ABSTRACT
Background: De Quervian's disease, which is painful inflammation of first dorsal compartment of wrist, and surgical, non surgical treatment modalities are being used for its management
Objective: To compare the frequency of pain among patients of de Quervian's disease managed by surgical decompression and steroid injection methods
Patients and Methods: This was an experimental study, conducted at Orthopedic Complex in Bahawal Victoria Hospital, Bahawalpur for six months from October 2009 to March 2010.We inducted 66 patients fulfilling the inclusion criteria. The patients were randomly divided into two groups. Group A patients were managed by surgical decompression and group B patients by steroid injection. After 4 weeks pain relief was assessed on the basis of Finkelstein's test result and visual analogue scale was used to describe the level of pain by patients
Results: The mean age of the patients in group A was 42 +/- 9 years and in group B was 42.2 +/- 10.7 years. The Male to female ratio was 1:6 in both groups. In distribution of pain relief, in group A there were 26[78.7%] patients who got complete relief of pain, 4[12.1%] patients who had mild pian, 2[6%] patients who had moderate pain and 1 [3%] patients who had severe pain. While in group B there were 22 [66.6%] patients who got complete relief of pain, 6 [18%] patients who had mild pain, 3 [9%] patients who had moderate pain and 2[6%] patients who had severe pain
Conclusion: Our study suggests that surgical decompression is a better treatment option than steroid injection because it has more chances of complete pain relief and permanent cure from the disease
ABSTRACT
To study the outcome of open reduction and fixation with K wires of supracondylar fractures of humerus in children presenting between 2-14 days after injury. Case series. Department of Orthopaedics, B.V.Hospital Bahawalpur, from April 2009 to March 2010. This study included patients with displaced extension type supracondylar fracture of the humerus [Gartland type III] who presented between 2-14 days post injury. Open reduction and internal fixation[ORIF] with crossed K-wire was done. The results were assessed by the criteria described by Flynn et al and Mark et al. The average age of patients was 4.5 year. The average hospital stay was 2 days [range 1-3 day]. The average duration of follow-up was 15 months [range: 12-24 months]. Forty patients were managed during the study period. Eighteen [45%] patients had excellent results with less than 5 degree loss of range of motion and minimal loss of carrying angle; thirteen [32.5%] had good results out of which seven had less than 10 degree loss of carrying angle and six had less than 20 degree loss of motion. Six [15%] had fair results due to transient nerve lesions. One of the six patients had 30 degree loss of motion. The remaining three [7.5%] had poor results due to varus deformity that needed corrective surgery. Delayed presentation of displaced supracondylar humerus fractures in children did not increase complication rates or unsatisfactory results following an open reduction and internal fixation with K wires. It is a safe and effective method of treatment even with delayed presentation of supracondylar fractures of humerus in children