Compare the Functional Outcomes of Closed Reduction and Percutaneous Cross Pinning versus Lateral Pinning in Supracondylar Fracture of Humerus in Children

2021 ◽  
Vol 15 (8) ◽  
pp. 2154-2156
Author(s):  
Abid Ali Khan ◽  
Mohammad Younas ◽  
Assad Mehmood ◽  
Bissma Laraib
Keyword(s):  
Traffic Accidents ◽  
Functional Results ◽  
Supracondylar Fracture ◽  
Supracondylar Fractures ◽  
Group I ◽  
Supracondylar Humerus Fractures ◽  
Group Ii ◽  
Mean Time ◽  
Methods Of Treatment ◽  
Radiation Time

Objective: To determine results of treating supracondylar fracture of the humerus in children using percutaneous cross pinning versus two lateral pinning. Study Design: Prospective study Place and Duration of Study: Department of Orthopaedics, King Abdullah Teaching Hospital Mansehra from 1st November 2020 to 30th April 2021 Methodology: Eighty four patients of both genders were enrolled. Baseline demographic details of patient’s age, sex and body mass index were recorded after taking consent. Patients aged between 2-14years were included. Children with supracondylar humerus fractures were enrolled and divided equally into 2-groups. Group I had 42 patients and received percutaneous cross pinning technique and group II had 42 patients underwent lateral pinning. Radiological and functional results were assessed by Flynn’s criteria among both groups and frequency of complications was also observed. Results: There were 50 (59.5%) males (25 in each group) and 34 (40.5%) were females (17 in each group. Mean age of the patients in group I was 5.14±9.88 years and in group II mean age was 6.14±8.35 years. Sports 60 (71.43%) was the most common cause of fracture followed by traffic accidents 17 (20.24%) and the rest were 7 (8.3%) fall from the height. Mean surgical time in group I was 30.42±6.09 minutes while in group II mean time was 34.24±2.16 minutes. Mean radiation time in group I was 3.98±9.44 sec and in group II radiation time was 2.11±1.1sec. According Flynn’s criteria excellent results in group I were found in 25 (59.5%) cases, good results in 12 (28.6%) and fair results found in 5 (11.9%) while in group II excellent results were found in23 (54.8%), good results in 15 (35.7%) and fair results in 4 (9.5%). Significantly no difference in outcomes was observed among both groups. Conclusion: Both methods of treatment of supracondylar fractures of humerus are safe and successful however less operative and high time of radiation in cross percutaneous pinning compared to two lateral pinning has been found. Keywords: Percutaneous cross pinning, Two lateral pinning, Supracondylar humerus fracture

Supracondylar Fracture of Humerus in Children Treated with Closed Reduction and Percutaneous Cross Pinning VS Lateral Pinning

2021 ◽  
Vol 15 (5) ◽  
pp. 1190-1192
Author(s):  
M. S. Zardad ◽  
S. A. Shah ◽  
M. Younas ◽  
M. Ullah ◽  
I. Muhammad ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Traffic Accidents ◽  
Functional Results ◽  
Supracondylar Fracture ◽  
Medical College ◽  
Group I ◽  
Supracondylar Humerus Fractures ◽  
Group Ii ◽  
Mean Time ◽  
Radiation Time

Objective: The aim of this study is to determine the outcomes between percutaneous cross pinning vs two lateral pinning in treatment of closed reduction supracondylar fracture of humerus in children. Study Design: Prospective study Place and Duration: Study was conducted in Orthopaedic Unit Ayub Medical Teaching Institute Abbottabad and DHQ Teaching Hospital Gomal Medical College Dera Ismail Khan during from October 2019 to May 2020 (09 months duration). Methods: Total 60 patients of both genders were presented in this study. Baseline demographically details of patients age, sex and body mass index were recorded after taking consent. Patients were aged between 2-14 years were included. Children who had supracondylar humerus fractures were enrolled and divided equally into 2-groups. Group I had 30 patients and received percutaneous cross pinning technique and group II had 35 patients underwent for lateral pinning. Radiological and functional results were assessed by Flynn’s criteria among both groups, frequency of complications was also observed. Complete date was analyzed by SPSS 22.0 version. Results: Total 36 (60%) were males (18 in each group) and 24 (40%) were females (12 in each group. Mean age of the patients in group I was 6.14±3.12 years and in group II mean age was 5.66±5.28 years. Sports 45 (75%) was the most common cause of fracture followed by traffic accidents 10 (16.67%) and the rest were 5 (8.33%) fall from the height. Mean surgical time in group I was 31.24±2.16 minutes while in group II mean time was 33.42±1.61 minutes. Mean radiation time in group I was 2.01±1.1 sec and in group II radiation time was 1.34±1.1 sec. According flynn’s criteria excellent results were found in 20 (66.7%) cases, good results in 8 (26.7%) and fair results found in 2 (6.7%) while in group II excellent results were found in 19 (63.33%), good results in 9 (30%) and fair results in 2 (6.7%). Significantly no any difference in outcomes was observed among both groups. Conclusion: We concluded in this study that the both techniques are safe and effective for the treatment of closed reduction supracondylar fracture of humerus in children but less operative and high radiation time was observed in percutaneous cross pinning as compared to two lateral pinning. Keywords: Percutaneous cross pinning, Two lateral pinning, Supracondylar humerus fracture, Children

