Comminuted olecranon fractures: locking compression plate fixation verses conventional plate fixation

Background: A variable consensus exists on the optimal management strategies for olecranon fractures. Though the mechanical properties of the conventional plates and the locking plates used show no difference, pre-contoured locking plates provide a significant advantage over non-locking plates in unstable fractures. The aim of the study was to compare clinical and radiological outcomes in the management of the comminute olecranon fractures by anatomically pre-contoured locking compression plates and the conventional plates.Methods: The present study was a prospective study of 50 patients with comminuted olecranon fracture, with 25 patients each randomized into two groups, those that underwent fixation of the fracture using a pre-contoured locking compression plate (group LCP) and those fixed using a conventional plate (3.5 mm reconstruction plate) (group CP). Patients were followed up to 1 year with functional outcome assessed at each follow-up with Mayo elbow performance score.Results: The mean MEPS (LCP vs CP) at 1.5 (47 vs. 43.4) and 3 (67.4 vs 61.6) months follow up showed a statistically significant difference between the two groups, but the difference was not significant at 6 (86.4 vs 85.6) and 12 (88.4 vs 87) months. The time to union (4.3 months vs 5.0 months) was not significantly different between the groups. There were 11 complications in group LCP and 12 complications in group CP.Conclusions: In the present study, we suggest that the use of a pre-contoured locking compression plate provides better outcomes at earlier periods as compared to the conventional plate; thus, returning the patient to normal function at the earliest

Vitamin C supplementation as adjuvant analgesic therapy in post-operative pain management in patients undergoing surgical decompression in a case of prolapsed intervertebral disc

Background: The management of postoperative pain has been a major challenge for the operating surgeons. Vitamin C has shown analgesic effects in specific clinical conditions, reducing patient suffering and improving the quality of life. The objective of this study was to evaluate the efficacy of vitamin C as an adjuvant in postoperative pain management and its effect on analgesia requirements in patients undergoing spinal decompression surgery.Methods: The present study was a prospective study of 50 patients aged 30-60 years with low back pain due to prolapsed intervertebral disc requiring surgical decompression, conducted in a tertiary care institute from 2018 to 2020. All patients underwent open discectomy. 25 patients each were randomized into two groups, those that were given vitamin c supplementation (group A) and those that weren't (group B). The patients were then followed up 1st, 2nd, 4th, and 6th week and the pain was graded at each follow-up according to the NRS scale. The total amount of diclofenac sodium consumed in the 6 weeks was calculated.Results: The mean NRS (A vs B) at 2 (2.68 vs 3.56) and 4 (0.88 vs 1.48) weeks follow-up showed a statistically significant difference between the two groups, but the difference was not significant at 6 (0.16 vs 0.36) weeks follow up. The difference in the consumption of analgesic (3.56 vs 5.46) at 6 weeks was statistically significant.Conclusions: In this clinical outcome-based study, we suggest that for postoperative pain management, vitamin C acts as an efficacious adjuvant with a dose-sparing effect on the consumption of analgesics