Comparison of Outcome of two different Methods for the treatment of Intra-articular fracture of Distal Radius

Objective: It is to compare the radiological and functional outcome of two different fixation methods for displaced intra articular distal radius fracture (DRF): open reduction and internal fixation with anatomical plate and closed reduction with percutaneous K-wires. Methodology: A randomized controlled trial was conducted in Orthopaedics department, Shaikh Zayed Hospital, Lahore for one year; from April 2017 to March, 2018. Total 90 patients were selected in the study by ‘non-probability, consecutive sampling technique’ with 45 patients in each group of the study; Group-A (fixation method: Open reduction with internal fixation with volar plate) and Group-B (Fixation method: Kirschner-wire known as K-wire). Results: The mean age in the group A and group B was 53.7 ± 11.8 years and 55.2 ± 12.3 years respectively. There were 58 male and 32 females in the study. The differences in volar tilt, radial inclination, radial length and modified Mayo score were significantly better in group A than group B (p-value < 0.05). The differences were not significantly different for articular step off in the two study groups (p-value > 0.05). Conclusion: Open reduction with internal fixation using volar locking plates yielded significantly better radiological and functional outcomes than percutaneous fixation using K-wire in the 6 months’ postoperative period

Comparison of casting versus elastic nail for the treatment of pediatric tibial diaphyseal fractures

Objective: To assess outcomes of Titanium elastic nail (regarding radiologic union, a discrepancy of limb length, malalignment, pain and complications) in treating pediatric tibial fractures in comparison with the traditional Casting method.Methodology: This randomized controlled trial study was conducted in Department of Orthopaedics, Shaikh Zayed Hospital, Lahore through emergency /Outdoor patient department from May 2018 to Feb 2019. The total number of patients were categorized into two groups, 14 each group. In Group A, patients underwent treatment by elastic nails and patients in group B, underwent treatment with cast method. Post op X-Rays (serial) were done and Leg length inequality, Malalignment, pain and radiological union were assessed radiologically. Follow up of the patients was done in the outpatient department of Orthopaedic department after 1,3 and 6 months. The comparison for this among both groups was done by using Chi-square test. P value ≤ 0.05 was considered significant.Results: The mechanism of injury was statistically same in both groups, p-value > 0.05. In group-A, 7(50.0%) cases had Transverse, 4(28.6%) had Oblique and 3(21.4%) cases had comminuted fracture while in group-B there were 5(35.7%) cases who had Transverse, 2(14.3%) had Spiral, 4(28.6%) cases had Oblique and 3(21.4%) cases had Comminuted fracture, p-value > 0.05. In both groups, the leg length inequality, frequency of malalignment, pain severity and complications were statistically same, p-value was > 0.05.Conclusion: Similar outcomes of Titanium elastic intramedullary nailing as compared to cast application in terms of bone union, alignment and infection rates