scholarly journals Outcomes of Pediatric Supracondylar Fractures of Humerus Treated by Posterior Triceps Splitting Approach

2016 ◽  
Vol 4 (1) ◽  
pp. 28
Author(s):  
Rajeev Dwivedi ◽  
Ruban Raj Joshi ◽  
Subin Byanjankar ◽  
Rahul Shrestha
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Standard Treatment ◽  
Functional Results ◽  
Supracondylar Fracture ◽  
Supracondylar Fractures ◽  
Radiological Criteria ◽  
Supracondylar Humeral Fractures ◽  
The Mean ◽  
Mean Time

Introduction: Close reductions and percutaneous pinning is the gold standard treatment for supracondylar fracture  of humerus. Open reduction and internal fixation is indicated in patients with unacceptable closed reduction, neurovascular compromise, and open fractures. Open reduction can be performed through various approaches. Every approach has their advantages and limitations. The aim of this study was  to assess the functional outcome of pediatric supracondylar fracture of humerus treated by posterior triceps splitting approach.   Methods: This was a prospective evaluation of 20 consecutive patients with displaced pediatric supracondylar humeral fractures operated by triceps spitting posterior approach in our institution for two years. At initial presentation, 19 cases were Gartland III  and one was flexion variant of injury. Complications such as reduction loss, pin migration, infection, osteonecrosis of any part of the elbow, bone healing, and functional results were evaluated. Flynn criteria were used to evaluate the final results.   Results: Twenty patients underwent open reduction and internal fixation by triceps splitting approach. Thirteen patients were male and seven were female with M:F ratio of 1.86:1. The mean age was 6.8 yr (SD=2.74, range 2-14). All the fractures united by six weeks; mean time for union was 4.5 wk (SD=0.94). All patients were assessed at six months using Flynn clinical and radiological criteria. Results were satisfactory in all patients.   Conclusion: Posterior triceps splitting approach is simple, safe and has good functional and radiological outcome. We recommend this approach  for open reduction and internal fixation in pediatric supracondylar fracture.

Comparison of Outcome of Lateral Pinning Versus Medial and Lateral Cross Pinning in Childhood Supracondylar Fractures of Humerus

2021 ◽  
Vol 15 (9) ◽  
pp. 2873-2875
Author(s):  
Mudassar Nazzar ◽  
Muhammad Adeel-Ur- Rehman ◽  
Rizwan Anwar ◽  
Omer Farooq Tanveer ◽  
Muhammad Abdul Hanan ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Functional Outcomes ◽  
P Value ◽  
Supracondylar Fractures ◽  
Group I ◽  
Pin Fixation ◽  
Group Ii ◽  
Carrying Angle ◽  
Ulnar Nerve Injury

Objectives: To compare the complications and outcomes of lateral entry pin fixation with medial and lateral pin fixation for Gartland type III supracondylar fractures of humerus. Methodology: This prospective comparative study involving 190 patients of Gartland type III close supracondylar fractures were included. from March-2019 to Dec-2020. In all patients, initially the elbow was mobilized using the splint placed above the elbow joint at 30 to 45 degrees’ flexion. After closed reduction, lateral pinning was applied in group I and in group II lateral and medial cross pinning was applied using the standard protocol. Patients were followed for iatrogenic ulnar nerve injury, radiologic and function outcomes in-terms of loss of reduction, elbow range of motion, loss in carrying angle and functional outcomes. Results: The two groups were comparable for loss of elbow range of motion, loss of carrying angle and loss of Bauman's angle. On clinical examination, immediate post-operative ulnar nerve injury was diagnosed in 4 (4.2%) cases in group II and in no patient in group I (p-value 0.12). Satisfactory functional outcomes were achieved in 85 (89.5%) patients in group I and in 88 (92.6%) patients in group II (p-value 0.44). Conclusion: Lateral pinning provided stable fixation clinically and radiologically as compared to lateral and medial cross pinning. Keywords: Supracondylar fracture of Humerus, Iatrogenic ulnar nerve injury, Lateral pin entry, lateral and medial cross pin entry.

