The role of open reduction and internal fixation in the treatment of the intercondylar fractures of humerus

Background: Inter-condylar fractures represent one of the most complicated and challenging fractures in the upper extremity. The results of managing these fractures non-operatively are limited by failure to get anatomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudo-arthrosis. The objective of this study was to evaluate and analyse the role of open reduction and internal fixation in inter-condylar fractures of distal humerus.Methods: The present study was done in Malla Reddy Institute of Medical Sciences between June 2014 and June 2017. Out of 34 cases of intercondylar fractures of humerus admitted during the period, 25 patients were selected for the study that satisfied our inclusion criteria. Three patients out of those selected could not be included in the study as one had cardiac issues pre-operatively, one refused surgery and one was lost to follow up.Results: Our study included 22 patients, 14 male and 8 female patients. Their average age was 41.4 years. The fractures were classified as per the AO classification. There were B1-3, B2-1, C1-6, C2-5, C3-7 fractures. Both compound and closed fractures were included. All the patients were operated by posterior olecranon Chevron osteotomy approach by a senior faculty member. Twenty two patients who satisfied our inclusion criteria were treated, followed up and the results analyzed using Cassabaum’s scale of elbow function we had 86% of excellent to good results. Our results are comparable with other similar studies.Conclusions: Posterior olecranon approach was found to be of most satisfactory approach by us. It allows good exposure of the joint and the ulnar nerve

Cemented hemi arthroplasty for unstable intertrochanteric fractures in elderly

Background: The incidence of the intertrochanteric fractures is increasing in recent times. It is found that more and more of these fractures are seen in elderly. The treatment of these fractures was historically non surgical. The use of dynamic hip screw and angled blade plate in the surgical management of these fractures is a recent practice. The objective of the study was to analyse the role of cemented hemi-arthroplasty in the treatment of unstable inter trochanteric fractures in elderly.Methods: This study was conducted between June 2014 to June 2016. Results were analysed prospectively. From a total 94 inter trochanteric fractures admitted during this period 20 patients were chosen who fulfilled our inclusion criteria. All the patients were treated in Malla Reddy Institute of Medical Sciences. Primary cemented hemiarthroplasty was done in the entire patient by a senior faculty member. The results were assessed according to Harris hip score.Results: There were 13 females and 7 males in our study. The average age was 69.2 years. There was Evan’s type 1-c 11, 1-d 7 and 1-e 2 in numbers all the patients were followed up for a period of 18 months.Conclusions: In our short study, it is concluded that the primary cemented hemi arthroplasty is a good option in unstable inter trochanteric fractures in elderly