scholarly journals COMPARISON OF FUNCTIONAL OUTCOME OF DYNAMIC CONDYLAR SCREW AND CONDYLAR BLADE PLATE IN TYPE A FRACTURES OF DISTAL FEMUR IN SKELETALLY MATURUE PATIENTS

2021 ◽  
Vol 12 (1) ◽  
pp. 17-23
Author(s):  
Dilshad Gill ◽  
Muhammad Javaid Iqbal Awan ◽  
Osma Bin Saeed ◽  
Basharat Manzoor
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Distal Femur ◽  
Type A ◽  
Blade Plate ◽  
Femur Fractures ◽  
Dynamic Condylar Screw ◽  
Lysholm Knee Score ◽  
Group A ◽  
Group B

ABSTRACT BACKGROUND & OBJECTIVE: Distal femur fractures are increasingly common injuries in today’s orthopedic practice. Early treatment with suitable implant brings in promising functional outcomes. There is a growing debate over the type of implant used in these injuries. Therefore, we have compared two commonly used implants to determine the functional outcomes in search of an implant that has less post op complications, less technically demanding and produces better results. To compare the functional outcome of dynamic condylar screw with condylar blade plate in treatment of distal femur fractures. METHODOLOGY: A total of 372 skeletally mature patients aging 18-60 years of both gender with fracture distal femur (Type A, according to OTA classification) presented within 3 weeks of fracture time were included. Patients meeting inclusion criteria were stratified into two groups having 186 patients each. Group A and Group B. Group A received dynamic condylar screw fixation and in group B, condylar blade plate fixation was preferred. Patients were followed for 3 years and their Functional outcome was evaluated with the help of Lysholm Knee Score. RESULTS: Lysholm knee score after 3 years in group A (Dynamic condylar screw) was excellent (95-100) in 173 patients (76.9%), Good in 33 (17.7 %), Fair in 8 (4.3%), poor in 2 (1.1%).However, group B had Excellent in 57(30.6%), Good in 59(31.7%), Fair in 38 (20.4%), and poor in 32 (17.2%). CONCLUSION: Dynamic condylar screw can be used as an effective treatment with better functional outcome as compared to condylar blade plate in type A fractures of distal femur.

scholarly journals Outcome of Dynamic Condylar Screw with Plate versus Distal Femoral Lock Compression Plate Fixation in Fracture of Distal Femur

2021 ◽  
Vol 33 (1) ◽  
pp. 45-49
Author(s):  
Md Gulam Mustofa ◽  
Chowdhury Foyzur Rob ◽  
Md Kamrul Alam ◽  
Akhlas Bhuiyan ◽  
Habibur Rahman Chowdhury ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Distal Femur ◽  
Plate Fixation ◽  
Lock Compression Plate ◽  
Locking Compression Plate ◽  
Plate Versus ◽  
Dynamic Condylar Screw ◽  
Compression Plate ◽  
Group A ◽  
Group B

Introduction: The dynamic compression screw with plate implant used to treat fractures of the distal femur. The distal femoral lock compression plate fixation is designed as an alternative surgical option to treat these fractures. The objective of this study was to assess the comparative endurance of both devices. The objective of the study is to compare the outcome of DF-LCP and DCS fixation in distal femoral fractures. Materials and Methods: This prospective comparative study was conducted in the Department of Orthopaedics, Sylhet MAG Osmani Medical College Hospital, Sylhet between January 2011 and December 2012. Thirty patients with AO type 33-B and 33-C fracture were selected and were divided randomly into group-A and group-B by odd and even number. Dynamic condylar screw (DCS) fixation was used in group-A and distal femoral locking compression plate (DF-LCP) fixation in group-B. Results: DCS group [9 male, 6 female; mean age, 44.9 ± 12.9 years] and DF-LCP group [10 male, 5 female; mean age, 42.6 ± 15.7) years] were similar in age (p=0.660) and sex (p=0.705). The total operation (minutes) [92.3 ± 7.5 versus 90.4 ± 6.9; p=0.484], length of postoperative hospital stay (days) [6.0 ± 0.9 versus 5.9 ± 0.9; p=0.695] and union time (weeks) [20.6 ± 5.0 versus 18.7 ±3.3 weeks; p=0.238] did not differ significantly between two groups. Total complications [6 (40.0%) versus 4 (26.7%); p=0.439] was also similar in both groups. Functional outcome was excellent in 13.3%, good in 33.3%, fair in 33.3% and poor in 20.0% cases in DCS group; while excellent in 53.3%, good in 20.0% fair in 6.7% and poor in 20.0% of cases in DF-LCP group; different was not significant (p=0.080). Conclusion: Dynamic condylar screw with plate and distal femoral locking compression plate fixation are equally effective for achieving satisfactory union and functional outcome in AO type 33-B, 33-C fracture distal femur. Medicine Today 2021 Vol.33(1): 45-49

