scholarly journals DYNAMIC HIP SCREW (DHS)

2016 ◽  
Vol 23 (01) ◽  
pp. 076-080
Author(s):  
Mehtab Pirwani ◽  
Abbas Memon ◽  
Shakeel Ahmed Memon
Keyword(s):  
Deep Infection ◽  
Lateral Approach ◽  
Gender Ratio ◽  
Superficial Infection ◽  
Non Union ◽  
Fracture Table ◽  
Group A ◽  
Hip Screw ◽  
Comparative Results ◽  
Group B

Objectives: To analyze the comparative results of dynamic DHS fixation in stableand the unstable intertrochanteric fractures at LUH. Study Design: Comparative study. Setting:Orthopedic unit I of LUH Jamshoro. Period: 26th May 2010 – 25th August 2011. Methodology:All 40 patients with femur intertrochanteric fracture were enlisted. All cases isolated in 2 groupsevery having 20 patients, group A stable fracture and group B unstable fractures. After completephysical examination, examinations and fracture arrangement evaluation, patients were readiedfor operation. Fracture table was used in each operation. Fracture reduction was initiallyattempted by close manipulation and was successful in 30 (75%) cases. Lateral approach forproximal femur was used in every case. All fractures, whether stable or unstable, were reducedanatomically without any type of osteotomy and then fixed with 135o dynamic hip screw.Results: Mean age was 62.8.2 years of the cases. Gender ratio was 3:1. According to modeof injury were found RTA in 21 (70%) patients. Postoperative complications were recorded as;superficial infection noted in 2 (5%) patients and there was no case of deep infection. Averagestay of hospital found 16.5 days in 17 (42.5%) patients belongs to stable group and 06 (15%)patients belong to unstable group. All (n=40) patients were pain free on their discharge fromhospital. In all (n=40) patients we achieved union and there was no case of delayed unionor non-union. We assessed functional outcome of our patients on the base of Stinchfield HipAssessment system. According to SHAS 28 (70%) patients were excellent, 05 (12.5%) patientswere good, 04 (10%) were fair and 03 (7.5) were poor. We had not found mortality in our patients.Conclusions: According to our conclusion DHS is the best implant for intertrochanteric fracturefixation. No matter; whether fracture is stable, unstable and fresh or old.

scholarly journals INTER-TROCHANTERIC FRACTURES;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Farhad Alam ◽  
Mudassar Jabeen
Keyword(s):  
Internal Fixation ◽  
Case Series ◽  
Deep Infection ◽  
Dynamic Hip Screw ◽  
Intertrochanteric Fractures ◽  
Superficial Infection ◽  
Group A ◽  
Hip Screw ◽  
Group B

Introduction: Hip fractures are a leading cause of death and disability among elderly. Approximately half of these injuries are intertrochanteric fractures and the incidence is continuously increasing. These fractures are the most common injuries around the hip region and are more common in elderly people. Different types of implants were tried at different times for internal fixation of these fractures, of which dynamic hip screw has remained the most popular one. But with the advent of some newer implants, the efficacy of dynamic hip screw is being questioned. Objectives: To determine the results of dynamic hip screw as a method of internal fixation in closed stable as well as unstable intertrochanteric fractures of femur in adults. Design: Descriptive case series. Setting: The study was conducted in orthopedic department Allied Hospital Faisalabad. Period: 11months (from 26th, march, 2015 to 25th Feb, 2016). Subjects and Methods: Sixty cases of intertrochanteric fractures were included and operated for internal fixation with dynamic hip screw under fluoroscopic guidance. Pre, per and post-operative findings during hospital stay and follow-up period were recorded. Results: We had a total 60 cases, 20 patients in group A stable intertrochanteric fractures and 40 patients in group B unstable intertrochanteric fractures. We have reported the follow up study up to 20 weeks. There were 10 (50%) male and 10 (50%) female in group A. In group B 27 (67.5%) males and 13 (32.5%) females. The youngest pt was 25 years in group A and 16 years in group B. The mean age in group A was 59.10 and st/deviation 16.942. In group B mean age was 54.85 and st/ deviation 14.123. Infection rate in group A was 5%. In group B superficial infection was 5% and deep infection was 2.5%. Nonunion in both groups was 5%. The failure rate was 5% in group A and 20% in group B. Conclusion: The use of Dynamic hip screw with aside plate is associated with good results and acceptable complication rate. Dynamic hip screw is implant of choice in both stable and unstable intertrochanteric fractures.

