Dynamic Compression Plate: A useful procedure for sub-trochanteric femur fracture with osteopetrosis.

Introduction: Osteopetrosis is an un common disease. It is of infantile and adult type. With adult type osteopetrosis, bones are vulnerable to fracture even with minimal injury. As there is increased bone density and small medullary canal, therefore, these fractures are challenging for orthopedic surgeons.Objective: To evaluate the results of Dynamic Compression Plate (DCP) for the fixation of sub-trochanteric fractures of femur with osteopetrosis in term of union malunion, non-union and post-operative infection.Methodology: This prospective study was conducted in the department of Orthopedic surgery at Muhammad Medical College Mirpur Khas from March 2015 to February 2017. Patients, with sub-trochanteric fractures of femur having osteopetrosis, between the age of 20-60 years of either gender were included in this study. All fractures were fixed with DCP. Post-operatively patients were mobilized with crutches in 1st week, followed by partial weight bearing in 3rd week and full weight bearing in 6 weeks.Results: Union of fractures occur in 98 %patients. Mal union in one patient and nonunion in one patient. Post-operative infection was observed in one patient.Conclusion: This study shows management of sub trochanteric fractures of femur in patients with osteopetrosis are best treated with DCP with little or no complications.Key words: Osteopetrosis, sub trochanteric fractures, DCP

Management of Idiopathic frozen shoulder.

Introduction: Frozen shoulder is a common condition which is characterized by progressive pain &stiffness of shoulder can last up to 2-3 years. It is challenging condition because the effectiveness of treatment is limited. It can cause difficulties with activities of daily living like washing, cleaning, wearing and combing. Objective: Treatment of idiopathic frozen shoulder with intraarticular corticosteroid injection and exercise. Methodology: Sixty patients with frozen shoulder were treated in outpatient department of orthopedic surgery in Muhammad Medical College Mirpurkhas from Jan 2014 to Dec 2016. All the patients were given intra articular methylprednisolone mixed with 2% xylocaine. Three injections were given at monthly interval followed by exercise. Follow up was done up to Six months. Results: 60 patients were treated with three intra articular injections of corticosteroids at monthly interval followed by exercise. 80% have excellent results i.e. relief from pain and achieved full range of motion.10%have mild pain and 10% have restricted internal rotation of shoulder. Conclusion: Patients with frozen shoulder have excellent results when treated with intra articular corticosteroid injection followed by exercise.   Key words: Frozen shoulder, Adhesive capsulate, intra articular corticosteroid