Comparison of Outcome with RNVL Compressive Plating in the Treatment of Extra Articular Supracondylar Femur Fractures

2021 ◽  
Vol 15 (12) ◽  
pp. 3410-3412
Author(s):  
Umair Ahmed ◽  
Umair Ahmad ◽  
Majid Zaheer ◽  
Ahmed Sadaqat ◽  
Zubair Khalid
Keyword(s):  
Functional Outcome ◽  
Prospective Trial ◽  
Study Groups ◽  
Retrograde Nailing ◽  
Femur Fractures ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Keywords Femur ◽  
Supracondylar Femur Fractures

Objective: To compare outcome of retrograde nailing versus locked compressive plating in the treatment of extra articular supracondylar femur fractures. Study Design: A randomized prospective trial. Place and Duration of the Study: Department of Orthopedic Surgery, Ghurki Hospital, Lahore, Pakistan from January 2020 to November 2021. Methodology: A total of 160 (80 in each group) patients aged between 18 to 50 years of both genders with extra articular supracondylar femur fractures were randomized into either retrograde nailing group (Group-A) or locked compressive plating (Group-B). Surgery time and functional outcome were compared in both groups. Demographic characteristics along with mean surgery time and functional outcomes were compared between both study groups. Results: In a total of 160 patients, mean age was 33.57±9.45 years. The mean age in Group-A was 33.24±8.61 years and in Group-B 33.90±10.26 years. In group-A, there were 49 (61.25%) male and 31 (38.75%) female cases while in group-B there were 56 (70%) male and 24 (30%) female cases. The mean surgery time in group-A was significantly less as compared to group-B (83.29±7.48 minutes vs. 106.62 ± 7.69 minutes, p<0.01). The frequency of excellent to good outcome was statistically higher in Group-A as compared to Group-B (p< 0.05). Conclusion: Retrograde nailing gave better results in the treatment of extra articular supracondylar femur fractures when compared with locked compressive plating. Retrograde nailing can be opted to reduce the surgery time and gain better functional outcome. Keywords: Femur fracture, nailing, plating, surgery time, functional outcome

scholarly journals The effectiveness of vitamin D supplementation in functional outcome and quality of life(QoL) of lumbar spinal stenosis(LSS) requiring surgery

2020 ◽  
Author(s):  
Sangbong Ko ◽  
Seungbum Chae ◽  
Wonkee Choi ◽  
Jaibum Kwon ◽  
Je-Yong Choi
Keyword(s):  
Vitamin D ◽  
Functional Outcome ◽  
Vitamin D Deficiency ◽  
Functional Outcomes ◽  
Vitamin D Supplementation ◽  
Functional Score ◽  
Study Objective ◽  
Sf 36 ◽  
Group A ◽  
Group B

