Functional outcome of open reduction and internal fixation of clavicle fracture

Background: Clavicle fracture is one of common bony injury; which is more common in young active individual. It has been traditionally treated with non-operative method. This present study was undertaken to study the role of the surgical management in the fresh middle third clavicle fracture.Methods: 30 adult patients (21 male and 9 female) of average age of 32 years presented with fresh middle third clavicle fracture and treated surgically with open reduction and internal fixation with plate and screws and followed. Study conducted between November 2011 to November 2012.Results: In 27 patients fracture were united at end of 12 weeks, in 2 patients fracture were united at end of 24 weeks and 1 patient went for non-union. One patient had superficial infection. None had deep infection. One patient had plate loosening at 4week but fracture was united at the end of 24 weeks. 2 patients had persistent pain which is controlled with occasional analgesic but not effecting ordinary work. One patient had gross restriction of shoulder movement. Functional outcome assessed according to near shoulder scoring system. 24 patients had excellent result, 4 patients had satisfactory result, 1 patient had unsatisfactory result and 1patients had failure.Conclusions: The study showed rigid fixation with plate and screw for fresh middle third clavicle fracture especially displaced and comminuted give immediate pain relief and prevent the development of shoulder stiffness &non-union and give good functional outcome.

Effect of early protected weight bearing in fractures of shaft of femur

Background: Fracture shaft of femur is a common and major musculoskeletal injury and in most of the cases the patients are immediately brought to hospitals for specialist orthopaedic management. The purpose of this study was to evaluate the effectiveness of early protected weight bearing in fractures of shaft of femur.Methods: This was observational study conducted on 35 patient’s hospital with transverse fracture mid-shaft of femur, between March 2007 and July 2011. Patients with high velocity trauma, with transverse fracture of mid shaft of femur amenable to closed reduction and interlocking intramedullary nailing and otherwise healthy individuals were included in this study. The preoperative parameters were recorded included age, gender, side of the fracture and medical history. All patients were operated on second day of admission.Results: A total of 35 consecutive cases were included, 34 patients were males and 1 was female. In 74% cases closed intramedullary nailing given excellent healing of fracture, in 14% cases healing was good, in 6% cases it was average and 6% cases poor healing was observed.Conclusions: Our study demonstrate that this method provides anatomical reduction and maintenance of femur length and early ambulation which promotes fracture healing by a stable internal fixation allowing micro motion at fracture site enhancing callous formation

Compartment pressure changes after closed fractures of tibia

Background: Compartment syndrome is a potentially devastating situation. Raised intracompartmental pressure has been implicated as the primary pathogenic factor in compartment syndrome. The purpose of the study was early detection of compartment syndrome and corroborating the findings with other physical signs and symptoms, to prevent the onset of ischaemia and subsequent tissue changes that lead to crippling deformities.Methods: The present study was conducted in the Department of Orthopaedics, Pushpagiri medical college hospital, Thiruvalla over a period of 12 months.  Closed fractures of tibia admitted to the casualty unit within 36 hours of injury were selected for the study. A total of 24 patients were included with the majority in the age group of 31– 45 years. Whitesides technique was used to measure the compartment pressure. A differential pressure of less than 30 mm Hg was taken as the criterion for diagnosis of compartment syndrome. Results: The present study included 24 patients with affected 25 limbs.15 out of 25 limbs were with lower third fractures (60%) followed by upper third 6 (24%) and middle third 4 (16%). Out of 25 limbs 20 cases (80%) had associated fracture of fibula and 5 (20%) were not associated. In this study, out of 32% cases with increased compartment pressure, one case with upper third fracture (above 45 mm Hg) and one of the case with middle third fracture (20-30 mm Hg) with associated fibula had underwent immediate fasciotomy.Conclusion: Compartment pressure measurement is a very good index for predicting and preventing compartment syndrome. Fasciotomy to fully decompress all involved compartments is the definitive treatment for compartment syndrome in the great majority of cases. Delays in performing fasciotomy increase morbidity

Primary modular straight stem cemented prosthetic replacement for unstable, comminuted intertrochanteric fracture in the elderly with severe osteoporosis

Background: The increasing number of hip fractures in the elderly, with the subset of unstable, comminuted intertrochanteric hip fractures is extremely relevant as the treatment is hampered by unsuccessful fixations and high complication rates. Osteoporosis and fracture geometry are two factors responsible for the failure of fixation in such fractures, upon which the surgeon has no control. Hence newer methods of fixation or treatment have to be opted for. The objective of the study was to evaluate the functional outcome of primary modular cemented prosthetic replacement for unstable, osteoporotic intertrochanteric fractures in a selected group of patients.Methods: A total of 34 patients with type II and type III unstable intertrochanteric fractures were treated with primary modular cemented bipolar prosthesis and followed up in Pushpagiri Institute of Medical Sciences and Research Centre, Tiruvalla.Results: After surgery 94.12% patients regained walking capacity. The functional outcome at the time of discharge was fair to excellent in 88.24% of cases. The complications were few and the major benefit was early ambulation of patients and return to pre-fracture level of activity.Conclusions: Primary modular bipolar straight stem cemented prosthetic replacement is probably the best option for treatment in previously independently ambulant, elderly osteoporotic patients with unstable, comminuted intertrochanteric fracture of femur

Study on functional outcome of bimalleolar ankle fractures treated by open reduction and internal fixation

