Journal of clinical orthopaedics and trauma
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J Clin Orthop Trauma · Jul 2017
Management of unstable pertrochanteric fractures with proximal femoral locking compression plates and affect of neck-shaft angle on functional outcomes.
Management of unstable pertrochanteric fractures remains a challenge with various implant choices. Intramedullary devices are usually preferred for the management of the unstable fractures. When nailing is unsuitable for the configuration of the fracture extra medullary procedures are preferred. PFLCP is a contact limited implant that allows multiple angularly stable fixations with preserving more bone stock after implantation as an extramedullary implant. There are only a few reports in the literature about the osteosynthesis of unstable trochanteric fractures with proximal femoral locking compression plates and their results are conflicting. In the present study we aimed to evaluate the functional and radiological outcomes of proksimal femoral locking compression plates in open reduction and internal fixation of AO/OTA 31A2-2 and 3 fractures. ⋯ Even though PFLCP is not the first choice in management of unstable pertrochanteric fractures, it must be kept in mind as an alternative to the other conventional plates and intramedullary implants with the properties of an increased stability by multiaxial screw locking and the results are satisfactory when appropriate settlement achieved.
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Post-traumatic unilateral or bilateral sub-axial cervical spine dislocations with locked facets are quite common. In developing countries like India, many patients with cervical injuries report late due to many reasons like rural backgrounds, lack of infrastructures and skilled surgeons, unawareness, poor socioeconomic status, lack of transportation to the specialized center with proper facility, etc. Early management is essential to maximize better neurological outcome. Delayed or neglected presentation makes treatment more challenging. Very few literatures are currently available regarding management of neglected cervical facet dislocation but no one offers clear cut management. Purpose of our study is to evaluate treatment outcome of 15 patients with post-traumatic neglected cervical facet dislocation. Here we have reviewed 15 patients with post-traumatic neglected presentation of cervical facet dislocations and evaluated their treatment outcome. ⋯ Proper decompression, reduction and fixation should be done in neglected cervical dislocation as it provides mechanical stability and alignment, facilitates rehabilitation, prevent kyphotic deformity as well as offers a fair chance of neurological recovery.
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J Clin Orthop Trauma · Jan 2017
Drivers of hospital length of stay in 56,000 orthopaedic trauma patients: The impact of postoperative cardiac events.
To determine whether postoperative cardiac complications following orthopaedic trauma treatment are associated with longer lengths of stay. ⋯ Orthopaedic trauma patients sustaining postoperative cardiac events have significantly longer hospital lengths of stay when compared to those who do not develop cardiac complications. This difference amounts to significantly higher health care costs.
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J Clin Orthop Trauma · Oct 2016
A simple method for fashioning an antibiotic impregnated cemented rod for intramedullary placement in infected non-union of long bones.
The intramedullary insertion of antibiotic impregnated PMMA rods, beads or nails are widely used and accepted modality of treatment for chronic osteomyelitis of long bones. But at times it becomes difficult to insert and remove these antibiotic delivery systems owing to narrowed medullary canals. Here we present a technique for preparing PMMA rods with diameter ranging from 6 mm to 3 mm. ⋯ We used this technique in seven cases and were successful in treating infection of long bones of upper and lower limbs (femur). With average follow up of 7.28 months rate of union in our series was 71% (five cases). Four cases (57%) had no evidence of infection and two cases (29%) had control of infection and in one case (14%) infection was still there but union was achieved.
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J Clin Orthop Trauma · Oct 2016
Case ReportsReimplantation of contaminated extruded segment of lateral femoral condyle cleansed with 10% povidine-iodine in complex floating knee injury with excellent outcome: Case report with 2 year follow up.
Traumatic extrusion of bone is a rare complication of high energy open fractures, and there are only few studies published in literature on reimplantation of the extruded bone segment. Studies with clear guidelines regarding timing of reimplantation, stabilisation of extruded bone segments, bone disinfection and disinfection techniques are very few. Previous reports describe disinfection using thermal or chemical methods. We present a case scenario of successful reimplantation of an extruded metaphyseal segment of distal femoral condyle following cleaning with copious saline and soaked in 10% povidine-iodine for 20 min in a 21 year old male patient of a complex floating knee injury with excellent outcome based on Karlstrom and Olerud criteria.