RESUMO
Lower limb deformities are debilitating and affect the function of the lower limb and the social life of the patient. The deformities around the knee joint might be a combination of multiple deformities in various planes including coronal, sagittal, or rotational and may be present in both the femur and the tibia. We present a case of a 19-year-old female with complex deformity around the left knee joint involving both the femur and the tibia with shortening. The deformity was thoroughly planned and managed with both the Ortho-SUV and the Ilizarov technique. Complications such as neurological injury and nonunion were faced, but the neurology was improved spontaneously, and the autologous bone graft was done. The end result was excellent with no residual neurodeficit and no limb length discrepancy. Deformities such as these have to be addressed with meticulous planning and strategic surgical management. Complications such as nonunion, infection, neurological injury, and noncompliance might be faced in the course of the treatment. Though the Ilizarov apparatus is the most commonly used to address deformities and limb lengthening, the newer six-axis devices such as the Ortho-SUV can greatly aid in deformity correction.
RESUMO
Road traffic accidents are responsible for most lower limb compound fractures. Such fractures have to be treated immediately with utmost care and precision. Patients are sometimes inadequately treated with traditional practices which causes further disability to the patient and makes it more difficult for the orthopedic surgeon. This case report highlights the meticulous planning and management of a distal tibia-fibula-infected nonunion which was initially mal-treated by an unqualified practitioner following trauma on multiple occasions.
RESUMO
Background Fractures of the forearm are very frequently encountered in day-to-day practice. These fractures have a bimodal age distribution. The forearm fractures are considered intra-articular and need absolute stability for adequate healing. The current treatment modalities include using intramedullary devices such as a square nail, locking intramedullary nail, or using a plate for fixation. In this study, we aim to determine the functional outcome of forearm fractures managed with a screw nail used as an intramedullary device as compared to a locking plate using the Grace-Eversmann criteria. Methodology Patients with forearm fractures were divided into two groups and treated with a screw nail and a dynamic compression plate. Patients were followed up at one month, three months, six months, and one year postoperatively and assessment was done using the Grace-Eversmann criteria. Results The study included a total of 30 subjects, ranging in age from 18 to 65. The majority of the patients had encountered a road traffic accident, following which they incurred a forearm fracture. Grace-Eversmann criteria was used for these patients at follow-up, and a total of 13 patients (86.6%) had good to excellent scores, which was similar when compared to the plate osteosynthesis group (86.6%). A significant difference in the amount of blood loss was noted in the screw nail osteosynthesis group as compared to the plate osteosynthesis group (p<0.05). Conclusions Though a dynamic compression plate is considered a standard method for fixation of the forearm fractures, the use of an intramedullary screw nail as a fixation device gives a similar result with excellent functional outcomes (Grace-Eversmann criteria). It also gives an added benefit of reduced blood loss and preservation of fracture biology.