Comparison of the Effects of Low Dose Methylprednisolone and Metoclopramide on Nausea and Vomiting and Respiratory Complications after Adenotonsillectomy

2021 ◽  
Vol 15 (9) ◽  
pp. 2753-2756
Author(s):  
Shahid Adalat Chaudhry ◽  
Madiha Zafar ◽  
Usman Zeeshan ◽  
Mubashar Iqbal ◽  
Arooj Fatima ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Score ◽  
Low Dose ◽  
Operative Time ◽  
Oral Intake ◽  
Respiratory Complications ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Mean Time

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake

scholarly journals Comparative Analysis of the Intrastromal MyoRing Implantation performed with the Femtosecond Laser

2017 ◽  
Vol 6 (2) ◽  
pp. 49-57
Author(s):  
Maksim V Sinitsyn ◽  
Nadezhda A Pozdeyeva ◽  
Nikolai P Pashtayev
Keyword(s):  
Comparative Analysis ◽  
Femtosecond Laser ◽  
Corneal Thickness ◽  
Functional Results ◽  
Standard Group ◽  
Pronounced Increase ◽  
Group I ◽  
Biomechanical Parameters ◽  
Group Ii

ABSTRACT Purpose To comparatively analyze the intrastromal MyoRing implantation with femtosecond laser (FL) using the standard and optimized technologies in the experiment and based on the long-term clinical-functional results of the patients with keratoconus (KC) at stages II and III. Materials and methods The experimental work was performed on 24 eyes of rabbits. All eyes were divided into six groups according to the method of operation. In the clinical part of the research, the surgical treatment of 70 patients (76 eyes) with KC at stages II and III was done. Depending on the technology of the operation, all patients were divided into two groups. Group I consisted of 29 patients (32 eyes) with KC, in which MyoRing implantation was performed according to the standard, group II consisted of 31 patients (32 eyes) with KC, in which MyoRing implantation was performed according to the optimized technology. Results Higher voltage was required for stretching samples of the second group in comparison with the third and the sixth group in comparison with the fifth group. In group I, during the period of 6 to 36 months the surgery reverses keratometry, corneal thickness above the MyoRing, and posterior corneal elevation. In group II, 12 months after surgery the clinical and functional parameters remained stable throughout the period of observation. Conclusion Greater reduction in corneal biomechanical stability was observed after formation of the intrastromal pocket in comparison with an intrastromal tunnel; a more pronounced increase in the strength characteristics of the cornea was observed after implantation of the ring in intrastromal pocket, compared with implantation intracorneal segments in intrastromal tunnel, and with increasing depth of intrastromal ring implantation. Application of optimized MyoRing implantation technology compared with standard allows more biomechanical parameters of the cornea to improve and reduce the risk of the ring protrusion. How to cite this article Sinitsyn MV, Pozdeyeva NA, Pashtayev NP. Comparative Analysis of the Intrastromal MyoRing Implantation performed with the Femtosecond Laser. Int J Kerat Ect Cor Dis 2017;6(2):49-57.

Apexification of Anterior Teeth

2012 ◽  
Vol 36 (3) ◽  
pp. 263-268 ◽  
Author(s):  
S Damle ◽  
H Bhattal ◽  
A Loomba
Keyword(s):  
Calcium Hydroxide ◽  
Treatment Time ◽  
P Value ◽  
Hydroxide Group ◽  
Anterior Teeth ◽  
Group I ◽  
Barrier Formation ◽  
Effective Option ◽  
Group Ii ◽  
Mean Time

