Online ISSN: 2515-8260

Keywords : open reduction and internal fixation

Comparative study of functional outcome of distal humerus intra-articular fracture treated with parallel plates and with orthogonal plates (A study of 30 cases)

Dr.Daljinder Singh, Dr Akashdeep Singh, Dr Sanjeev Sareen, Dr Annie Sandhu

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 39-52

Intra-articular distal humerus fractures remain one of the most difficult injuries to
manage. These fractures comprises 2-6% of all fractures and have bimodal age
distribution. The majority of these fractures occur either as low energy falls or high
energy trauma. Most fractures in elderly patients are intra- articular with bi-columnar
involvement. They are commonly multifragmental and occur in osteopenic bone. High
energy injuries occur in adults, which are accompanied with other associated injuries.
The elbow is anatomically a trocho-ginglymoid joint in which distal humerus bifurcates
into two divergent cortical columns, termed as medial and lateral columns. The articular
segment functions architecturally as a tie arch. The elbow is one of the most constrained
joints of the body and tolerates immobilization poorly and any alteration within the
architecture of the joint has the potential to limit motion and compromise
function.Treatment outcomes are often related to elbow stiffness, weakness and pain.
Meticulous planning is required in obtaining an anatomic intra-articular reduction, and
creating a fixation construct that is rigid enough to tolerate early mobilization. Usually,
70% of patients that sustain an elbow fracture, fall directly on to the elbow because they
are unable to break their fall with an out stretched arm. This randomized, prospective
study was undertaken to compare the functional outcomes of distal humerus intraarticular
fractures in adults treated with parallel plates and orthogonal plates. From a
clinical perspective, a parallel plating method appears to provide better rigid fixation that
is adequate for obtaining bone union. However, no statistical significant differences were
observed between the orthogonal and parallel double plating methods in terms of clinical
outcomes and complication rates. If meticulously applied, with suitable plates, both
parallel and orthogonal positioning can provide adequate stability and anatomic
reconstruction of the distal humerus fractures.

Infective Organisms With Their Changing Antibiotics Sensitivity Trends In Orthopedics Implant Surgery Infections

Mangal Mohammad Naeem; Khalid M. Qasem; Orya Mujeeburrahman

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 5349-5352

Objective: To know about the various pathogens causing infection in orthopaedic implant surgeries and their antibiotic sensitivities.
Methods: This prospective study was conducted jointly in Departments of Orthpaedics and Trauma of Kausar Hospital, Afghan Hospital and Emergency Hospital, Kabul, from April 2019 to April 2020. All patients having close fractures of long bones including humerus, radius/ulna, femur and tibia requiring open reduction and internal fixation (ORIF) were included. Patients data was noted on a preformed proforma. Patients were followed up to 6 months.
Results: 30 patients out of 650 developed Surgical site infection were selected. 23 were male and 7 were female patients. Age range was from 5-75 years. Staphyloccus Aureus including Methicillin resistant Staphylococcus Aureus MRSA was most common cultured organism, followed by E Coli and pseudomonas. 23 cases yielded single organism, 5 cases yielded 2 organisms, 1 case yielded 3 organisms. There was no organism growth in one case.
Conclusion: Staphylococcus Aureus including MRSA is the main cause of surgical site infection in orthopedics implant surgery. Other bacteria like E.Coli may cause surgical site infection. Antibiotics should be prescribed according to culture and sensitivity reports.