Background: Ankle injury is the most common weight bearing orthopaedic musculoskeletal trauma encountered in emergency medicine and practice. Ankle joint is highly congruous and any disturbance of normal articular relationship may result in some progressive arthrosis of biomechanical dysfunction. As with all intra-articular fractures it necessitates accurate reduction and stable internal fixation. The objectives were to study the functional outcome of surgical treatment of bimalleolar ankle fractures and to know the complications of open reduction internal fixation of bimalleolar fractures.Methods: 45 patients with malleolar fractures were included in this prospective longitudinal interventional study. Patients who underwent operative treatment were followed up regularly for 6 months with OPD visits and X-ray imaging at each stage. Patient parameters were recorded at immediate post op period, 6 weeks, 12 weeks and 24 weeks. Baird and Jackson scoring system for ankle were used for the functional outcome measurement.Results: Most common type of injury pattern was supination-external rotation with 21 cases (47% of cases). The results are excellent to good in 65% of patients, 27% of patients had fair and 8% had poor result. Syndesmotic screw fixation was done with 4.5 mm cortical screw in 7 cases. Most common complication was surgical site infection in 3 cases (6.67%). 2 patients underwent implant removal due to unresolved infection at 3 months.Conclusions: The results of operative fixation were satisfactory in 90% of patients. Most of the complications were minor and resolved within three weeks.

Myctophid fishery along the Kerala coast with emphasis on population characteristics and biology of the headlight fish, Diaphus watasei Jordan & Starks, 1904

Myctophids form bycatch in deep sea shrimp trawls with an annual average catch of 2668 t during 2009 - 2011 in Kerala coast. Fishery occurred almost round the year with peak during November - February. Fishery and biology of the dominant species, Diaphus watasei was monitored. Peak spawning and recruitment of the species was during January-August. Growth parameters L∞ and K are estimated as 15.06 cm and 0.8 per year respectively. These values indicate that the species growth is relatively fast. Natural mortality estimate (M) is 1.21, total mortality (Z) 1.68 and fishing mortality (F) 0.47. The exploitation rate (E) is low being 0.279. These indicate that the stock is at its initial stage of exploitation and there is large scope for enhancing their commercial exploitation. The stock abundance, biomass and distribution of the resource need to be assessed. These factors have to be taken into consideration while planning for exploitation of myctophids in future

First record of the Garman's lanternfish Diaphus garmani (Family: Myctophidae) from Indian waters

The myctophid Diaphus garmani is recorded for the first time from Indian waters. Three specimens (54-59 mm standard length) were collected from deep sea shrimp trawlers off Quilon, southwest coast of India, between 80 -110 N and 740-760 E, at depths from 250 to 450 m

Preliminary study on the length-weight relationship of Sacura boulengeri (Heemstra, 1973) from Indian waters

Sacura boulengeri (Heemstra, 1973) is a rare serranid fish (Subfamily: Anthiinae) having very distinct distribution in the western Indian Ocean. The rarity of the species is evident from earlier reports and, so far, no related studies on the species have been published except on taxonomy and distributional records. In the present investigation, the length-weight relationship of Sacura boulengeri was estimated to be W = 0.0777 × L2.690 (with 95% confidence intervals for b and r2). An analysis of the stomach contents revealed that sergestid shrimps and copepods were the major food items of the diet

Lanternfishes (Myctophids): by-catch of deepsea shrimp trawlers operated off Kollam, south-west coast of India

By-catch and discards have received a great deal of scientific attention, their minimisation being a goal of marine fisheries management (Powers, 2006). The Nordic workshop (Nordic Council of Ministers, 2003) defined by-catch as “the proportion of the catch which is taken on the board, or brought to the surface by the vessel and which is subsequently thrown back to sea, dead or dying or likely to die”. Most of the earlier studies deal with optimisation of fishing efficiency and minimisation of fishing impact, but by-catch and discards data have rarely been used to learn about the distribution, abundance and biology of the incidental species being caught, although several recent studies have indicated the informative value of by-catch concerning food habits (Koen Alonso et al., 2001), feeding ecology (Rheeder and Sauer, 1998) and recruitment indices (Payne et al., 2005)

Proximate composition and fatty acid profile of the myctophid Diaphus watasei Jordan & Starks, 1904 from the Arabian Sea

The edible portion of Diaphus watasei, a benthopelagic fish collected off Quilon, south-west coast of India was analysed for proximate composition and fatty acid profile. The fleshy part of the fish was found to contain 15.62% protein, 11.71% fat, 0.47% minerals, 0.28% soluble carbohydrate and 0.01% crude fibre. The dry matter in the fish was found to be about 28%. Monounsaturated fatty acids (MUFA) were found to have the highest (36.7%) share among total fatty acids followed by saturated fatty acids (SFA) (33.3%) and polyunsaturated fatty acids (PUFA) (25.5%). The abundant fatty acids were found to be oleic acid, palmitic acid, docosahexaenoic acid, stearic acid, myristic acid, linolenic acid, eicosapentaenoic acid and palmitoleic acid. The most predominant fatty acid was recorded as oleic acid which contributed 32% to the total fatty acids. Docosahexaenoic acid formed the single largest component of PUFA (9.33%) followed by γ linolenic acid (3.97%) and eicosapentaenoic acid (3.83%). The ω-3 PUFA contributed about 70% of the total PUFAs. The most important ω-3 PUFAs were EPA and DHA that contributed 73% to the total ù -3 polyunsaturated fatty acids