Purpose: This study was undertaken to compare the clinical and radiographic effectiveness of Mineral Tri-oxide Aggregate (MTA) and Calcium Hydroxide in apexification of traumatized young permanent incisors. Methods: Thirty permanent incisors with necrotic pulps and open apices were evenly divided into two groups –Group I (MTA group) & Group II (Calcium Hydroxide group) and treated by apexification. The time taken for apical barrier formation was analyzed. In MTA group, obturation using gutta-percha points was done after 24 hours, whereas in Calcium Hydroxide group obturation was carried out after radiographic confirmation of an apical barrier. Follow up evaluation (clinical and radiographic) was carried out at- 3, 6, 9 and 12 months. Results: The mean time taken for barrier in Group I was 4.50 ± 1.56 months whereas for Group II was 7.93 ± 2.53 months (p value- 0.0002). Radiographic evidence of mean time taken for completion of lamina dura in Group I was 4.07 ± 1.49 months whereas the time period for Group II was 6.43 ± 2.59 months (p value- 0.0067). Conclusion: MTA demonstrated good success and an effective option for apexification with the advantage of reduced treatment time, good sealing ability, biocompatible and provides barrier for immediate obturation.

scholarly journals Comprehensive Treatment of Patients with Constricted Hernias and Metabolic Syndrome Signs

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
I. V. Melnyk
Keyword(s):  
Metabolic Syndrome ◽  
Postoperative Period ◽  
Abdominal Hernia ◽  
Wound Complications ◽  
Comprehensive Treatment ◽  
Clinical Group ◽  
Hernia Defect ◽  
Group I ◽  
Group Ii ◽  
Methods Of Treatment

57 patients with constricted abdominal hernia and diagnosed metabolic syndrome were examined. They were performed the urgent hernia defect plastics with polypropylene mesh Linteks-Esfil (St. Petersburg). Patients were divided into two clinical groups: clinical group I (20) included patients in the postoperative period treated with conventional comprehensive conservative treatment. Clinical group II (37) consisted of patients treated with 2.5% solution of 2 ml tiotriazolini in muscle and metformin in a dose of 500 mg / day for metabolic syndrome correction in addition to above mentioned conventional treatment. Lipid metabolism indices improved on the 7th day in 59.2% of patients in clinical group II and only in 15% of patients in clinical group I.Postoperative wound complications such as seromas and infiltrations developed in 6.3% of patients and were eliminated by conservative methods of treatment. Patients of group II tolerated postoperative period better. Average duration of hospital stay decreased by 2.03±0.2 bed days. Thus, the treatment of patients with constricted hernia of anterior abdominal wall and metabolic syndrome should be in complex with hernia defect plastics by propylene mesh and medicamentous correction of metabolism disorders.  

scholarly journals Hook plate with or without coracoclavicular ligament augmentation in the treatment of acute acromioclavicular separation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Chung-Ting Liu ◽  
Ten-Fang Yang
Keyword(s):  
Plate Fixation ◽  
Functional Results ◽  
Hook Plate ◽  
Group I ◽  
Ligament Augmentation ◽  
Significant Difference ◽  
Before And After ◽  
Acromioclavicular Separation ◽  
Group Ii ◽  
Type V

Abstract Background Acromioclavicular (AC) separation can be treated with the use of a hook plate. Some studies have reported that coracoclavicular (CC) ligament augmentation is necessary to reduce the complications of hook plate fixation, whereas others recommend hook plate fixation alone without augmentation. The aim of this study was to compare the results and complications between these two groups. Methods This was an observational case-control study. Patients with acute (less than 2 weeks) Rockwood type V AC separation were treated with a hook plate at our hospital. A total of 105 cases received hook plate fixation with CC ligament augmentation (group I), and 112 cases received hook plate fixation without augmentation (group II). Constant-Murley scores were used to evaluate the function before and after implant removal, and radiographs were taken to evaluate the complications. The results and complications were compared between groups. Results Before removal, the Constant-Murley score was significantly higher in group I (mean, 50.1) than in group II (mean, 42.6) (p = 0.004); however, there was no significant difference between groups at 3 and 6 months after removal. The incidence of significant acromion osteolysis was higher in group II (65/112) than in group I (25/105). Before removal, the patients with significant acromion osteolysis had worse Constant-Murley scores than those of the patients without osteolysis in both groups. The incidence of peri-implant fracture of the hook plate was higher in group II (8/112) than in group I (1/105). Conclusion The patients without CC ligament augmentation had worse functional results before hook plate removal, a higher incidence of radiographic acromion osteolysis, and a higher incidence of peri-implant fractures than those patients with CC ligament augmentation. Therefore, CC ligament augmentation is highly recommended to improve short-term outcomes and decrease complications for Rockwood type V AC separation treated by hook plate.

scholarly journals Surgical management of 2- or 3-part proximal humeral fractures: comparison of plate, nail and K-wires

