European Journal of Molecular & Clinical Medicine

Introduction: This study compares two of the widely used procedures for olecranon fracture fixation in attempt to find a conclusive data and form a treatment protocol.
Material and Method: It is a single-blinded, prospective randomized study performed at single centre, aims to compare the outcomes of tension band wiring and plating for the isolated two part olecranon fracture fixation. 40 patients with mean age of 32y ( range 22 to 45) were included in the study and randomized to either TBW (n=20) or plate fixation (n=20) group  and were evaluated at 4 weeks, 12 weeks, 6 months and 12 months, post-operatively.
Results: Patients were assessed using DASH (Disabilities of Arm, Shoulder and Hand) score and Visual Analogue Score (VAS) at final follow-up at one year. DASH scores were comparable among two groups, Range of movement were satisfactory in both groups, four patients in TBW group complained of implant protrusion through skin and irritation during elbow movement, those patients were re-operated for loosening of implant and implant irritation. One patient in Plate group complained of painful range of movement and joint stiffness. Mean Union time was comparable in both groups. (6-8 weeks). Overall complication rates were higher in TBW group.
Conclusion:  Although fracture union time and range of movement was almost similar in both groups, TBW group patients reported complications more often, mostly because of implant irritation and impingement.

To evaluate whether a tapered short term course of Deflazacort given with Acetaminophen has any additional benefit in treatment of frozen shoulder for improving pain, function and range of motion compared to Acetaminophen alone.
Design: Randomised control trial.
Participants: 59 participants [27 Group A, 32 Group B].
Interventions: Group A – Tapered short course Deflazacort + Acetaminophen
Group B - Acetaminophen
Main outcome measures: Activity related pain, DASH, range of active motion measured at presentation, 1^st, 3^rd, 6^th and 12^th weeks.
Results: Overall VAS score outcome at 12th week was better in group-B than group-A [2(1-3) vs. 0(0-2), p value <.05]. No significant difference was seen in DASH score at presentation (42.31±15.86 vs 36.24±18.28, p value=0.183) to 12th week (34.27±14.87 vs 25.97±20.69, p value=0.079) between the two groups. In the short term, better outcome in range of movement was seen in group A in flexion upto 3 weeks [160(150-170) vs 140(130-160), p value=0.006] and extension upto 6 weeks [40(30-43.75) vs 30(30-40), p value=0.015] which was not maintained at further follow-up at 12^th week. No significant difference in abduction, adduction, external rotation, internal rotation was seen between the two groups.
Conclusion: Providing a short tapered course of oral Deflazacort as an adjuvant in treatment of frozen shoulder showed short term improvement in single plane of movement which was not maintained by 12^th week and with poorer outcomes in the long term on pain and no additional benefits in daily functional ability and other movements

Introduction: Shoulder pain is the most common complaints in medicine and disorders attributed to the rotator cuff are the most common cause of shoulder pain. More than 50% of all shoulder pains are considered to be that related to tendinopathies of the rotator cuff, as supraspinatus in complete thickness tears and tendinosis1. Platelet rich plasma (PRP) is a preparation of concentrated autologous platelets containing growth factors and bio active substances essential to musculoskeletal healing. It involves minimum risk of immune reactions and transmission of infectious and contagious disease. With this we need assess the efficacy of PRP shoulder.

Background: To study the surgical management of fractures of lower one third of humerus by Extra articular distal humerus locking compression plate in adults.
Materials and Methods: The present study was done in Govt Medical College /Hospital, Suryapet from December 2021 to May 2022. 20 cases of lower one third humerus shaft fractures were treated with open reduction and internal fixation with Extra Articular Distal Humerus Locking Compression Plates (EADHP).
Results: 6 patients were (30%) in the age group of 18-35 yrs & 51-65 yrs each. 14(70%) were Male patients. 13(65%) Left side involved patients. 16(80%) patients sustained injury due to road traffic accident. 12 B1 Type was most common pattern. 18(90%) were closed fractures. 3(15%) were associated with multiple injuries Mean of time for Fracture union in 18 patients (90%) was 13.9 weeks. 3(15%) patients developed post-operative complications. Radial nerve neuropraxia 2(10%) cases and Superficial infection 1(5%) case. Average DASH score was 17.6 with range 12.5 to 33.5 points. Functional outcome as per Mayo Elbow Performance Score was excellent in 18(90%) cases; good in 2(10%) cases.
Conclusion: We conclude as per AO principles that early operative intervention with Extrarticular Distal Humerus Locking Compression Plating (EADHP) on postero- lateral column of humerus for these fractures will result in excellent functional outcome.

Introduction: Pain and decreased ROM is a common presenting condition to orthopaedic outpatient department. Primary Frozen shoulder is estimated to affect 3 to 5% of the general population since PRP is an autologous biologic material, it involves a minimum risk of Immune reactions and transmission of infectious and contagious disease. With this we need assess the efficacy of PRP Shoulder.
Aim and Objective: To assess the efficacy of Platelet Rich plasma in periarthritis shoulder.
Methods: This study included 50 patients diagnosed with periarthritis shoulder and were recruited from the outpatient department of orthopaedics, VIMS, Bellary from the period between November 2018 -2020. The study included both sexes. All patients were injected intraarticularly with PRP. They were evaluated by visual Analogue scale (VAS) for pain and a shortened version of disabilities of arm, shoulder and hand using DASH score for function.
Results: Descriptive and inferential statistical analysis has been carried out in the present study Descriptive and inferential statistical analysis has been carried out in the present study using Student ‘t’ test (two tailed, dependent & independent) and Fisher test. The improvement in VAS score and DASH scores at 3rd, 6th and 12th week follow up in patients who received PRP injections was statistically more significant compared to scores at the time of admission as inferred by p value of <0.05. Using Student ‘t’ test (two tailed, dependent & independent) and Fisher test. The improvement in VAS score and DASH scores at 3rd, 6th and 12th week follow up in patients who received PRP injections was statistically more significant compared to scores at the time of admission as inferred by p value of <0.05.
Interpretation & Conclusion: Our study concludes that the efficacy of single injection of platelet rich plasma to relieve the pain of Periarthritis shoulder is effective less-invasive lines of treatment over a short term follow up period. However more studies are required to evaluate the efficacy of PRP over long term with multi centric study & comparison with the current available treatment options.

Introduction: The goal of treatment of distal fracture of radius is restoration of normal function and prevention of complication like malunion, joint stiffness and deformity but achievement of desired outcome is always a challenge in fracture of distal end of radius.
Materials and Methods: Patients with unstable comminuted fracture of distal radius admitted in the department of orthopedics and enrolled for this study based on inclusion and inclusion criteria. For functional assessment of outcome, we used DASH (Disability of the Arm, shoulder and hand) Method.
Result: The mean of DASH score was16.24±4.62 in external fixation group and 14.65±3.98 in internal fixation group. Both groups are comparable to each other as it is not statistically significant (P˃ .05). There is no incidence of compressive neuropathy, Sudeck’s osteodystrophy, iatrogenic rupture and nerve injury.
Conclusion: DASH score was less in internal fixation group. Post-operative infection was high in internal fixation group. Functional outcome was better in internal fixation group.