scholarly journals FRACTURE OF SHAFT OF FEMUR

2018 ◽  
Vol 25 (04) ◽  
pp. 627-632
Author(s):  
Sajjad Rasool ◽  
Basharat Manzoor ◽  
Muhammad Omer Aslam
Keyword(s):  
Deep Infection ◽  
Delayed Union ◽  
Implant Failure ◽  
P Value ◽  
Superficial Infection ◽  
Non Union ◽  
Interlocking Nail ◽  
Screw Breakage ◽  
Group A ◽  
Group B

Introduction: Fracture of the shaft of the femur is among the most commonfractures encountered in orthopedics practice.1 Objectives: The aim of the study was alsocompare the outcome of solid versus canmulated inter locking nails as a method of internalfixation in closed fractures of the shaft of femur in adults. Design: Quasi Experiment design.Setting: Orthopedic Department Allied Hospital P.M.C Faisalabad. Results: We had total of60 cases, 30 in groups of solid I/M nailing and 30 in group B of Cannulated in I/M nailing wehave reported the follow up study up to 9 months. (1) There were 27 (90%) males and 3 (10%)females in group A. (2) If in group B 26 (86.666%) were males 4 (13.333%). (3) The mean agewas 37.4 + 1.61 years. Union: Group A, In 26 (86.666%) patients the fracture uniting within 3months. 3 (10%) patients went into phase of delayed union which ultimately united. 1 (3333%)patient into non-union for which bone grafts has to be done after nine months. Group B: In 26(86.666%) patients the fracture united within 3 months. Patient in group B went into nonuniondue to deep infection, second due to nail breakage an in third no apparent causes was found.Total no of cases of non-union in group B were 3. Infection: In group A one patient in groupB 2 patient had superficial infection which were treated with appropriate antibiotics. In groupB one patient had deep infection and went into non-union due to infection. Implant Failure:In group B one case with nail breakage.. 2 Cases with distal Inter Locking screws breakage& 1 case with proximal interlocking screw breakage were noted. Conclusion: (1) There isno statistical difference in union and infection in both groups (P-Value > 0.05). (2) There issignificant difference in implant failure in both groups no patients in group A went with implantfailure but four patients in group B developed implant failure (P-value < 0..05) so Solid interlocking nail is stronger than cannulated interlocking nail.

scholarly journals Superficial and Deep Infections Rate in Primary Total Ankle Replacement through Anterior Approach versus Lateral Transfibular Approach

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003 ◽  
Author(s):  
Federico Giuseppe Usuelli ◽  
Cristian Indino ◽  
Luigi Manzi ◽  
Camilla Maccario ◽  
Ettore Vulcano
Keyword(s):  
Anterior Approach ◽  
Operative Time ◽  
Deep Infection ◽  
Lateral Approach ◽  
Trabecular Metal ◽  
Ankle Replacement ◽  
Group A ◽  
Group B ◽  
Approach Group