Abstract Study design: Retrospective cohort comparative study Objective: To identify the prevalence of vitamin D deficiency in patients with LSS requiring surgery, and to compare the differences between the cases whether vitamin D is supplemented and vitamin D is not supplemented in terms of a QoL during postoperative two year. Summary of Background Data: Vitamin D supplementation is considered to be associated with good functional outcome. Thus, a few studies have proposed vitamin D supplementation is benefit to the functional outcome in LSS requiring surgery. Methods: All patients with LSS who underwent surgery from March 1, 2015 to August 31, 2016 were enrolled. Among them, 61 patients with vitamin D deficiency were divided into two groups (supplemented group (A) and non-supplemented group (B)). Functional outcomes using Oswestry Disability Index (ODI) and Rolland Morris Disability Index (RMDQ) and QoL using SF-36 were evaluated at 12month, and 24month follow up periods. Differences in functional score and SF-36 between the vitamin D supplemented and non-supplemented group were compared. Results : Among the total 102 patients, 78 patients (76.5%) had vitamin D deficiency. Of the 78 patients, 61 patients were included, 27 patients were group A and 27 patients were group B. There was no difference in age and 25-OHD level between the two groups (all 0>0.05). Group A were better functional outcomes at two years after surgery (p<0.05). On the QoL, group A were higher score than group B from twelve month later after surgery (p<0.05). Conclusions: Vitamin D deficiency was highly prevalent in LSS patients (76.5%). Assessment of serum 25-hydroxyvitamin D (25(OH)D) are recommended in LSS needing surgical intervention and active treatment vitamin D supplementation and maintenance of normal range should be considered for better postoperative functional outcome and QoL.

Perforator-Based Flap Reconstruction after Melanoma Resection: Evaluation of Oncological, Aesthetic, and Functional Outcomes

2021 ◽  
Author(s):  
Beniamino Brunetti ◽  
Rosa Salzillo ◽  
Stefania Tenna ◽  
Bruno Brunetti ◽  
Mario Alessandri Bonetti ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Locoregional Recurrence ◽  
Demographic Data ◽  
Exact Test ◽  
Significant Difference ◽  
Chi Squared ◽  
Group A ◽  
The Aesthetic ◽  
One Year ◽  
Group B

Abstract Background Evidence in literature about the best reconstructive approach after melanoma resection is controversial, with some authors advocating that tissue rearrangement flap techniques might hinder the early detection of local relapses. The aim of the present study is to evaluate oncological, aesthetic, and functional outcomes following melanoma reconstruction using pedicled perforator-based flaps. Methods The authors reviewed all patients affected by melanoma treated during a 6-year period. Demographic data, tumor characteristics, and operative variables were evaluated. Locoregional recurrence was assessed with clinical and radiological follow-up. One-year postoperatively patients rated on a 5-point Likert scale the aesthetic and functional outcomes of the procedure. Three blind observers examined preoperative and 1-year postoperative photographs and rated the aesthetic outcome of the reconstructive procedure. Results One-hundred sixty-five patients were treated with wide excision and delayed reconstruction, including pedicled perforator-based flaps in 70 patients (group A) and primary closure in 95 patients (group B). Mean Breslow thickness was 2.972 and 2.189 mm in group A and B, respectively. There was no statistically significant difference in locoregional recurrence (chi-squared test, p = 0.8333; Fisher's exact test, p > 0.9999) between the two groups. Group A reported a higher satisfaction with both the aesthetic (mean rating 4.390 in group A and 4.094 in group B) and functional (mean rating 4.732 in group A and 4.170 in group B) outcomes of the procedure, the latter being statistically significant (p = 0.0006). Conclusion This series suggests that pedicled perforator-based flaps provide optimal aesthetic and functional outcomes in melanoma reconstruction without impairing the locoregional control of the disease.

scholarly journals Best technique for fixation of displaced transverse olecranon fractures: tension band wiring or plate fixation?

2020 ◽  
Vol 6 (5) ◽  
pp. 1012
Author(s):  
Lokesh Kumar Yogi ◽  
Gagandeep Mahi ◽  
C. R. Thorat ◽  
Moti Janardhan Naik
Keyword(s):  
Functional Outcome ◽  
Large Scale ◽  
Plate Fixation ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Clinical Event ◽  
Dash Score ◽  
Group A ◽  
Group B ◽  
Olecranon Fractures

