Functional Outcome of Interlocking Intramedullary Nailing of Fracture Shaft of Humerus: A Prospective study

INTRODUCTION: Fractures of the shaft of humerus account for approximately 3-5% of all fractures treated. Historically humeral shaft fractures have been classified by fracture location, fracture pattern, associated soft tissue injuries and quality of bone. This fracture has been treated by closed reduction & cast application with/without cast bracing and open reduction & internal fixation using dynamic compression plate. Many authors have documented the general good outcome that occurs after compression plate fixation, which is still considered the gold standard for operative treatment of acute humeral shaft fractures. Though plate fixation has given high rates of union, it involves extensive soft tissue stripping, potential injury to radial nerve and poor fixation in osteoporotic bone. Later flexible nails of many varieties were used. The advantages of intramedullary nailing are minimal surgical exposure, better biological fixation, minimal disturbances of soft tissues and early mobilization of neighboring joints. The technique of interlocking nailing represents the newer approach of the treatment of humeral fractures. Interlocking nailing also avoids complications like lack of rotational control, migration of nail and requirement of supplementary bracing. The Seidel nail was the first nail to be tested clinically. Eventually several nail systems evolved. AIM OF THE STUDY: The aim is to prospectively study the “functional outcome of interlocking intramedullary nailing in acute fractures and non-union of the diaphysis of humerus” , at the Department of Orthopaedics and Traumatology , Government Kilpauk Medical College, Chennai. MATERIALS AND METHODS: This is a prospective study of 20 Humeral diaphyseal fractures treated by Interlocking intramedullary nailing conducted for a period of 20 months from March 2007 to November 2008 at the Department of Orthopaedics, Government Kilpauk Medical College Hospital . Inclusion Criteria - • Acute shaft of humerus fractures, • Fracture Non-union, • 2cm below surgical neck to 3 cm above olecranon fossa, • Age above 18 years, • Pathological fractures, • Osteoporotic bone, • Polytrauma, • Neurovascular involvement, • Angulation more than 15 degrees after closed reduction, • Non compliance. Exclusion Criteria - 1. Presence of open physis, 2. compound fractures of more than Grade-I severity, 3. fracture involving proximal 2cms and distal 3cms of the diaphysis. RESULTS: Of the twenty cases in our study which was carried out from march 2007 to November 2008 1 patient died and 2 lost follow up. All cases were followed upto a period of maximum of 20 months and a minimum of three months on an average of 10 months. Of the 2 cases that lost follow up 1 case was an acute fracture of the humeral diaphysis and the other was a case of non-union fracture shaft of humerus. The outcome was studied based on the Rodriguez-Merchan's scoring system. CONCLUSION: Inter locking nailing of humerus is a safe and good alternative to treat acute fractures and non – union of the diaphysis. • The union rate is very good and comparable to that of Plateosteosynthesis. • The infection rate is very minimal • Intraoperative blood loss is less. • Chances of iatrogenic Radial N injury is less • Lesser malalignment. • Rotationally stable and cosmetically appealing. • Shoulder stiffness can be prevented with early fixation and proper rehabilitation protocol

Antimicrobial potent (E)-2-(1-phenylethylidene)-1-tosylhydrazines

399-405A series containing ten (E)-2-(1-phenylethylidene)-1-tosylhydrazines have been synthesized by thionyl chloride catalyst assisted condensation between 1-tosylhydrazine and substituted acetophenones. These benzylidenes have been characterized by their physical constants, UV-Vis, IR, 1H and 13C NMR spectral techniques. The antibacterial and antifungal activities of the synthesized benzylidene have been evaluated

Effect of substituents on phenazine derivatives by spectral studies

C NMR spectral data of prepared phenazines were correlated with Hammett substituent constants, F and R parameters using single and multi-regression analysis. From the results of statistical analysis, the effect of substituents on the infrared frequencies (ν, cm -1 ) and 13 C nmr chemical shifts(δ, ppm) has been studied