Category: Ankle, Ankle Arthritis, Periprosthetic Infections Introduction/Purpose: Periprosthetic joint infections represent a relatively infrequent complication following total ankle replacement (TAR), with reported incidence ranging from 2% to 8,6%. Early treatment of any wound infection is the key to prevent disastrous outcomes. One of the most recent TARs (Zimmer Trabecular Metal Total Ankle, Zimmer Biomet, Warsaw, IN) requires implantation through a lateral transfibular approach. Potential advantages of this approach include the supposed decreased risk of wound complications, thanks to a preservation of the distal leg angiosomes. The purpose of this study is to retrospectively compare the rate of superficial and deep infections between TARs performed through an anterior approach and TARs performed through a lateral transfibular approach at 12-months follow-up. Methods: This study included 150 consecutive primary TARs performed between May 2011 and July 2015 with at least 1-year follow up. The 3-component uncemented Hintegra implant (Newdeal SA, Lyon, France) was used in 81 TARs (54.0%) through an anterior approach (group A). The 2-component uncemented Zimmer Trabecular Metal Total Ankle prosthesis, was implanted in 69 TARs (46.0%) through a lateral transfibular approach (Group B). Operative time, tourniquet time and superficial and deep infections were recorded up to 1-year follow-up. All patients were clinically and radiologically evaluated postoperatively at two, six and twelve months. Superficial wound infections were classified as dehiscence, eschar, or wound drainage according to criteria of the Centers for Disease Control and Prevention for surgical wound infection. Deep infections were classified according to Fitzgerald’s classification: acute postoperative, deep late infections, late hematogenous infections. We compared the incidence of superficial and deep infections as well as the operative time. Results: In group A there were 4 (4.9%) superficial infections. Two of these patients developed a deep infection. Overall, there were 3 (3.7%) deep infections in group A that required: intravenous antibiotics and vacuum assisted closure; replacement of the tibial component and polyethylene liner; polyethylene exchange and VAC treatment. In group B, there were 2 (2.9%) superficial infections. One of these patients developed the only deep infection (1.4%) that was treated with antibiotic-impregnated cement spacer. There was no statistically significant difference in terms of superficial (P= 0.687) and deep infections (P= 0.625). The mean operative time in group A was 115.2 minutes (65-150) and 179.5 minutes (105-333) in group B. Operative time was statistically different between group A and group B (P <0.001). Conclusion: This study demonstrates a lower superficial and deep infection rate in the lateral transfibular approach group compared to the anterior approach group. Nonetheless, this difference was not statistically significant. The significantly longer operative time in the lateral approach group did not seem to affect the infection rates. In conclusion, TARs performed through a lateral approach appear to be as safe as TARs done through an anterior approach in terms of the infection rate within the first postoperative year. Further studies on larger cohorts and longer follow-up are essential to validate the findings from this study.

scholarly journals Profile vs Tubular Plate in Unimalleolar or Bimalleolar Fractures: is There a Real Difference in Wound complications?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0015
Author(s):  
Paolo Ceccarini ◽  
Rosario Petruccelli ◽  
Michele Bisaccia ◽  
Giuseppe Rinonapoli ◽  
Auro Caraffa
Keyword(s):  
Wound Dehiscence ◽  
Deep Infection ◽  
Ankle Fractures ◽  
Bone Union ◽  
Wound Complications ◽  
Fisher Exact Test ◽  
Superficial Infection ◽  
Operative Care ◽  
Group B

Category: Ankle; Trauma Introduction/Purpose: The aim of our study is to compare two types of plates, one third tubular plate and LCP distal fibula plate, evaluating the clinical outcome and the skin complications associated with their use. Methods: We collected the data of 122 consecutive unimalleolar or bimalleolar fractures treated by internal fixation for a closed, displaced distal closed fibular fracture. Exclusion criteria were: 1) open ankle fractures,2) trimalleolar fractures, 3) previous ankle fractures 4) severe venous insufficiency, 5) ankleosteoarthritis previous to surgery, 6) associated ankle dislocation. After this selection, 93 patients were included in our study and assigned in two groups, based on using of different implant: in group A48 patients were treated with one-third tubular and in group B 45 patients were treated with LCP distalfibula plate. There were no significant differences in the baseline characteristics. Patients received the same surgical procedure and the same post-operative care, then they were radiologically evaluated at1-3-12 months and clinical examination was made at 24 (range 15-36) months using AOFAS clinical rating system. All data were evaluated using chi-square test. Results: At the final 24-month follow-up a comparison between the two groups showed no statistical significant differences in reduction accuracy and bone union ratio at radiological examination. The wound complications rate of the overall study group was 7.6%. There were no statistical differences in the rate of wound complications between the two groups. There were no differences between both group in percentage of hardware removal at follow-up (overall 5.4%). In the group A occurred 1 deep infection, 2 superficial infection, no wound dehiscence; in group B occured 1 deep infection, 1 superficial infection and 2 wound dehiscence. There were no statistical differences in the rate of wound complications between the two groups (p=0.70; Fisher exact test). Conclusion: Our study has shown no difference in radiographic bone union rate, no significant differences in terms of clinical outcomes, in time of bone reduction and wound complication rate between the LCP distalfibula plate and conventional one-third tubular plate. RCT or metanalasys are in this case useful to improve scientific evidence and give more information for the correct surgical treatment of ankle fractures.

