Hoffa fracture: analysis of factors affecting the final outcome after treatment with partially threaded screws

Background: Coronal fractures of the femoral condyles are rare injuries.Methods: This retrospective case series included patients with coronal fractures of the femoral condyles managed operatively. The surgeries were performed by authors NJ, RL and VB. A total of 11 patients with Hoffa fracture were operated between May 2011 and July 2012.Results: We report the outcome of open reduction and internal fixation using partially threaded screws in 11 patients with Hoffa fracture. There were 10 male and 1 female patient operated at a mean age of 37 years. The average duration of follow up was 15.6 months. Fractures in all the patients united with a mean 115.450 range of flexion at knee at final review. The final outcome had a poor correlation with the shear angle of the fracture but fracture comminution and open nature of injury had a negative effect on the final outcome achieved. The number of screws used and the type of rehabilitation followed post operatively also had no bearing on the final range of motion achieved.Conclusions: Partially threaded screws offer consistently good results in coronal fractures of the femoral condyles and the outcome is dictated only by perioperative factors like comminution and open nature of injury

Analysis to Assess the Prevalence and Causes of Low Back Pain in a Known Population at a Tertiary Care Hospital

Background:Low back pain (LBP) is a significant health issue in all developing nations. It is also the most frequently treated health issue in healthcare sector. Hence; the present study was undertaken for assessing the prevalence and causes of low back pain in a known population.Materials & Methods: A total of 500 patients who reported to the Department of Orthopedics, S.P. Medical College and Associated Groups of P.B.M. Hospitals, Bikaner, Rajasthan (India) were enrolled. Complete demographic data of all the patients was obtained. Thorough clinical and medical history of all the patients was assessed. Chief complaint was recorded and radiographic examination of all the patients was done. Diagnosis of low back pain was established and prevalence of CLB pain was recorded. A Performa was framed and various etiologic factors of CLB were assessed.Results: Overall prevalence of LBP was 42.4 percent. Lumbar herniated disc was present in 11.79 percent of the patients while degenerative disc disease was present in 13.68 percent of the patients. Spinal stenosis and osteoarthritis were seen in 16.04 percent and 13.21 percent of the patients respectively. Tumour and compression fracture were seen in 10.38 percent and 8.49 percent of the patients.Conclusion: LBP is a significant health issue affecting major proportion of world’s population. Degenerative disc disease, Spinal stenosis and Osteoarthritis are the major factor responsible for its occurrence

To Find Out the Incidence of Osteoporosis Among Smokers: An Institutional Based Study

Background: Osteoporosis is a complex heterogeneous disorder. Smoking is well known to cause various health problems, including osteoporosis and bone fracture. Hence; the present study was undertaken for assessing the incidence of osteoporosis among smokers.Materials &Methods: A total of 500 smokers with smoking history of minimum of 10 cigarettes per day for a minimum of past 5 years were included. Also, a total of 500 normal controls (non-smokers) were also enrolled. Complete demographic and clinical data of all the patients was obtained. Detailed medical and personal history of all the subjects was also recorded. Thorough clinical and oral examination of all the subjects was done. Incidence of osteoporosis was also recoded. Results: Overall incidence of osteoporosis among smokers and non-smokers was 31.6 percent and 4.2 percent respectively. Incidence of osteoporosis was significantly higher in smokers in comparison to non-smokers. In the smoker’s group, 50.63 percent of the patients with osteoporosis belonged to the age group of more than 45 years while 34.81 percent of the patients belonged to the age group of 30 to 45 years. In the non-smokers group, 47.62 percent of the patients with osteoporosis belonged to the age group of more than 45 years while 38.09 percent of the patients belonged to the age group of 30 to 45 years. In the smokers and non-smokers group, 66.46 percent and 61.91 percent of the patients with osteoporosis were females.Conclusion: Smoking is a significant risk factor for osteoporosis. Keywords: Osteoporosis, Smokers

Flexible intramedullary nailing in paediatric femoral fractures. A report of 73 cases

Abstract Background Flexible intramedullary nailing has emerged as an accepted procedure for paediatric femoral fractures. Present indications include all patients with femoral shaft fractures and open physis. Despite its excellent reported results, orthopaedic surgeons remain divided in opinion regarding its usefulness and the best material used for nails. We thus undertook a retrospective study of paediatric femoral fractures treated with titanium or stainless steel flexible nails at our institute with a minimum of 5 years follow up. Material and methods We included 73 femoral shaft fractures in 69 patients treated with retrograde flexible intramedullary nailing with a minimum follow up of 5 years. Final limb length discrepancy and any angular or rotational deformities were determined. Results Mean age at final follow up was 15.5 years (10-21 years). Mean follow up was 7.16 years (5.0-8.6 years). Titanium and stainless steel nails were used in 43 and 30 cases respectively. There were 51 midshaft, 17 proximal, and 5 distal fractures. All fractures united at an average of 11 weeks but asymptomatic malalignment and LLD were seen in 19% and 58% fractures respectively. LLD ranged from -3 cm to 1.5 cm. Other complications included superficial infection(2), proximal migration of nail(3), irritation at nail insertion site(5) and penetration of femoral neck with nail tip(1). There were 59 excellent, 10 satisfactory and 4 poor results. Conclusion Flexible intramedullary nailing is reliable and safe for treating paediatric femoral shaft fractures. It is relatively free of serious complications despite asymptomatic malalignment and LLD in significant percentage of fractures.</p