Injury
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Comparative Study
Augmentation of intramedullary nailing in unstable intertrochanteric fractures using cerclage wire and lag screws: a comparative study.
Unstable intertrochanteric fractures present a challenge to orthopaedic surgeons, with varied geometry of the fractures and a wide choice of implants and techniques. The patients are usually osteoporotic, with multiple co-morbidities and poor tolerance for complications and re-operations. Lateral wall reconstruction and stability of the trochanteric fragments are considered important in providing a better outcome of these difficult injuries. We present a technique of lateral wall and trochanteric reconstruction using Cerclage wires and lag screws in the greater trochanter in addition to intramedullary nailing, and the radiological and functional outcome of this technique of augmentation. ⋯ This new technique of augmentation of fixation of intramedullary nail in unstable trochanteric fractures using cerclage wires and lag screws for lateral wall reconstruction is useful in reducing complications of the procedure and provides good radiological and functional outcome. It requires little additional operating time with minimal blood loss and soft tissue injury.
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Comparative Study
Investigation of perioperative hidden blood loss of unstable intertrochanteric fracture in the elderly treated with different intramedullary fixations.
Our aim was to investigate perioperative hidden blood loss (PHBL) of unstable intertrochanteric fracture (UIF) in the elderly treated with different intramedullary fixations. ⋯ Elderly patients with UIF treated by intramedullary fixations always have a significant amount of PHBL, which is much greater than that observed intra-operatively. Regular perioperative measurements of full blood count are necessary to avoid anaemia. InterTan nail is associated with a significantly higher PHBL than that of TGN and PFNA, which needs to be monitored carefully in usual clinical practice.
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Non-union following interlocking nailing is a troubling complication in treatment of shaft femur fractures. There is no clear consensus on the treatment of this problem. This research was undertaken to study the role of augmentation plating combined with exchange nailing in such cases. ⋯ Augmentation plating combined with exchange nailing in non-unions following intramedullary nailing of femur shaft fractures is a reasonably good and effective procedure with a very high success rate.
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Multicenter Study
Delayed presentation or delayed diagnosis? A retrospective study of prospectively collected data of 482 foot and ankle injuries.
Delayed presentation of injury cases is common in developing countries like India. It is prudent to study reasons for delayed presentations to focus preventive measures towards responsible factors. Since foot and ankle orthopaedics is in its infancy in India, it was deemed to be worthwhile to study reasons for delayed presentations of foot and ankle injuries. ⋯ In developing countries like India, patients did neglect their foot and ankle injuries and presented late. In fact, by way of delayed diagnosis, clinicians were more responsible for indirect delayed presentations of foot and ankle injuries. This is contrary to the common belief that in developing countries like India, only patients would be solely responsible for delayed presentations after injury. Because delayed diagnosis by clinicians seemed more alarming than delayed presentation by patients, focus of prevention of foot and ankle injuries in developing countries should shift more towards educating clinicians than patients.
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Comparative Study
Biomechanical evaluation of the tension band wiring principle. A comparison between two different techniques for transverse patella fracture fixation.
The aim of this study was to investigate the validity of the dynamic compression principle of tension band wiring in two techniques for patella fracture treatment. ⋯ Tension band wiring fulfills from a biomechanical perspective the requirements for sufficient stability of transverse patella fracture fixation. It should, however, rather be considered as a static fixation principle than a dynamic one. Tension band wiring with cannulated screws was found advantageous over Kirschner wires in terms of interfragmentary movements at the posterior fracture site.