Functional outcome of intertrochanteric fractures in elderly patients with proximal femoral nail: retrospective study

Background: Intertrochanteric fractures are disabling injuries in elderly population and they are the most frequently operated fracture type which has the highest postoperative fatality rate of all surgically treated fractures. The objective of the study was to evaluate the functional outcomes of intertrochanteric fractures treated with proximal femoral nail (PFN) in elderly patients.Methods: A retrospective study of 24 patients, all above 60 years treated with PFN between March 2016 to April 2018. Data collected include age, sex, mechanism of injury, type of fracture pattern according to Boyd and Griffin’s classification. Patients were followed up at intervals of 6, 12, 18 and 24 weeks and final results were evaluated using Kyle’s criteria at the end of 24th week. All patients had a minimum follow up of one year.Results: The study included 24 patients, 10 males, 14 females with mean age of 75.77 years (range: 60-82 years). The fracture union rate was 96% and average union time was 14.2 weeks. Our results were excellent (80%), good (8%), fair (8%) and poor (4%). Our complications include thigh pain (20%) shortening (20%), varus displacement (8%), knee and hip stiffness (8%), z effect (4%) and non-union (4%).Conclusions: PFN is a reliable fixation in intertrochanteric fractures only after good intraoperative reduction leading to high rate of bone union and with reduced rate of implant failure or complications

Open reduction and internal fixation of volar Barton’s fractures by polyaxial locking plates: a retrospective study

Background: A Barton’s fracture is a compression injury with a marginal shearing fracture of the distal radius. Conservative management of these fractures are highly unsuccessful with multiple complications. Locked plate and screw systems acts as single unit for fracture fixation, allows early mobilisation with good functional recovery.The objective of the study is to evaluate the functional and radiological outcome of volar Barton’s fractures treated with polyaxial locking plates.Methods: Thirty six patients with volar Barton’s fractures, who underwent surgical treatment with polyaxial locking plate between June 2014 to June 2018, with a minimum one year of follow up. The fractures were classified according to Mehara’s classification and the outcome was evaluated using Pattee and Thompson criteria for outcome of wrist.Results: We achieved 100 % union in all patients. Our results were excellent (61%), good (28%) and fair (11%). Our complications include superficial infection, finger stiffness, radiocarpal arthritis, extensor tendon rupture and Sudeck’s osteodystrophy.Conclusions: Polyaxial locking plates restore articular congruity of the volar Barton’s fracturess and give best possible results with least complication rates, provided the technique is carefully performed

Cross pinning versus lateral pinning in type III supracondylar fracture: a retrospective analysis

Background: The commonly accepted treatment of type III supracondylar fractures of humerus in children is closed reduction percutaneous pinning (CRPP). There is a long debate over stability and complications associated with cross and lateral pinning. The present study compares the functional outcome and complications of both pinning techniques.Methods: A retrospective analysis of results with regard to ulnar nerve injury, carrying angle and range of movements was made in 27 children with lateral pinning and 28 children with crossed pinning was done in our institution. Functional outcome was graded according to Flynn’s criteria and loss of reduction by Skagg’s criteria.Results: There was no statistically significant difference with regard to functional outcome and loss of reduction between the two groups. Iatrogenic ulnar nerve injury (IUNI) occurred in three cases (11%) after crossed pinning in which two had significant palsy, which recovered by three months and the other had only  transient paraesthesia.Conclusions: Lateral pinning technique is reliably safe method in terms of stability as it avoids IUNI, we recommend it

Proximal femur locking compression plate in complex proximal femoral fractures: a retrospective analysis

Background: Proximal femoral fractures are one of the most common fractures in old age patients. Fixation of these fractures is technically high demanding owing to the high risk of complications. The aim of our study is to analyze the outcomes of proximal femoral locking compression plate (PF-LCP) in these fractures.Methods: We retrospectively analyzed 18 proximal femoral fractures treated with PF-LCP from May 2012 to May 2015. There were 12 females (67%) and six males (33%) with an average age of 59.6 years (range, 32 to 84 years). The peritrochanteric fractures constituted by intertrochanteric and subtrochanteric fractures were classified by Boyd and Griffin classification along with Seinshemier’s classification, respectively. Among that, 14 cases (77%) were of intertrochanteric and four cases (23%) were of subtrochanteric fracture pattern. The functional outcome was evaluated by harris hip score and the parker palmer mobility score one year after surgery.Results: Among 18 patients, 16 patients obtained fracture union without further intervention; two patients required additional bone grafting. There were no cases of hip screw cutting the femoral head. There was no post-operative mortality in our study. The average harris hip score was 85.5 (83-94). The assessment by parker and palmar mobility score was 7.6 (range 4-9).Conclusions: The PF-LCP is a good stable alternative in the treatment of complex proximal femoral fractures. It provides good to excellent bone healing with limited complications

Locking compression plate in humeral shaft nonunion: a retrospective study of 18 cases