Comparison of Outcome of Three Different Approaches for Supracondylar Humerus Fractures in Children

2021 ◽  
Vol 15 (10) ◽  
pp. 3482-3484
Author(s):  
Syed Usman Shah ◽  
Mohammad Younas ◽  
Naseer Ullah Khattak ◽  
Amina Gul Shehzar Khan ◽  
Sultan Shah ◽  
...  
Keyword(s):  
Posterior Approach ◽  
Lateral Approach ◽  
Supracondylar Fractures ◽  
Medial Approach ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Significant Difference ◽  
Group A ◽  
Humerus Fractures ◽  
Group B

Objective: The aim of this study is compare the outcomes among three different approaches (lateral approach, medial approach and posterior approach) for supracondylar humerus fractures in children. Study Design: Retrospective cohort study Place and Duration: The study was conducted at Orthopedics department of Ayub Teaching Hospital, Abbottabad for duration of one year from January 2020 to December 2020. Methods: There were one hundred and thirty five children had supracondylar humerus fracture were presented. Patients were aged between 3-12 years. Informed written consent was taken from authorities for detailed demographics age, sex, cause of fracture and side of fracture. Patients were categorized into three equal groups, group A had 45 patients and received lateral approach, group B had 45 patients and received medial approach and group C received posterior approach with 45 cases. Shaft Condylar Angle (SCA) and Baumann angle were used to analyze the radiological result. All children were assessed using Flynn's criteria for functional outcomes, and the results were divided into Excellent, Good, Fair and Poor. Post-operative outcomes among all the three groups were calculated and compared. SPSS 23.0 version was used to analyze complete data. Results: There were 90 (66.7%) males (30 in each group and 45 (33.3%) females (15 in each group). In group A mean age was 6.88±5.45 years, mean age in group B was 7.11±5.33 years and in group C mean age was 7.17±5.66 years. Sports 85 (62.9%) was the most common cause of fracture followed by traffic accidents 30 (22.2%) and the rest were 20 (14.8%) fall from the height. According to radiological outcomes, Mean shaft condylar Angle in group A was 41.5±6.3, in group B was 41.8±1.9 and in group C was 40.1±3.8 respectively (P>0.05). Mean Bauman angle in group A was 18.8±6.11, group B was 19.4±7.5 and in group C 20.4±5.3 with (P>0.05). According to Flynn’s criteria, excellent outcomes were observed in 33 (73.3%) in LA group, 24 (53.3%) in MA group and 22 (48.9%) in PA group, good results were observed in 11(24.4%), 19 (42.2%) and 21 (46.7%), fair outcomes in 1 (2.2%), 2 (4.4%) and 2 (4.4%). Conclusion: As a result of this research, we have concluded that the lateral technique for supracondylar fractures is superior to the medial or posterior approaches in terms of radiological and functional results. However, there was no statistically significant difference between the three groups. Keywords: Supracondylar fractures, Flynn’s criteria, Functional outcome, Open reduction

