, residual articular displacement, soft tissue scarring and early mobilization.The functional result is directly proportionate to the anatomical reduction and fixation during operation and inversely proportionate to the fracture comminution.