Competency of distal femur locking plate as an answer for fixation of all varieties of distal femur fractures

Background: Distal femur fractures are common and need to be treated operatively and for optimal functional outcome. Multiple implants are available for fixation e.g. angled blade plate, dynamic condylar screw, buttress plate, antegrade nailing, retrograde nailing, locking distal femoral plates, external fixator etc. We have designed this study to analyse clinico-radiological outcome and competency of locked plating for all varieties of distal femur fractures.Methods: We conducted a prospective interventional study on 79 consecutive patients with fractures of distal femur operated with locking distal femur plate from January 2015 to February 2018. Patients were regularly followed up with x-rays and clinical examination. At the end of clinicoradiological union, patients were evaluated with Neer’s score.Results: Total 79 distal femur fractures were studied based on inclusion and exclusion criteria. There were 63 (79.75%) males and 16 (20.25%) females. As per AO classification fracture of type A were 39 (49.36%), type B were 10 (12.65%) and type C were 30  (37.97%). Average time period from injury to surgery was 8.2 days. In our study, the average period of clinicoradiological union was 16 weeks. 62 (78.48%) patients had excellent to satisfactory outcome, 13 (16.45%) patients had unsatisfactory and 4 (5.06%) patients had poor outcome.Conclusions: Distal femur fractures are common, complex injuries and different implant option are available for fixation. All types of distal femur fractures can be fixed using distal femur locking compression plate. If fixed following basic principles of fracture fixation good results can be obtained

Paraplegia in young female after stab injury: a rare injury with heavy socioeconomic burden and its impact

Thoracic spinal cord stab injuries are rare lesions. We report a 32 years old young married female, of a lower middle class, who was stabbed on her back with a sickle by her neighbor after a quarrel. She presented with complete paraplegia with muscle power of zero on all muscle groups, complete sensory loss from thoracic dermatome level 4 and below, acute urinary retention, and a 3-centimeter vertically placed wound on the posterior thoracic region from which cerebrospinal fluid mixed with blood was oozing out. A high-dose methylprednisolone protocol was started (30 mg/kg in one hour and then 5.4 mg/kg over next 23 hours), urinary catheter placed and sterile cleaning and dressing was done. Antibiotics and analgesics were also administered. The Magnetic Resonance Imaging scan was done urgently and scanning revealed thoracic spinal cord contusion at D5 vertebral level with cord oedema at D4 to D6 vertebral level and fracture spinous process of T4 vertebral body. The case is managed conservatively and she is under follow up. As patient is a young married female, wedge worker by occupation, having lower middle class of socioeconomic status, this condition has high impact considering the socioeconomic issues