Clinical study on the tunnel approach in laparoscopic radical right hemicolectomy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16135-e16135
Author(s):  
Xijie Zhang ◽  
Junli Zhang ◽  
Yuzhou Zhao
Keyword(s):  
Colon Cancer ◽  
Operation Time ◽  
Right Hemicolectomy ◽  
Lateral Approach ◽  
Radical Right ◽  
Lymph Node Yield ◽  
Group A ◽  
Laparoscopic Right Hemicolectomy ◽  
Group B ◽  
Approach Group

e16135 Background: The medial to lateral approach Laparoscopic right hemicolectomy complies with the “no-touch” principle, but need a demanding procedure with a steep learning curve. This study was designed to assess the superiority of the tunnel approach compared to traditional medial-to-lateral approach in laparoscopic right hemicolectomy for patients with right-sided colon cancer. Methods: The new method was called Tunnel Approach: The tunnel was formed with Toldt's gap was dissociated upward from the attachment of ileocecal part and retroperitoneum, then the right mesocolon was lifted to expose and divide the superior mesenteric blood vessel. We analyzed retrospectively the patients with resectable right-sided colon cancer confirmed by colonoscope and imaging who received the laparoscopic radical right hemicolectomy. The patients were divided into the tunnel approach (group A) and the traditional medial-to-lateral approach (group B) according to the surgical maneuver performed. Results: A total of 84 patients who received laparoscopic radical right hemicolectomy were assigned to group A (n = 42) or group B (n = 42) between January 2016 to June 2017. There was no difference in baseline characteristics including demographics, body mass index (BMI), tumor stage, tumor location and differentiation. The operation time and intraoperative blood loss in group A were significantly better than group B (137.74±22.7 vs. 153.1±28.8min, p < 0.05; 49.0±40.7 vs. 142.9±87.4ml, p < 0.05, respectively).There was no difference in tumor size(5.7±2.1 vs. 5.7±2.1cm, p>0.05), conversion to laparotomy rate(0 vs. 3, p>0.05), lymph node yield(30.5±14.4 vs. 27.9±12.7, p>0.05), time to first flatus(3.4±1.3 vs. 4.0±1.3d, p>0.05), postoperative hospital stays(10.0±2.2 vs. 12.3±3.0d, p>0.05) and complications(2 vs. 3, p>0.05) between two groups. There was no treatment-related death in both groups. Conclusions: The characteristic of “tunnel” approach is to convert the anatomy from a two-dimensional to a three-dimensional view, it showed the benefits of both speed and safety with low intraoperative conversion to laparotomy rate and mortality. This new tunnel approach right hemicolectomy is worth recommended.

scholarly journals Fascitis plantar. Estudio comparativo entre tres esquemas terapéuticos. [Plantar fasciitis. Comparative study between 3 therapeutic schemes]

2019 ◽  
Vol 84 (4) ◽  
pp. 336-341
Author(s):  
Ignacio Arzac Ulla
Keyword(s):  
Plantar Fasciitis ◽  
Plantar Flexion ◽  
Plantar Fascia ◽  
Return Time ◽  
Current Treatment ◽  
Group A ◽  
Comparative Results ◽  
Group B ◽  
First Time

