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Bhalerao, Bhalchandra Prabhakar
- Functional Outcome of Distal End Radius Fracture Treated by Ligamentotaxis by External Fixator with or without K Wire Augmentation
Abstract Views :190 |
PDF Views:110
Authors
Brijbhushan S. Mahajan
1,
Vishal Patil
1,
Yogesh Rathod
1,
Ameya Kulkarni
1,
Nimesh Nebhani
1,
Bhalchandra Prabhakar Bhalerao
1
Affiliations
1 Department of Orthopaedics, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik – 422003, Maharashtra, IN
1 Department of Orthopaedics, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 5, No 2 (2018), Pagination: 178-184Abstract
Background: One of the most common injuries encountered in orthopedic practice are Distal Radius fractures. This comprises of 8%−15% of all fractures in adults1. The reason for comminuted DER fractures is high-energy trauma in young and low-energytrauma in elderly. They present as shear and impacted fractures involving the articular surface of the distal radius with displacement of the fragments2-7. External fixation for distal radius fracture relies on the principle of Ligamentotaxisin which, a distraction force applied to the carpus aligns the fragments by means of intact ligaments. The length and alignment of fracture fragment is guided by pull and counter pull which are otherwise difficult to control8. Objective: To study functional outcome of distal end radius fracture treated by ligamentotaxis with evaluation of functional results according to Disabilities of the Arm, Shoulder and Hand (DASH) score system. Material and Methods: We included 30 patients (Male 24 and Female 6) treated for distal end radius fracture during a period from 2015 to 2017. Patients were evaluated clinically by subjective assessment using DASH Scoring system. Result: After functional evaluation of patients according to the scheduled follow up with mean DASH Score of 76.08 at 1st month, 62.92 at 3rd month and 42.60 at 6th month, and was found to be Highly Significant (p<0.001) among all the compared groups. Conclusion: We concluded that external fixation and ligamentotaxis applied to complex distal radius fractures, when added with augmented K-wire fixation can provide direct augmentation of fracture stability and a good wrist function.Keywords
Disabilities of the Arm, Shoulder and Hand (DASH) Score, Ligamentotaxis, Radius Fracture.References
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- Mehta JA, Bain GI, Heptinstall RJ. Anatomical reduction of intra-articular fractures of the distal radius: An arthroscopically-assisted approach, J Bone Joint Surg Br. 2000 Jan; 82(1):79-86. https://doi.org/10.1302/0301-620X.82B1.10101, https://doi.org/10.1302/0301-620X.82B1.0820079. PMid: 10697319.
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- Functional Outcome of Burk Schaffer’s Approach for PCL Tibial Avulsion Fracture Fixed with Cancellous Screw
Abstract Views :325 |
PDF Views:107
Authors
Satyen Joshi
1,
Nikhil Challawar
2,
Nitish Agrawal
3,
Bhalchandra Prabhakar Bhalerao
3,
Ameya Kulkarni
3,
Yogesh Rathod
3
Affiliations
1 Associate Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
3 P.G. Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
1 Associate Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
3 P.G. Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 6, No 2 (2019), Pagination: 183-188Abstract
Background: Posterior Cruciate Ligament (PCL) is the main posterior stabilizer of the knee. Injuries of the PCL are rare. Isolated PCL disruption most commonly occurs as avulsion at its tibial insertion as compared with its femoral origin or as a mid-substance tear. In PCL bony avulsion, fixation of the avulsed fragment with cancellous screw is a recommended procedure. Objective: To evaluate efficacy of Burk Schaffer’s approach in treatment of PCL tibial avulsion fracture with cancellous screw and evaluation of functional results according to Tegner Lysholm score. Material and Methods: We included 30 patients (Male 26 and Female 4) operated for isolated PCL avulsion from tibia during the period from 2015 to 2017. Patients were evaluated clinically by posterior drawer test, radiologically by X-ray and using functional scale of Tegner-Lysholm. MRI was advised for suspected other ligaments and meniscal injuries. All cases were operated with 4mm cannulated screw fixation by Burk and Schaffer approach. Results: Mean Tegner Lysholm score of 30 patients was 95.37 after 6 months of surgery, which was excellent. After 3 months 75% has grade 0 posterior drawer test, 12.5% has grade 1 and 12.5% has grade 2 laxity. Conclusion: Approach by Burk and Schaffer is safer and easier than the classical one. Open reduction and fixation with cannulated screw for tibial avulsion of PCL gives good functional outcome.Keywords
Burk and Schaffer’s Approach, Posterior Cruciate Ligament (PCL) Avulsion Fractures, Tegner Lysholm Score.References
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- Functional Outcome of Arthroscopic Reconstruction of Single Bundle Anterior Cruciate Ligament with 5 Strand Hamstring Autograft
Abstract Views :208 |
PDF Views:83
Authors
Nitin Wagh
1,
Brijbhushan Mahajan
2,
Bhalchandra Prabhakar Bhalerao
3,
Nitish Agrawal
3,
Nimesh Nebhani
3,
Yogesh Rathod
3
Affiliations
1 Associate Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
3 Former PG Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
1 Associate Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
3 Former PG Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 7, No 1 (2020), Pagination: 78-85Abstract
Background: Most commonly reconstructed ligament of knee is Anterior Cruciate Ligament that aims to halt or minimise the number of instability episodes 1. Testing with biomechanical parameters has shown that there is correlation between graft cross-sectional area and maximum load to failure 2. This study attempts to analyse the functional outcome of ACL reconstruction with 5 strands of hamstring autograft. Aims and Objectives: This study is based on hypothesis that larger graft will be stronger, stiffer providing better functional outcome. Materials & Methods: 35 Patients having ACL injury were treated at a tertiary care hospital; using a 5-strand hamstring graft, fixed with suspensory fixation at femoral side and aperture fixation at the tibial side. Cases were diagnosed with ACL on clinical examination & MRI. Tegner-lyshom score and International Knee Documentation Committee - Orthopaedic Scores (IKDC) is used post-operatively to grade the functional outcome of an ACL reconstruction. Results: Male predominance was observed in study subjects than female with left side slightly more commonly involved than right. Laterality didn’t influenced outcome. Graft diameter observed is 9mm in 68.6%, 8 mm and 10 mm was observed in 11.4% and 20% respectively. Lysholm score at baseline was 41.63 which increased progressively to 93.45 at the end of 9 months. The IKDC score at baseline was 32.5 which increased progressively to 83.45 at the end of 12 months. Superficial infections was seen in 8.6% while complaint of knee pain was given by 2.9% cases. Lachman test was positive in 2 (5.7%) cases. Conclusion: Five-strand graft offers very high strength and more length than the 4ST. It is useful in patients with ligamentous laxity, small tendons, or other stability risk factors.Keywords
ACL, Autograft, Graft Diameter, 5 StrandReferences
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