Functional Outcome Of Extra-Articular Distal Humerus Fracture Fixation Using A Lateral Column Locking Compression Plate.

Background: : A host of different methodologies have been implemented in the management of distal humerus fractures, including conservative measures and surgical fixation with a variety of plates. This study was conducted to evaluate the functional outcome of open reduction and internal fixation of extra articular distal humerus fractures with distal humerus locking compression plate. Methods: This is a retrospective cohort study of patients with close extra articular distal humerus fractures who underwent open reduction and internal fixation with a distal humerus locking compression plate at Ghurki Trust Teaching Hospital from July 2017 to December 2019. Various demographic indicators were used for data analysis and radiological union was assessed in serial follow-ups. Functional outcome was evaluated using the Mayo Performance Elbow Score at the final follow-up. Results: Thirty-one patients presented with extra-articular fracture of humerus (N=31) with average age 33.5±9.90 years. The average follow-up period was 13.8 months. Radiological union was achieved in 14.8 weeks (range 12-20 weeks). Out of 31 patients, 28 had excellent results with mean Mayo Elbow Performance Score of 94.8. Two patients (6.5%) had radial nerve palsy post-operatively. Conclusion: This study shows that open reduction and internal fixation of extra-articular distal humerus fractures with distal humerus locking compression plates allows for stable fixation, good functional outcome, and low complication rates.

Medical Students' Online Learning Perceptions, Online Learning Readiness, and Learning Outcomes during COVID-19: The Moderating Role of Teacher's Readiness to Teach Online.

This study determined the direct and indirect effects of medical students' online learning perceptions on learning outcomes via their readiness for online learning. It also determined the moderating effect of teachers' online teaching readiness on medical students' online learning perceptions and learning outcomes. We apply the theoretical lens of self-determination theory and constructivist theory to formulate hypotheses. We used self-administered and postal survey methods to collect data from fourth and fifth-year medical students on online learning perceptions, readiness for online learning, and learning outcomes in two waves. We also collected data from the teachers about their perceptions of online teaching readiness. We received 517 usable students' responses (Level-1) and 88 usable teachers' responses (Level-2). We tested Level-1 hypotheses about direct and indirect effects in Analysis of Moment Structures (AMOS), and a Level-2 hypothesis about moderating effect was tested using Hierarchical Linear Modeling (HLM). The results for the Level-1 hypotheses supported the positive effects of students' online learning perceptions and readiness for online learning on learning outcomes. Student readiness for online learning significantly mediated the relationship between online learning perceptions and learning outcomes. HLM results also supported a moderating effect of teachers' online teaching readiness on medical students' online learning perceptions and learning outcomes in such a way that learning outcomes were high when students' online learning perceptions and teachers' online teaching readiness were high. Based on the study's findings, we offer contributions to theory and practice.