Introducción: La fascitis plantar, descrita, por primera vez, por Plettner, es la causa más común de dolor en el talón. Su etiología continúa en estudio, participan factores anatómicos, como el acortamiento de la flexión plantar, y relacionados con el aumento de peso. Si bien no se ha publicado cuál es el mejor tratamiento para este cuadro, se recomienda el tratamiento conservador temprano. El objetivo de este estudio fue comparar tres métodos de tratamiento de la fascitis plantar.Materiales y Métodos: Entre marzo de 2016 y marzo de 2017, se trató a 90 pacientes con fascitis plantar, quienes fueron divididos en tres grupos, según el tratamiento recibido: grupo A o de control, ejercicios de elongación de la fascia plantar; grupo B, infiltración corticoanestésica y ejercicios de elongación de la fascia plantar, y grupo C, infiltración con solución salina y ejercicios de elongación de la fascia plantar. Resultados: Se mencionan los resultados comparativos sobre la base de la edad, el lado afectado, las enfermedades previas, la forma del pie, las cirugías previas del pie, el dolor posinfiltración, la escala analógica visual: grupo A: 0,73; grupo B: 1,03, grupo C: 2,7 y el tiempo hasta el retorno a la actividad previa: grupo A: 19.1 días, grupo B: 12.63 días, grupo C: 15.12 días. Conclusiones: Nuestro estudio demuestra que los tres tratamientos para la fascitis plantar son eficaces. La recuperación fue más rápida en los pacientes tratados con infiltración corticoanestésica, con un bajo número de complicaciones, pero sin diferencias a largo plazo. AbstractIntroduction: Plantar fasciitis, described for the first time by Plettner, is the most common cause of heel pain. In the etiology of this pathology under study, involved anatomical factors such as shortening of plantar flexion and related to weight gain. Although the current treatment does not exist in the current literature, the early start of conservative treatment has been recommended. The objective of the present study is to compare 3 treatment methods of plantar fasciitis. Materials and Methods: Between March 2016 and March 2017, 90 patients with plantar fasciitis were treated. They were divided into 3 groups based on the treatment performed. Group A or control: plantar fascia elongation exercises, Group B: anesthetic cortical infiltration and elongation exercises of plantar fascia and Group C: infiltration with saline solution and elongation exercises of plantar fascia.Results: Comparative results are mentioned based on age, affected side, previous pathologies, foot shape, previous foot surgeries, post infiltration pain, analogous visual scale Group A: 0.73 Group B: 1.03 Group C: 2.7 and return time a previous activity Group A: 19.1 days Group B: 12.63 days Group C: 15.12 days.Conclusions: Our study shows that the three treatments for PF are effective, seeing a recovery in less time to patients treated with anesthetic cortical infiltration with a low number of complications but no long-term differences.

scholarly journals PROSTATIC HYPERPLASIA;

2017 ◽  
Vol 24 (10) ◽  
pp. 1560-1565
Author(s):  
Muhammad Sheraz Javed ◽  
Safdar Hassan Javed
Keyword(s):  
Prostatic Hyperplasia ◽  
Significant Response ◽  
Age Group ◽  
Urinary Tract Symptoms ◽  
Prostate Size ◽  
Group A ◽  
Male Patients ◽  
Comparative Results ◽  
Group B ◽  
Lower Urinary

Lower Urinary Tract Symptoms. Alpha-1 adrenoceptor antagonists are mostfrequently prescribed medical management for LUTS and among these tamsulosin andterazosin are the most common. Objectives: To access comparison of efficacy of tamsulosinand terazosin for management of LUTS due to prostatic hyperplasia in terms of InternationalProstate Symptom Score (IPSS). Place and duration: Study being conducted at Departmentof Urology and Kidney Transplantation, Allied Hospital, Faisalabad for period of 24 months from01-07-2014 to 30-06-2016. Methodology: 659 male patients enrolled in study and randomlyassigned to Group A (Patients being administered with tamsulosin) and Group B (Patients beingadministered with terazosin) and improvement in IPSS monitored over period of two weeks.Results: 659 patients enrolled with mean age+sd as 61.9+10.2 years. Group A includes 330patients while Group B include 329 patients. Among Group A, 250 patients showed significantimprovement in IPSS while in Group B, 215 patients showed significant response to medicalmanagement in terms of IPSS and both groups showed statistically comparative response.Statistical response of management also determined in terms of variables of IPSS severity,prostatic size and age of patient and found that efficacy of the two groups were statisticallycomparable for patients with mild IPSS while in patients with moderate IPSS has response totreatment with tamsulosin but no statistical association of efficacy for treatment with terazosin.No statistical response was found for improvement in symptoms in cases with severe IPSS ineither groups. When response monitored in terms of prostate size in both groups, it was foundthat both groups have statistical response when prostate size is less than 35 grams, between35-55 grams but in case when prostate size was more than 55 grams, no statistical responsewas found with group B patients. When response was measured in terms of variable of age,results were consistent with the fact that statistically significant response of efficacy was foundin either groups for age group 45-55 years and 56-65 years but no statistical response wasfound for Group B when considered for age group more than 65 years. Conclusion: Based onresults it is concluded that both tamsulosin and terazosin has got comparative results in overallresponse. However, tamsulosin has superiority in treatment when IPSS is moderate, prostatesize is more than 55 grams and age of patient is more than 65 years.

scholarly journals Comparison of outcome with medial versus lateral approach for operative fixation of superacondylar humeral fractures in paediatric patients.

