The joy stick technique: an easy, reliable, safe and cost effective, technique in closed reduction and percutaneous fixation of supracondylar fracture of the humerus in children

Background: Supra condylar fractures of humerus account for approximately 16% of all pediatric fractures. This produces an extension type fracture in 97–99%. Flexion type accounting for 1-3%. This often causes significant morbidity due to malunion (gun-stock deformity) reported in 12 to 20%, while neurovascular complications and compartment syndrome is documented in worse scenarios.Methods: A prospective study was conducted with 24 cases of supracondylar humerus fracture between June 2017 to June 2021. Both males and females aged 3 years to 12 years, within 5 days of injury, with modified Gartland’s type III and type IV, without compartment syndrome were included and followed up for 6 months to one year. The fracture was closely reduced using a 2-2.5 mm k-wire (joystick) in proximal fragment placed 5-7 cm proximal to fracture line and fixed with multiple percutaneous pinning under C-arm. All the patients were followed for rate of union and functional outcome using Flynn’s criteria.Results: All the 24 cases were managed by closed maneuver with the help of a joy stick. This reduces the surgical time and stress, preventing opening of fracture. Outcome was assessed in each follow up using Flynn’s criteria. 87.5% of patients had good to excellent outcomes.Conclusions: Our results demonstrate that good functional outcomes are expected in supracondylar fracture regardless of age at injury, sex, weight, side of extremity provided satisfactory reduction by closed technique with help of joy stick. This simple technique reduces surgical stress, duration of surgery and also minimizes the C-arm exposure

Health and socioeconomic status of the elderly people living in Hilly areas of Pakhribas, Kosi Zone, Nepal

Background: The rising geriatric population is facing significant health and social problems in the developing world that are impacting the quality of their lives. Objective: The study describes the general health status and the socioeconomic characteristics of the elderly people of Pakhribas village development committee (VDC) of Eastern Nepal. Materials and Methods: Descriptive cross-sectional study was carried out targeting the people aged 60 years and above in the sample area using a semi-structured questionnaire and convenient sampling to get the required sample size. A total of 189 elderly people who consented were interviewed in May 2010. Result: The major part of the elderly population was in the age group of 60-69 years. Seventy-two percent were illiterate and 75% were still earning with the majority involved in farming. Nine out of ten were living with their families and still made decisions for the household, Eighty-two percent did not feel lonely and 88.4% did not report any misbehavior by the house members. Regarding health, 69% had some diagnosed health issue with 36% suffering from gastritis and 20.4% from chronic lung disease. Using the ICD 10 criteria, depression was found among 18%. The most prevalent geriatric problem was a dental problem as found in 61% even though 87% claimed to brush their teeth regularly. More than half were suffering from visual difficulty and the proportions suffering from memory and hearing issues were also substantive. Smoking habit was found in 60%, and the relation between smoking and chronic respiratory diseases had a statistical association (P = <0.05). The geriatric cases who were misbehaved with felt depressed or neglected in the family (P = <0.0001). Conclusions: The results of the study show that employment, family support, and pension schemes have a positive impact on the social status of the elderly. Health screening clinics should be established in the community to detect health-related disorders. Elderly populations need health education to emphasize the importance of personal and dental hygiene and to abstain from smoking and alcohol