Functional analysis of cemented bipolar hemiarthroplasty with medial calcar augmentation for unstable intertrochanteric fractures in elderly

Background: Intertrochanteric fracture is one of the most common fractures among the elderly osteoporotic population, constituting about 50% of hip fractures. These fractures are managed either by fixation using dynamic hip screw (DHS), proximal femur nail (PFN) or by replacement, based on the stability of fracture pattern, age of the patient, quality of bone and associated co-morbid conditions. Prosthetic replacement which is routinely done for femoral neck fractures requires modification when done for trochanteric fractures to improve stability. This study aims to analyse the short term functional outcome of cemented bipolar hemiarthroplasty with medial calcar augmentation for unstable intertrochanteric fractures in elderly.Methods: Our study includes 60 patients of age more than 70 years admitted in our institution during June 2012 to September 2016 with unstable intertrochanteric fractures. All patients operated through posterior approach to hip and cemented hemiarthroplasty with medial calcar augmentation with bone graft was done. Patients were followed up for an average of period of 2 years. Functional outcome was evaluated with Harris Hip score.Results: 28% of cases had excellent outcome. 43% of cases had good and 23% of cases had fair outcome. 2% of cases ended with poor outcome. The in-hospital mortality rate was 3.3%. The survival rate of the patients in this study at the end of one year is 85%. Conclusions: Cemented bipolar hemiarthroplasty with medial calcar augumentation can be considered as a good primary option for elderly unstable intertrochanteric fracture patients with osteoporotic bones and associated co-morbidities. 

Synthesis, spectral, antibacterial and docking analyses of (3,4-bis((E)-(arylidene)amino)phenyl)(phenyl)methanones

Biologically active Schiff bases namely (3,4-bis((E)-(arylidene)amino) phenyl)(phenyl)methanones have been synthesized through ultrasonicated condensation of (3,4-diaminophenyl)(phenyl)methanone and various benzaldehydes in ethanol medium. Synthesised Schiff bases have been examined by different techniques like molecular formula calculation, molecular weight determination, melting point determination, micro analysis and spectroscopic data. The in vitro antibacterial actions of these E-imines have been assessed against bacterial strains by zone inhibition and serial dilution methods. Further, molecular docking analysis of all E-imines have been accomplished to comprehend the order of binding of Schiff bases with protein

Ultrasonicated synthesis of some potent antimicrobial aryl sulphonamides

1373-1377Nine N-(2,4-difluorophenyl) substituted benzene sulphonamides have been synthesized by ultrasonication method within short reaction time having more than 90% yield. These sulphonamides have been analyzed by spectral and analytical techniques. The higher yields of sulphonamides have been found to be in case of ultrasonication process as compared to microwave and conventional heating methods. The antimicrobial activities of these sulphonamides have been evaluated using Bauer-Kirby disc diffusion method by means of measurement of mm of zone of inhibition

Student Satisfaction and Performance in an Online Teacher Certification Program

The article presents a study which demonstrates the effectiveness of an online post baccalaureate teacher certification program developed by a Wisconsin university. The case method approach employing multiple methods and multiple data sources were used to investigate the degree to which pre-service teachers were prepared to teach. It was concluded that the study supports online delivery as an effective means of teacher preparation, but it was limited in the number of students followed into their first year of teaching

Antimicrobial potent (2<em>E</em>)-3-chloro-4-nitro-phenylchalcones

1094-1102Novel (2E)-3-chloro-4-nitro-phenylchalcones have been prepared by ultrasonicated crossed aldol condensation of 3-chloro-4-nitro-acetophenone and substituted benzaldehyde. In this work, the obtained yields are more than 90%. The products have been tested by their physical data, micro methodology and spectroscopic analysis. The antimicrobial action of these chalcones have been analysed by Bauer-Kirby disc diffusion and serial dilution methodology