European Journal of Molecular & Clinical Medicine

Aim: To study the management of fibrous dysplasia of proximal femur by internal fixation
without grafting.
Methods: This retrospective study was carried out in the Department of Orthopaedic, IGIMS,
Patna, Bihar, India 17 patients with FD of proximal femur treated by internal fixation only
without grafting, were included in the study. Records of the patients were assessed for the
epidemiologic data, clinical manifestations, pathologic and radiologic investigations, number
and type of surgical procedures, the choice of implant used for fixation, functional outcome,
and complications. Pre- and postoperative plain radio- graph were reviewed; also, CT and
MRI were reviewed when available.
Results: The study included 11 male patients (64.71%) and 6 female patients (35.29%). The
mean age of the patients was 21.74 years. The mean follow-up period was 54.60 months the
mean MSTS score was 28.62 points. Four patients (76.47%) had postoperative complications.
One patient (5.88%) developed mild limping, which required shoe lift of 1 cm. One patient
(5.88%) experienced superficial wound infection, which was managed with antibiotics
efficiently. One patient (5.88%) had residual varus deformity and mild limping, which
required shoe lift of 1 cm. One patient (5.88%) had residual varus deformity and 3 cm limb
length discrepancy, which required also shoe lift.
Conclusion: we concluded that the internal fixation only without grafting has satisfactory
functional outcome that alleviates the patient’s symptoms, improves the limb function, and
prevents future morbidities such as deformities and pathologic fractures

Background: Major and unstable pelvic fractures as ipsilateral fractures of the
femur and acetabulum are likely to cause severe pain and shock. Poly trauma
management proceeds in line with ATLS protocol and Patients may require
lifesaving surgeries. The study aimed to assess outcome of open reduction and
internal fixation of psilateral fracture of acetabulum and fracture femur through
one approach as the effect way of treatment. Patients and methods: A prospective
study included 18 patients were presented with posterior wall acetabular fracture
with ipsilateral femoral fracture. Patients admitted Orthopedic surgery Department
of Zagazig University hospitals for fracture surgical fixations. Full history, clinical
examination and radiological assessment and Majeed Score were performed for all
patients. Follow up X rays were done in the 1st day postoperative, after two weeks,
3months , 6 months. Results: the healing time of femoral fracture ranged from 14
weeks up to 33 weeks with mean of 21.78 ± 5.9 and healing time of acetabular
fracture was 17.22 ± 4.1 weeks. 55.6% of studied group gave excellent Majeed score
of hip function, while only 16.7% were fair. Conclusion: Ipsilateral fractures of the
femur and acetabulum treated simultaneousness using Kocher-Langenbeck
approach did not demonstrate an increased risk of wound complications, and not
contraindicated to antegrade femoral nailing.

Bilateral femur fractures are uncommon in the adult population with most of the
patients presenting with or develop features of Fat embolism in early stages. The treating
team including Emergency physician,Surgeon and Intensivist and Anaesthesiologist are often
in a dilemma about appropriate management of these patients.The purpose of this study was
to review our institutional experience with a study of simultaneous bilateral femur fractures
with evolving symptoms of fat embolism and to highlight the presentation, treatment, and
outcomes of these injuries , in order to identify any clinically relevant differences that may
guide future management. Our study also helps us to guide for early intervention with
damage control nailing with smaller diameter nail instead of waiting for the symptoms of fat
embolism to wean off.

The importance of this biological and minimally invasive fracture treatment is to achieve
anatomical reduction and stabilization, which is not expected by conservative methods. The
biological principle of the elastic nail is based on symmetrical bracing action of two elastic
nails inserted into the metaphysis across the fracture site, each of which bears against the
inner bone surface at 3 points. Diaphyseal fractures of the femur and tibia accounts for 10-
15% of all paediatric fractures. This novel technique of elastic stable intramedullary nailing
(ESIN) has dramatically changed the treatment of pediatric fractures. The objective of current
study was evaluate the outcome, safety and efficacy of diaphysis fracture of femur and tibia in
children - treated by Titanium Elastic Nailing System (TENS). This observational,
interventional study was conducted in 30 patients in the age group of 6-12 years old children,
with fractures of long bones with Inclusion criteria: 6-12 years of age, Diaphyseal fractures,
closed fractures, Ipsilateral fractures, Fractures with head injury and exclusion criteria: of
Metaphyseal fractures, Compound fractures, Pathological fractures, Age group below 6 years
and above 12 years. TENS technique was used to stabilize these fractures. Patients were
followed-up clinically as well as radio-logically at 3,6,12 and 24 weeks and evaluated by Flynn
criteria. The current study had shown excellent results in 17 fractures (77.3%), good in 3
fractures (13.6%) and 2 cases has shown (9%) poor in femur fractures. Tibia results were
excellent in 5 fractures (62.5%) and good in 3 fractures (37.5%) with no poor results.
Conclusion: This study concludes that Titanium Elastic Nail System (TENS) technique is an
ideal treatment method for treatment of pediatric Diaphyseal fractures of lower limb bones.