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1.
Int J Clin Pract ; 75(9): e14488, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34115438

RESUMO

OBJECTIVE: To evaluate the clinical and radiological outcomes of the Ilizarov fixator in the proximal and distal fractures of the tibia. MATERIALS AND METHODOLOGY: This retrospective study reviewed 59 patients having high-energy intra-articular proximal and distal tibia fractures associated with severe soft-tissue injury, who were managed surgically with an Ilizarov fixator. The functional outcome was evaluated by using the American Orthopaedic Foot and Ankle Society scoring system (AOFAS) and the Association for the Study and Application of the Method of Ilizarov (ASAMI) Italy scoring system for tibial plateau and plafond fractures respectively. RESULTS: The most common mode of injury was road traffic accidents. According to the Gustilo open fracture classification, there were 16 patients with grade-I and nine with grade II open fractures. The remaining had closed fractures. According to the Schatzker classification of plateau fractures, 20 were graded as type V and 15 as type VI. According to the AO classification of plafond fractures, 12 fractures were graded as Type-43C1, 5 as Type-43C2, and 7 as Type-43C3. There was delayed union in 11 proximal and four distal fractures, all of which achieved union without additional bone grafting. In proximal fractures, according to AOFAS, out of 35, 26 had an acceptable while nine had a fair result. In distal fractures, according to ASAMI, out of 24, 16 had an acceptable while five had fair results. There were 192/448 wires in 58 patients with pin site infection; all were superficial and settled. Posttraumatic joint arthrosis was noted in nineteen. CONCLUSIONS: The postoperative clinical and radiological outcome indicated that primary Ilizarov external fixator is a reliable minimal invasive surgery and definitive fixation method for high-energy intra-articular proximal and distal tibial fractures with compromised soft-tissue. It also offers early stabilisation and painless joint motion without a high rate of complications.


Assuntos
Fraturas Intra-Articulares , Fraturas da Tíbia , Adulto , Fixadores Externos , Humanos , Fraturas Intra-Articulares/diagnóstico por imagem , Fraturas Intra-Articulares/cirurgia , Estudos Retrospectivos , Tíbia , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/cirurgia , Resultado do Tratamento
2.
Int J Clin Pract ; 75(5): e14056, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33525057

RESUMO

OBJECTIVE: The purpose of the current analysis is to evaluate the predominance of vitamin D inadequacy in children with supracondylar fracture of the humerus. METHODS: This is a cross-sectional study conducted at Dr Ruth K. M. Pfau Civil, Hospital, Karachi, Pakistan, from December 2019 to July 2020. Patients aged 18 months-18 years presenting with supracondylar fractures were included in the study. Patients were divided into four groups based on their age as toddlers (18 months to 3 years), pre-school age (3-5 years), school-age (6 to 11 years) and adolescents (11-18 years). RESULTS: A total of 227 children presented with upper limb fractures of which 72 (31.7%) were supracondylar. The mean vitamin D level was found to be 32.5 ± 9.1 ng/mL. Of the study subjects, low vitamin D levels were found in 34.7% (n = 25), adequate in 59.7% (n = 43) and ideal in 5.5% (n = 4) of patients. The mean vitamin D levels for toddlers were 33.5 ng/mL, for preschool children was 27.66 ng/mL, for school-age children was 30.4 ng/mL and for adolescents was 37 ng/mL. CONCLUSION: Vitamin D deficiency is not only restricted to Pakistan but also other parts of the world, although the reasons may vary in each of those regions. However, vitamin D supplementation in all parts of the globe can prevent a significant number of fractures. This prevalence study showed vitamin D deficiency in 35% of children with supracondylar fractures, with the lowest mean values in the preschool age group.


Assuntos
Deficiência de Vitamina D , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Humanos , Úmero , Paquistão/epidemiologia , Prevalência , Vitamina D , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia
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