ABSTRACT
PURPOSE@#Long proximal femoral nail anti-rotation (PFNA-II) is a preferred implant in recent years for fixation of pertrochanteric fractures, especially in osteoporotic patients. The purpose of this study is to prospectively investigate the effect of distal locking in long PFNA-II fixation of stable intertrochanteric fractures.@*METHODS@#A total of 58 patients with isolated stable intertrochanteric fractures and treated in our hospital during the study period of 2017-2019 by distal locked or unlocked long PFNA-II fixation were included in this study. Patients who had multiple injuries or open fractures were excluded. There were 40 female and 18 male patients, with 33 affecting the left side and 25 the right side. Of them, 31 belonged to the distal locked group (group A) and 27 to the unlocked group (group B). Surgical procedures and implants used in both groups were similar except for the distal locking of the nails. General data (age, gender, fracture side, etc.) showed no significant difference between two groups (all p > 0.05). The intraoperative parameters like operative time, radiation exposure and follow-up parameters like functional and radiological outcomes were recorded and compared. Statistical tests like the independent samples t-test Fischer's exact and Chi-square test were used to analyze association.@*RESULTS@#The distribution of the fractures according to AO/OTA classification and 31A1.2 type of intertrochanteric fractures were most common in our study. All the included fractures united and the average functional outcome in both groups were good and comparable at the end of one year. The operative time (mL, 107.1 ± 12.6 vs. 77.0 ± 12.0, p < 0.001) and radiation exposure (s, 78.6 ± 11.0 vs. 40.3 ± 9.3, p < 0.001) were significantly less among the patients in group B. Fracture consolidation, three months after the operative procedures, was seen in a significantly greater proportion of patients in group B (92.6% vs. 67.7%, p = 0.025). Hardware irritation because of distal locking bolt was exclusively seen in group A, however this was not statistically significant (p = 0.241).@*CONCLUSION@#We conclude that, in fixation of stable intertrochanteric fractures by long PFNA-II nail, distal locking not only increases the operative time and radiation exposure but also delays the fracture consolidation and increases the chances of hardware irritation, and hence is not required.
Subject(s)
Humans , Male , Female , Fracture Fixation, Intramedullary/methods , Bone Nails , Treatment Outcome , Retrospective Studies , Hip Fractures/etiology , Femoral Fractures/etiologyABSTRACT
Government of India launched PPI in 1995 to eradicate polio by the end of 2000. Despite this 733 cases were reported last year alone. There is a need to understand the reason behind high number of cases being reported even after so many years of programme implementation. This study was therefore conducted to assess knowledge of people about polio and PPI, their attitude and practice towards PPI. This cross sectional study was done in Mangalore city of Karnataka. Only houses having under five children were taken for the study. Data was collected by interviewing any adult member of the household using a pretested questionnaire. Out of 100 participants 99 were literates but only 11 knew the correct mode of transmission of polio. Twenty seven had misconception that polio is a curable disease. Only 40 participants knew that polio drops can be given to children even with mild illnesses. Few (2%) participants felt that PPI causes vaccine overdose and 8 participants thought PPI to be a substitute for routine immunization. This study identified few important misconceptions associated with polio and PPI. This needs to be addressed by large scale awareness campaigns in order to eradicate polio in the near future.