scholarly journals K-Wire Fixation of Proximal Three Part Humerus Fractures - An Everlasting Result Oriented Technique

2021 ◽  
Vol 10 (8) ◽  
pp. 511-514
Author(s):  
Amber Varyani
Keyword(s):  
Low Income ◽  
Proximal Humerus ◽  
Early Discharge ◽  
Income Group ◽  
Fracture Site ◽  
Clear Cut ◽  
Neer Classification ◽  
Wire Fixation ◽  
Operative Complications ◽  
Post Operative Complications

BACKGROUND Proximal humerus (3rd) part fractures have always been posing great challenges to the orthopaedicians, due to extreme complexity involved in it, mainly, deformed muscular forces around fracture site, osteoporosis and non-affordability to new generation plates and screws etc. Ever since the inception of internal fixation, different approaches have been used, for proximal humerus (3rd) part fractures, like fixation with anatomically contoured locking plates with locking screws and nonlocking plates, hemi-arthroplasty, percutaneous k-wire etc. but only little had been compiled and recorded on such fractures. This study was conducted to evaluate and determine the efficacy of K-wire fixation in such fractures with supporting data to draw a clear-cut favourable conclusion over other methods of fixation of such fractures. METHODS 20 patients were included (matching our inclusion criteria), rest were treated differently and were excluded from the study. All fractures were classified in accordance with Neer classification. All patients were treated with K-wire fixation; only the number of K-wires differed from case to case. After their discharge from hospital, all patients were called for stringent review for 15, 30, 60, 90 days on half yearly and yearly basis. Final outcome was evaluated using constant Murley score. RESULTS The average union time was 22 weeks; the mean constant Murley’s score was 82 points. Only 3 post-operative complications were noted among all the 20 patients; these were, one mal-union and two cases of pin tract infection. Result was overwhelming success for us. The results of our study were extremely encouraging and in favour of K-wire fixation of such fractures. CONCLUSIONS K-wire fixation of proximal humerus [3rd part] fractures provide stable fixation of such fractures, with negligible post-operative complications and at an extremely cheap cost, easily affordable to average and low-income group patients with early discharge from the hospital, with very low intra operative blood loss and very low operative time, and exposure to C-arm machine. KEY WORDS Proximal Humerus [3rd] Part Fracture, Percutaneous K-Wire Fixation, Neer Classification, Greater Tuberosity

scholarly journals Circumosseous wire fixation for metacarpal fractures: an old method revisited

2020 ◽  
Vol 8 (1) ◽  
pp. 48
Author(s):  
Anil Malik ◽  
Parvesh Malik ◽  
Vijay Kumar Pandey ◽  
Dev Jyoti Sharma ◽  
Kumar Pushkar
Keyword(s):  
Functional Recovery ◽  
Fracture Fixation ◽  
Metacarpal Fracture ◽  
Operative Indication ◽  
Metacarpal Fractures ◽  
Wire Fixation ◽  
Operative Complications ◽  
Post Operative Complications

Background: Different methods are in use for fixation of metacarpal fractures. Krischener wire and titanium miniplates are most commonly used methods. Both these methods require special & sophisticated instruments. In this study, we have used a dental wire in circumosseous fashion to fix the metacarpal fractures.Methods: In the study, we included all the fracture of metacarpals with operative indication. K-wire, minilplate system and circumosseous dental wire methods were used randomly.Results: The results were compared in term of immediate post-operative complications & functional recovery in form of ability of fist formation at 06 weeks. All the three methods were found comparable, in fact in this study the results of fractures treated with circumosseous wiring were appreciable and significantly better.Conclusions: Circumossoeus use of dental wire can be an alternate method of metacarpal fracture fixation.

Pelvic Canal Narrowing Caused by Triple Pelvic Osteotomy in the Dog

1994 ◽  
Vol 07 (03) ◽  
pp. 110-113 ◽  
Author(s):  
D. L. Holmberg ◽  
M. B. Hurtig ◽  
H. R. Sukhiani
Keyword(s):  
Postoperative Complications ◽  
Pelvic Osteotomy ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Canal Width ◽  
Operative Complications ◽  
Post Operative Complications

SummaryDuring a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.

scholarly journals Global trends in medical education accreditation

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Deborah Bedoll ◽  
Marta van Zanten ◽  
Danette McKinley
Keyword(s):  
Medical Education ◽  
World Bank ◽  
Low Income ◽  
Regional Cooperation ◽  
Medical Schools ◽  
Income Group ◽  
Low Income Countries ◽  
Fiscal Year ◽  
The World ◽  
Google Search

Abstract Background Accreditation systems in medical education aim to assure various stakeholders that graduates are ready to further their training or begin practice. The purpose of this paper is to explore the current state of medical education accreditation around the world and describe the incidence and variability of these accreditation agencies worldwide. This paper explores trends in agency age, organization, and scope according to both World Bank region and income group. Methods To find information on accreditation agencies, we searched multiple online accreditation and quality assurance databases as well as the University of Michigan Online Library and the Google search engine. All included agencies were recorded on a spreadsheet along with date of formation or first accreditation activity, name changes, scope, level of government independence, accessibility and type of accreditation standards, and status of WFME recognition. Comparisons by country region and income classification were made based on the World Bank’s lists for fiscal year 2021. Results As of August 2020, there were 3,323 operating medical schools located in 186 countries or territories listed in the World Directory of Medical Schools. Ninety-two (49%) of these countries currently have access to undergraduate accreditation that uses medical-specific standards. Sixty-four percent (n = 38) of high-income countries have medical-specific accreditation available to their medical schools, compared to only 20% (n = 6) of low-income countries. The majority of World Bank regions experienced the greatest increase in medical education accreditation agency establishment since the year 2000. Conclusions Most smaller countries in Europe, South America, and the Pacific only have access to general undergraduate accreditation, and many countries in Africa have no accreditation available. In countries where medical education accreditation exists, the scope and organization of the agencies varies considerably. Regional cooperation and international agencies seem to be a growing trend. The data described in our study can serve as an important resource for further investigations on the effectiveness of accreditation activities worldwide. Our research also highlights regions and countries that may need focused accreditation development support.

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