Background: Humeral shaft nonunions are frequently seen in Orthopaedic practice. Osteosynthesis with bone grafting is the treatment of choice. Locking compression plate (LCP) is the latest implant used in treating them. We retrospectively evaluated the outcome of use of LCP in humeral shaft non-union resulted by both conservative management and following failed internal fixations.Methods: Eighteen patients with nonunion of humeral shaft in which ten were treated by traditional bone setters and eight followed by failed internal fixation were included in these study. The mean duration of nonunion was 18.3 months (range 8-22).  The mean follow up period was 18 months (range 12-26). The mean age of patients was 44.4 years (range 22-60). All patients underwent osteosynthesis with LCP and autologoous cortico-cancellous iliac crest graft. The outcome measures include radiographic assessment of fracture union and preoperative and postoperative function using modified constant and murley scoring system.Results: All fractures united following osteosyntesis average time for union was15 weeks (range 10-24). We did not have any delayed union or non-union. The complications were superficial infection (n=1) and wound haematoma (n=1).Three patients with preoperative radial nerve palsy recovered at the end of four months. Functional evaluation using constant-murley score showed excellent result in 14, good in 3 and fair in 1. We did not have any poor results.Conclusions: LCP with cancellous bone grafting is a safe reliable option for all forms of humeral shaft nonunion. We recommend it

A retrospective study of ilizarov fixation in infected non-union tibia: 36 cases

Background: Infected non-union of tibia is most frequently met due to high energy trauma and it poses significant challenge to the treating orthopaedic surgeon. The aim of the study is to evaluate the clinical and functional results in treating infected non-union of tibia by Ilizarov method.Methods: 36 patients with infected non-union of tibia with bone loss; shortening and deformity treated were retrospectively analyzed in the institution during the period of May 2010 to May 2015 were included in the study. The results were evaluated according to association for the study and application of the methods of Ilizarov (ASAMI) criteria. The Pin tract infections were assessed by Moore and Dahl Grading.Results: The bony results were excellent in 65% patients, good in 20%, fair in 15%, and poor in nil. The functional results were excellent in 50% patients, good in 25%, fair in 15%, and poor in 10%. The most common recorded complication was pin tract infection.Conclusions: Ilizarov ring fixator still remains an excellent treatment modality for tibial non-union as it addresses to the problems associated with it

Enantiomerically pure N-aryl-β-amino alcohols by enzymatic resolution

N-Aryl-β-amino acetates, obtained by opening epoxides with aromatic amines followed by acetylation of the hydroxyl group, were resolved using crude pig liver esterase (PLE) enzyme in DMSO in high enantiomeric excess

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Not AvailableAnalysis of stress-associated miRNAs of Glycine max (L.) Merrill reveals wider ramifications of small RNA-mediated (conserved and legume-specific miRNAs) gene regulatory foot prints in molecular adaptive responses. MicroRNAs (miRNAs) are indispensable components of gene regulatory mechanism of plants. Soybean is a crop of immense commercial potential grown worldwide for its edible oil and soy meal. Intensive research efforts, using the next generation sequencing and bioinformatics techniques, have led to the identification and characterization of numerous small RNAs, especially microRNAs (miRNAs), in soybean. Furthermore, studies have unequivocally demonstrated the significance of miRNAs during the developmental processes and various stresses in soybean. In this review, we summarize the current state of understanding of miRNA-based abiotic and biotic stress responses in soybean. In addition, the molecular insights gained from the stress-related soybean miRNAs have been compared to the miRNAs of other crops, especially legumes, and the core commonalities have been highlighted, though differences among them were not ignored. Nature of response of soybean-derived conserved miRNAs during various stresses was also analyzed to gain deeper insights regarding sRNAome-based defense responses. This review further provides way forward in legume small RNA transcriptomics based on the adaptive responses of soybean and other legume-derived miRNAs.Not Availabl

Formulation of Mouth Dissolving Tablets Using Solid Dispersion Technique: A Review

Mouth-dissolving tablets are also called as fast disintegrating tablets, melt-in mouth tablets, orodispersible tablets, quick dissolving etc. Mouth dissolving tablets are those when put on tongue disintegrate rapidly thereby releasing the drug, which dissolve or disperses in the saliva. The faster the drug dissolved into solution, quick will be the absorption and onset of clinical effect. Mouth dissolving tablet containing solid dispersion was developed to improve the solubility of drug and stability of solid dispersion. Such tablets are disintegrate and/or dissolve rapidly in the saliva without the need for water. Hence it is regarded as the safest, most convenient and most economical method of drug delivery having the highest patient compliance. The later portion of the article focus on the progress in methods of manufacturing, evaluation and various latest technologies involved in the development of Mouth dissolving tablets. Solid dispersion is basically a drug with polymer two-component system; hence the drug–polymer interaction should be determined first in order to ensure the stability of the formulation. This review is intended to discuss the recent advances related on the area of solid dispersion technology. Since different methods are used for the preparation of solid dispersions such as fusion method, solvent method, melting solvent method, melt extrusion method, lyophilisation technique, melt agglomeration process, use of surfactant, electro spinning and super Critical Fluid Technology, of them which method is good and suitable for which type of drug. The use of Mouth dissolving dosage forms has solved various problems noted in administration of drugs to the pediatric and elderly patient, which constitutes a large proportion of the world's population. The initial focus of this review article is based on solid dispersion mainly advantages, disadvantages, types, the method of preparation, and characterization of the solid dispersion at laboratory and industrial level