2020 ◽  
Vol 27 (10) ◽  
pp. 2045-2049
Author(s):  
Kashif Siddiq ◽  
Asad ullah Mehmood ◽  
Muhammad Hamayun Hameed ◽  
Muhammad Khalid Chishti ◽  
Muhammad Nasir Ali ◽  
...  
Keyword(s):  
Lateral Approach ◽  
Type Ii ◽  
Medial Approach ◽  
Supracondylar Humeral Fracture ◽  
Excellent Outcome ◽  
Satisfactory Outcome ◽  
History Of ◽  
Group A ◽  
Carrying Angle ◽  
Group B

Objectives: To compare the outcome in terms of carrying angle with medial versus lateral approach in the treatment of these fractures among children. Study Design: Randomized Clinical trial. Setting: Department of Orthopaedic Surgery Civil Hospital Bahawalpur and Nishtar Hospital Multan. Period: From June 2018 to September 2019. Material & Methods: A total of 154 children of both genders, aged 2-14 years having supracondylar humeral fracture of type II and III, with duration of fracture within 7 days, were enrolled. Patients were divided in two groups (77 in each group), group A and group B. Group A was managed by open reduction internal fixation (ORIF) with cross K-wire through medial approach and group B underwent lateral approach. Results: Out of 154 cases, 102 (66.2%) were boys and 52 (33.8%) were girls. Overall, mean age was noted to be 7.98 ± 2.23 years. Obesity was present in 16 (10.4%) cases. Mean duration of fracture was noted to be 4.21 ± 1.34 days while 106 (68.8%) had duration less than 5 days. There were 119 (77.3%) cases with history of fall and 35 (22.7%) had history of road traffic accidents (RTA). Sixty one (39.6 %) cases were classified as Gartland type II fractures while remaining 93 (60.4 %) were type III fractures. Excellent outcome with carrying angle 0–5o in group A was noted to be 67 (87 %) while that of group B was 54 (70.1%) (p = 0.011). Conclusion: Medial approach for the treatment of pediatric SHF was noted to be superior in terms of postoperative carrying angle having satisfactory outcome in comparison with the lateral approach.

Comparing approaches to sciatic nerve blocks in dogs during tibial plateau-levelling osteotomy

2020 ◽  
Vol 25 (10) ◽  
pp. 1-7
Author(s):  
Robyn Thomson ◽  
Delphine Le Chevallier ◽  
Emma Love ◽  
Jo Murrell
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Lateral Approach ◽  
Sciatic Nerve Block ◽  
Nerve Blocks ◽  
Transgluteal Approach ◽  
Block Number ◽  
Group A ◽  
Group B ◽  
Approach Group

The aim of this study was to compare the postoperative analgesic requirements in dogs receiving a sciatic nerve block by either the lateral or transgluteal approach. The secondary aim was to determine if there was a difference in ease of performing the nerve block. Forty-two client-owned dogs were used in this study. Sciatic nerve block was performed by the transgluteal approach (group A), or the lateral approach (group B) combined with a psoas compartment block. All blocks were performed using a nerve stimulator and 0.1 ml/kg bupivacaine 0.5%, per block. The time taken to perform the sciatic nerve block, number of attempts, the current (mA), and intraoperative and postoperative opioid requirements were recorded. Overall, 52% of dogs required methadone intraoperatively, with no difference between groups (P=0.516). Postoperatively, 24% in group A and 12% in group B required methadone (P=0.314). There was no difference in the time taken to perform the sciatic nerve block, current or the number of attempts between groups. Both approaches to the sciatic nerve block conferred similar levels of analgesia and may be used as part of a multimodal analgesic protocol for dogs undergoing pelvic limb surgery.

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