A comparative study of treatment outcomes of femur neck fracture with dynamic hip screws versus multiple cancellous cannulated screws

Background: Dynamic hip screws (DHS) and multiple cannulated cancellous screws (MCCS) are commonly used in anatomic reduction of femur neck fractures. However, there is limited information on the complications of various fixation methods. Objective: To assess the outcome of two different modalities of femur neck fracture fixation. Methodology: This prospective, randomized, comparative interventional study included 32 subjects with recent trauma. Patients were randomized to DHS and MCCS treatment groups (16 patients each). Post-surgical radiographs were obtained and clinical evaluation for deformities was performed using the Harris hip score (HHS). The duration of surgery, average blood loss, and complications were noted and assessed. Chi-square test was used to check the association between attributes. Two-sample t-test was employed to compare the mean between two groups. P≤0.05 indicated statistical significance. Results: A significant difference (p<0.001) between the 2 groups was noted with regard to patients’ age. The median operative time for DHS and MCCS groups was 75 mins (range 60-90 mins)  and 60 mins (range 50-70 mins), respectively. Average blood loss was more in DHS (200 mL) than in MCCS (120 mL) group. Majority of the patients (75%) in the DHS group showed excellent HHS results

Modified Tension band wiring vs Tension band with cannulated cancellous screws in treating transverse patellar fractures

Purpose: Despite being the most favoured modality of treatment in patellar fractures, modified tension band wiring (MTBW) technique has serious demerits with regards to clinical outcomes. Tension band with cannulated cancellous screws (TBCC) is a recent technique to overcome the demerits associated with former technique.  This study was aimed to compare these two techniques, in terms of clinical outcomes, in treating patellar fractures. Methods: This hospital based prospective randomized study was conducted in a tertiary care hospital for 2 years. Thirty patients with Gustillo-Anderson grade 1 and 2 compound fractures were randomly divided into two treatment groups, viz MTBW and TBCC groups. After performing pre-operative investigations, patients were anesthetized, and knee was operated by the standard procedures. Post-surgery, radiographs were taken and range of motion, pain score (Visual Analogue Scale (VAS)), time taken for radiological union, clinical outcomes were recorded. Results: Mean age of the patients included in the MTBW and TBCC group were 53 years and 58.5 years, respectively. Between the groups, range of motion, IOWA score assessed at the end of 6 months, did not vary significantly (P>0.05).  Meanwhile, the difference noticed with average time taken for radiological union was also nonsignificant (MTBW =11 weeks. TBCC=10 weeks)

A Comparative Study of Treatment Outcomes of Femur Neck Fracture with Dynamic Hip Screws Versus Multiple Cancellous Cannulated Screws

Background: Dynamic hip screws (DHS) and multiple cannulated cancellous screws (MCCS) are commonly used in anatomic reduction of femur neck fractures. However, there is limited information on the complications of various fixation methods. Objective: To assess the outcome of two different modalities of femur neck fracture fixation. Methodology: This prospective, randomized, comparative interventional study included 32 subjects with recent trauma. Patients were randomized to DHS and MCCS treatment groups (16 patients each). Post-surgical radiographs were obtained and clinical evaluation for deformities was performed using the Harris hip score (HHS). The duration of surgery, average blood loss, and complications were noted and assessed. Chi-square test was used to check the association between attributes. Two-sample t-test was employed to compare the mean between two groups. P≤0.05 indicated statistical significance. Results: A significant difference (p<0.001) between the 2 groups was noted with regard to patients' age. The median operative time for DHS and MCCS groups was 75 mins (range 60-90 mins)  and 60 mins (range 50-70 mins), respectively. Average blood loss was more in DHS (200 mL) than in MCCS (120 mL) group. Majority of the patients (75%) in the DHS group showed excellent HHS results

Modified Tension Band Wiring Vs Tension Band with Cannulated Cancellous Screws in Treating Transverse Patellar Fractures

Purpose: Despite being the most favoured modality of treatment in patellar fractures, modified tension band wiring (MTBW) technique has serious demerits with regards to clinical outcomes. Tension band with cannulated cancellous screws (TBCC) is a recent technique to overcome the demerits associated with former technique.  This study was aimed to compare these two techniques, in terms of clinical outcomes, in treating patellar fractures. Methods: This hospital based prospective randomized study was conducted in a tertiary care hospital for 2 years. Thirty patients with Gustillo-Anderson grade 1 and 2 compound fractures were randomly divided into two treatment groups, viz MTBW and TBCC groups. After performing pre-operative investigations, patients were anesthetized, and knee was operated by the standard procedures. Post-surgery, radiographs were taken and range of motion, pain score (Visual Analogue Scale (VAS)), time taken for radiological union, clinical outcomes were recorded. Results: Mean age of the patients included in the MTBW and TBCC group were 53 years and 58.5 years, respectively. Between the groups, range of motion, IOWA score assessed at the end of 6 months, did not vary significantly (P>0.05).  Meanwhile, the difference noticed with average time taken for radiological union was also nonsignificant (MTBW =11 weeks. TBCC=10 weeks)