<p><strong>Background:</strong> Fractures of olecranon are common fractures in upper limb. Tension band wiring (TBW) and plate fixation (PF) are mostly used techniques but choice is based on type of fracture and surgeon’s preference.</p><p><strong>Methods:</strong>  A study assessed functional results in 28 patients that were enrolled after the clinical event of trauma has occurred. Patients were divided into two groups- Group (A) for TBW and Group (B) for PF; here gender, age and side of fracture were ignored. Post-operative functional outcome were evaluated by using the Mayo Elbow Performance (MEP) and the Disabilities of the Arm, Shoulder and Hand (DASH) score parameters.</p><p><strong>Results:<em> </em></strong>Mean (SD) union time as determined by postoperative radiographs was 8.5 (1.48) weeks for group (A) and 9 (2.08) weeks for group (B). Mean (SD) MEP score at 9 months in group (A) 84.28 (7.28) and 80.71 (10.92) in group (B). Mean (SD) DASH at 9 months in group (A) 12.2 (8.8) and 11.7 (10.4) in group (B). Complications were reported in group (A) 6 patient (42.85%) out of 14 patients and in group (B) 1 patient (7.14%) out of 14 patients.</p><p><strong>Conclusions:<em> </em></strong>The current study shows that there are no significant differences in functional outcome between both the study groups. Due to lesser complications, we recommend the plate fixation approach as the better choice for transverse displaced olecranon fractures. More large scale studies are required to further confirm our results.</p>

scholarly journals A study to assess functional outcome of cemented and uncemented total hip replacement in a tertiary care center

2019 ◽  
Vol 5 (5) ◽  
pp. 828
Author(s):  
Kunal Ajitkumar Shah ◽  
Mohan Madhav Desai
Keyword(s):  
Functional Outcome ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Cost Effective ◽  
Harris Hip Score ◽  
Total Hip ◽  
Vas Score ◽  
Group A ◽  
The Difference ◽  
Group B

<p class="abstract"><strong>Background:</strong> Total hip replacement (THR) is the most successful and cost effective treatment with aim of pain relief and functional rehabilitation for hip disorders. As the implant designs of THR have evolved over time, the functional outcome and survivorship has improved. Even after so many advancements, it remains unclear that which implants are better, uncemented or cemented. Hence, we took up this study to analyze which of the uncemented or cemented THR have better functional outcome.</p><p class="abstract"><strong>Methods:</strong> This was a longitudinal study conducted during 2014 to 2018. Hundred cases were randomized into groups of 50 each. All patients with age between 55-80 years in whom THR was indicated were included in the study. Uncemented THR was done in Group A and cemented THR was done in Group B. Patients were followed up at 12 weeks, 6 months, 12 months, and 3 years. At follow-up, functional examination in terms of visual analogue scale (VAS) score and Harris hip score (HHS) was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of patients in Group A (uncemented) and Group B (cemented) was 62.5 years and 60 years respectively. We found that the difference of VAS score and HHS between Group A and B was statistically significant at 12 weeks and 6 months. The difference of VAS and HHS scores between Group A and B at 12 months and 3 years was not significant.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that cemented THR has better functional outcome at short term. They are cost effective option at age ≥55-60 years.</p>

Clinical Result of Surgical Treatment in Distal Femur Fractures using Dynamic Compression Screw and Blade Plate

1996 ◽  
Vol 9 (3) ◽  
pp. 557
Author(s):  
Seung Baik Kang ◽  
Joong Hee Won ◽  
Bong Soon Chang ◽  
Eui Seong Choi ◽  
Jin Seon Yoo ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Result ◽  
Distal Femur ◽  
Dynamic Compression ◽  
Compression Screw ◽  
Blade Plate ◽  
Femur Fractures ◽  
Dynamic Compression Screw

scholarly journals FIXATION OF POSTERIOR TIBIAL PLATEAU FRACTURE AND ITS OUTCOME: A COMPARATIVE STUDY

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Hrishikesh Saodekar ◽  
Kamal Agrawal
Keyword(s):  
Functional Outcome ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Plate Fixation ◽  
Tibial Plateau Fractures ◽  
Fracture Union ◽  
Posterior Tibial ◽  
Plateau Fracture ◽  
Group A ◽  
Group B

