Role of dynamic hip screw with locking side plate in intertrochanteric fractures in elderly patients

Background: Dynamic hip screw (DHS) is a vital mainstay implant in managing intertrochanteric fractures. While most of the modifications of implant have been done in screw design, this study evaluates the role of employing locking side plate with DHS to increase the screw hold and avoid plate pull out in trochanteric fractures of elderly patients.Methods: A prospective study was conducted from August 2012 to August 2014 on 30 patients having trochanteric fractures. The fixation, fracture consequences, functional outcome and complications were assessed clinically and radiologically in immediate post-operative period and on follow-ups at six weeks, three months, six months and one year. Young patients (<55 years), fractures with subtrochanteric extension and pathological fractures were excluded from study. Fractures in elderly patients from AO 31A1.1 to AO 31A3.1 were included in study. Evaluation of the clinical outcome was done by modified Harris hip score at the last follow-up.Results: Average age of the patients in study was 64 years; males had better outcome scores, which was statistically significant. The mean trauma-surgery interval was four days. Trauma surgery interval and functional outcome by Harris hip score was statistically significant and was inversely proportional. Union was achieved in all patients with delayed union noted in four cases; the average time to union was 12.2 weeks with no major complications and good functional outcome by Harris hip score.Conclusions: This study suggests that locking side plate with DHS would make a stronger bone implant construct and a valuable modification to prevent sliding, screw cut-out and side plate pull-out with low infection rates

Atypical CT Findings in Plexiform Ameloblastoma

Ameloblastoma is an uncommon epithelial odontogenic neoplasm that is nonmineralized, locally aggressive, and, in most cases, benign. Most ameloblastomas develop in the molar-ramus region of the mandible with 70% of them arising in the molar-ramus area. Radiologically they are unilocular or multilocular radiolucency with a honeycomb or soap bubble appearance. The radiographic appearance of ameloblastoma can vary according to the type of tumor. CT is usually helpful in determining the contours of the lesion, its contents, and its extension into soft and hard tissues. Through this case we would bring to light some of the unusual CT findings which include the destruction of the surrounding structures by the lesion which appeared to be normal routine lesion when viewed clinically

Association of occupational stress factors on nicotine dependence among patients visiting dental care unit of Indo-Tibetian border police force station in India

Background. Tobacco use is the foremost preventable cause of death and disease in the world today and work strain might be related with nicotine dependence by its provoking effect. Objective. To assess the association between occupational stress and nicotine dependence. Material and methods. A cross sectional survey was conducted among 200 subjects visiting a satellite dental clinic of Swami Devi Dyal Hospital and Dental College, Barwala, Panchkula, India. Nicotine dependence was measured using the Fagerstrom Test for Nicotine Dependence (FTND). The extent of the stress factors experienced at work was assessed using the Effort-Reward Imbalance scale (ERI). Chi-square test and multiple logistic regression analysis were employed for statistical analysis. Confidence level and level of significance were set at 95% and 5% respectively. Results. The results of bivariate analysis revealed association of occupational stress with age, marital status, educational status, level of nicotine dependence, frequency of cigarette smoking and religious attendance. However, multivariate analysis elicited the significant association of occupational stress with only two variables, level of nicotine dependence and frequency of smoking. Conclusion. Occupational stress was found to be associated with nicotine dependence in the present study implying a need of other tranquil measures to be incorporated for the relief of work related stress