Results of Autogenous Trephine Biopsy Needle Bone Grafting in Fractures of Radius and Ulna

Cortico-Cancellous bone graft harvested from the anterior iliac crest by the conventional open method is associated with more morbidity and is more time consuming as compared to the percutaneous method using trephine biopsy needle. The aim of the study was to determine whether cancellous bone graft harvested from anterior iliac crest using trephine biopsy needle consistently achieved bone union in comminuted fractures and fractures of more than 3 weeks duration of radius and ulna and also to determine the morbidity at the donor site. Autogenous cancellous bone graft was harvested percutaneously from 28 iliac crests in 16 patients and applied at fracture sites of 30 forearm bones using a 4mm trephine biopsy needle after the fratures had been fixed with plate and screws. The patients were followed up regularly upto 6 to 9 months post - operatively in the OPD to determine the union status of the fractured bones and the morbidity at the donor site. 29 of the 30 fractures of the forearm bones united without any problems. The shaft of a trephine got bent during the harvesting procedure at the beginning of the study due to improper technique. Cancellous bone graft harvested from the anterior iliac crest results in predictable good union results in comminuted fractures of forearm bones and also fractures presenting after 3 weeks of injury. It is also an easier and quicker way of harvesting bone graft and is associated with lesser morbidity and earlier recovery as compared to conventional open method. Key Words: Bone graft, trephine, fracture of radius and ulna morbidit

Effect of Impairment and Disability on Health-Related Quality of Life of Elderly: A Community-Based Study from Urban India

Introduction: Increasing population of elderly and the emergence of epidemic of chronic or (non-communicable) diseases, which is likely to adversely affects their health-related quality of life (HRQOL), has implications on health systems in developing countries such as India. A study was conducted to know the common impairments and disabilities and their effect on HRQOL in elderly population. Materials and Methods: A community-based cross-sectional study on elderly, selected by cluster sampling from central Delhi, India, was conducted from April 2005 to February 2006. A pre-tested, semi-structured questionnaire, along with Short Form -36 (SF-36) survey was used for data collection. The data was analyzed using Chi square and student′s t test on SPSS v12 statistical software. P value of less than 0.05 was considered statistically significant. Results: A total of 200 elderly were included in the study. 71.5% subjects had at least one disability/impairment. Around 40% subjects reported their health being poor and another 50% of worsening of their health in the last 1 year. HRQOL score for people with and without chronic morbidity/disability was 51.8 and 73.5, respectively (P<0.05), with overall mean score 56.7 (±17.2). The most commonly affected HRQOL domains were Role Physical, Physical Functioning, and General Health. The HRQOL and domain scores decreased with increasing age, and females had lower mean scores than males (P<0.05). Conclusion: The HRQOL of elderly in urban India is severely affected by impairments and disabilities. There is an immediate need for specific preventive and rehabilitative measures targeted on elderly to maintain their health related quality of life. This information may be utilized for designing any policy and/or program targeted for elderly in India and in other similar settings