2020 ◽  
Author(s):  
N. Setaro ◽  
M. Rotini ◽  
P. Luciani ◽  
G. Facco ◽  
A. Gigante
Keyword(s):  
Intramedullary Nailing ◽  
Revision Surgery ◽  
Short Form ◽  
Functional Results ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plates ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Abstract Background Proximal humeral fractures (PHFs) are fairly common injuries, and their treatment is a challenge. The aim of this study is to compare clinical and functional outcomes of different osteosynthesis techniques. Materials and methods We retrospectively reviewed patients’ files and the hospital’s digital database between March 2002 and April 2018. We treated surgically 148 patients with 2- and 3-part PHFs: 64 with plate and screws, 53 with intramedullary nailing and 31 with retrograde K-wires. We constituted three groups according to the type of treatment and two subgroups for each according to the number of fragments (Neer II or Neer III). Disabilities of the Arm, Shoulder and Hand (DASH) and Short Form-12 (SF-12) scores were recorded. Results Mean DASH and SF-12 scores both from the group treated with plate (Group I) and the one subjected to intramedullary nailing (Group II) were statistically superior to results from the patients treated by retrograde K-wires (Group III), while nails showed better functional results than the locking plates. In the first two groups, no difference was found between Neer II and III subgroups, while in Group III the DASH scores were significantly better in Neer II subgroup than those in Neer III subgroup. Avascular necrosis was the most frequent cause of revision surgery in Group I (4 cases) where we had 8 cases of reintervention (12.5%). In Group II, the subacromial impingement was the only cause for revision surgery with 3 cases (5.6%). Conclusions Intramedullary nails showed better functional results and a lower complication rate than the locking plates. Both techniques showed superior results compared to those available with retrograde K-wires. So the nail seems to be a more reliable and adequate method for treating 2- and 3-part proximal humeral fractures.

Effects of cloprostenol and flurogestone acetate sponge on embryo yields and quality in indigenous ewes in Bangladesh

2014 ◽  
Vol 54 (10) ◽  
pp. 1605 ◽  
Author(s):  
B. F. Zohara ◽  
Azizunnesa ◽  
M. F. Islam ◽  
M. G. S. Alam ◽  
F. Y. Bari
Keyword(s):  
Recovery Rate ◽  
Group Iv ◽  
Corpora Lutea ◽  
Group Iii ◽  
Embryo Recovery ◽  
Fertilisation Rate ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Mean Time

The effects of two doses of cloprostenol and two doses of flurogestone acetate sponge on the onset of oestrus, and embryo recovery and quality were evaluated. Thirty-two indigenous ewes (Wera breed) were allocated into four groups of eight. All ewes were synchronised with 100 µg (Group I) or 175 µg (Group II) cloprostenol injection, 9 days apart, or insertion of intravaginal sponges containing 30 mg (Group III) or 45 mg (Group IV) flurogestone acetate (FGA) for 12 days. The ewes were superovulated with 600 IU PMSG intramuscularly 10 days after the second cloprostenol injection or immediately after sponge removal on Day 12. After the detection of oestrus, the ewes were mated naturally at 6 and 12 h, and some ewes were inseminated laparoscopically. Embryos were recovered surgically 5 or 6 days after service. All ewes exhibited oestrus. The onset of oestrus occurred significantly (P < 0.05) earlier in FGA-treated (50.0 ± 1.5 and 48.0 ± 0.00 h) than in cloprostenol-treated groups. There were no significant differences (P > 0.05) in the mean time of onset of oestrus (50.0 ± 1.5 and 48.0 ± 0.00 h) between the two doses of cloprostenol. The mean number of corpora lutea (8.1 ± 1.26) and embryos recovered (6.1 ± 1.00) was significantly (P < 0.05) higher in ewes treated with 45 mg FGA than in ewes treated with cloprostenol. Embryo recovery rate was significantly (P < 0.05) higher in ewes treated with 45 mg FGA (75.4%) than in other groups (41.7% and 51.6% in 100 μg and 175 μg cloprostenol- and 52.7% in 30 mg FGA-treated groups, respectively). Fertilisation rate was 93.3% in ewes given 100 µg cloprostenol, whereas other groups showed 100% fertilisation rate. The highest percentage (100%) of Grade 1 embryos was in FGA groups. In conclusion, despite FGA protocol presenting superior results, cloprostenol protocol was equally efficient in synchronising oestrus. The embryo recovery rate was better after 45 mg FGA than 30 mg FGA or after either dose of cloprostenol.

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