Introduction: Tibial plateau fractures are complex injuries of proximal tibia which are produced by high- or low-energy trauma and principally affect young adult population. These fractures usually have associated soft-tissue lesions affecting the treatment. Posterior tibial plateau fractures (PTPF), may be medial or lateral, are common and they occur in about 28.8% patients as a part of bicondylar tibial plateau fractures. These fractures are difficult to reduce, therefore articular incongruity was not found to be detrimental factor in final functional outcomes. Studies have supported the fact that residual articular incongruence is well tolerated by proximal tibial plateau fracture in the form of minimal functional limitation or onset of arthrosis.  Anterolateral and anteromedial surgical approaches do not show adequate reduction and fixation of posterolateral and posteromedial fragments. To achieve this, it is advised to reduce and fix the fracture through specific posterolateral or posteromedial approaches that allow optimal reduction and plate/screw placement. Material and Methods: This comparative prospective cohort study on done on 50 adult patients. Two groups were formed: Group A – double-plate fixation with both posterior and anterolateral  having 25 participants and Group B – single anterolateral plate fixation having 25 participants in PTPFs were followed up to 1 year. For Group A, the reduction was done under direct vision and assisted with fluoroscopy in two planes. The reduction was assessed with submeniscal approach. In Group B posterior fragment was reduced by screws through the anterolateral plate followed by CT scan. Patients were evaluated by radiographs every 6 weeks till fracture union is evident. Fracture union was assessed by cortical continuity and progressive loss of fracture line on X-rays. Functional status at 1-year postoperative CT scanogram was done at final follow up to record articular subsidence, nonunion, coronal, or sagittal deformities. Knee functions were assessed by the International Knee Documentation Committee 2000 subjective knee evaluation form and objective functional Knee Society Score (KSS). Results: There were 22 male and 3 female in Group A while in Group B there were 20 male and 5 female. Right tibial fracture was observed in 15 cases and left in 10 cases in group A while in Group B right fracture was seen in 17 cases and in 8 cases left sided fracture. 23 cases each in group A and B were associated with RTA. Operative time (minutes) in group A and group B was 124 ± 26.7 and 79.52± 16.22 respectively. Total mean hospitalization days were 9.4±2.6 in group A and 8.2±1.5 in group B. Union time in group A was 14.6±3.4 weeks while in group B was 15.4±3.2. Statistically significant correlation was observed in group A and B with respect to KSS clinical outcome and KSS functional outcome. Flexion deformity was observed in 3 (12%) cases in group A and in 6 (24%) cases in group B. Conclusion:  PTPF can achieve an early and satisfactory functional outcome. Rehabilitation and fracture healing are better in PTPF. Keywords: Tibial plateau fractures, PTPF, Open reduction and internal fixation (ORIF)

scholarly journals Effect of Teriparatide in Fracture Healing in Lower Limbs- An Interventional Study

2021 ◽  
Author(s):  
Sanjeev Kumar ◽  
Girish Sahni ◽  
Harjit K Singh Chawla ◽  
Daljinder Singh
Keyword(s):  
Functional Outcome ◽  
Adverse Reactions ◽  
Weight Bearing ◽  
Test Group ◽  
Control Group ◽  
Dash Score ◽  
Early Weight Bearing ◽  
Group A ◽  
Group B ◽  
Radiological Union

Introduction: Many of the trauma patients presenting to the orthopaedic departments suffer from lower limb fractures. This often leads to prolonged period of morbidity and absence from work. Fracture healing can be delayed in elderly patients, postmenopausal women and in communited fractures. Teriparatide (TPH) given subcutaneously for 6 to 9 months, in such cases, may promote clinical and radiological union of bone. Aim: To know the effect of TPH in improving clinical and radiological union and also to evaluate early weight bearing, improvement in pain and functional outcome. Materials and Methods: In this prospective interventional study, a total of 125 patients were initially enrolled for the study and then after meeting inclusion criteria total 104 patients were selected for the study. They were allocated into two groups by randomisation by 1:1 method-group A was test group of 52 cases in which subcutaneous injection TPH 20 mcg daily (for six months) was given along with standard dosage of calcium and vitamin D; while in 52 cases in group B (control group) only calcium and vitamin D were given. Injection TPH was started within 10 days of fracture and given for six months. No placebo injection was given in control group. Time to weight bearing, time to clinical and radiological union and pain by Visual Analogue Score (VAS) were noted at regular follow-up at one month, three months, six months and 12 months and were compared in both the groups. Functional outcome by Disabilities of the Arm, Shoulder and Hand (DASH) score was noted as an additional tool, as DASH score questionnaire shows many activities of daily living that require mobility and stability of lower limb too. Adverse reactions were noted and compared within test and control groups. The collected data were analysed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 22.0 software and Mann-Whitney U test was used to calculate p-value. Results: Average time period for full weight bearing with or without support for test group A was 11±2.7 weeks and 16±1.8 weeks in control group B (p-0.001). Average time to clinical union in test group was 12±1.9 weeks and in control group 16±2.2 weeks (p-0.001). Average time to radiological union was 13±1.4 weeks in test group while 22±2.2 weeks in control group (p-0.001). Pain score by VAS and functional outcome by DASH were improved in test group (p-0.001). There was no difference in adverse reactions in both the groups (p>0.05). Conclusion: Regular intake of TPH 20 mcg subcutaneous daily for six months can reduce time to clinical and radiological fracture union, promote early weight bearing and provide better pain control. Hence, better functional outcome and prefracture ambulatory status can be achieved with no significant adverse events.

scholarly journals A comparative study of two operative procedures in anterior hypospadias repair: limited urethral mobilization and tubularized incised plate urethroplasty.

2021 ◽  
Vol 28 (11) ◽  
pp. 1578-1584
Author(s):  
Shafiq ur Rehman ◽  
Fareena Ishtiaq ◽  
Zarlish Fazal ◽  
Muhammad Anwar ◽  
Saad Fazal
Keyword(s):  
Hospital Stay ◽  
Functional Outcomes ◽  
Operative Time ◽  
Operation Time ◽  
Cosmetic Appearance ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Tubularized Incised Plate Urethroplasty ◽  
The Mean ◽  
Group B

Objectives: This study is aimed to compare the results of limited urethral mobilization and tubularized incised plate urethroplasty in the management of anterior hypospadias, in terms of cosmetic and functional outcomes, complication rate, operative time, and hospital stay. Study Design: Prospective Randomized Controlled study. Settings: Department of Pediatric Surgery, DHQ Teaching Hospital Sahiwal. Period: January 2019 to December 2020. Material and Methods: A total of 89 patients with anterior hypospadias were included. Patients were divided randomly into two groups. In group A, limited urethral mobilization was performed and in group B, tubularized incised plate urethroplasty was carried out. A self-structured performa was used to collect the data of all patients. Both groups were compared in terms of the operation time, hospital stay, postoperative complications, cosmetic appearance, and functional outcomes. Results: Forty-five patients were included in group A, age ranged from 2.5 to 12 years (mean 4.83years). Forty-four patients were included in group B and their ages ranged from 3.5 to 11years (mean 4.76 years). The operation time was significantly less for group A than for group B. In group A, it ranged from 54 to 69 min with an average time of 60.51 min and in group B from 70 to 88 min, with an average of 79.34 min. The mean hospital stay period in group A was 7.37 days, ranged from 7 to 9 days, and in group B was 11.04 days, ranging from 10 to 13 days. The mean follow-up period in both groups was 7.45 months, ranging from 3 months to 12 months. Meatal stenosis was the most common complication in group A, which developed in 6.66% (n=3) patients. Urethrocutaneous fistula was the most common complication in group B, which developed in 6.81% (n=3) patients. Cosmetic appearance and functional outcome were good and comparable in both groups. Conclusion: Although both techniques, tubularized incised plate and limited urethral mobilization urethroplasty are acceptable modalities for the management of anterior hypospadias. But limited urethral mobilization urethroplasty seems to be a good option due to its simplicity, short hospital stay, significant shorter operative time, low fistula formation rate, and good cosmetic and functional outcomes.

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