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Register a new userLater results for treatment of intracapsular femoral neck Fractures in alt Patientes (after 1-2 year) by using partial prothesies (Bipolar)
نتائج علاج كسور عنق الفخذ داخل المحفظة عند المسنين (بعد سنة - سنتين) عن طريق استبدال المفصل الجزئي (Bipolar)
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غياث حلوم( باحث )
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شملت الدراسة 25 مريض, تم متابعتهم لمدة سنتين متواصلتين. تراوح عدد الإناث 18 مريضة بنسبة مئوية 72 %, تراوح عدد الذكور 7 مريض بنسبة 28 % . نسبة الإصابة بهذه الكسور عند النساء أكثر من الرجال بنسبة 1/3 و خاصة في العقدين السابع و الثامن حيث نلاحظ سيطرة النتائج الجيدة عند الإناث. يحدث الضعف العضلي بعد الجراحة بسبب قلة الاستخدام, و يستمر الضعف العضلي لفترة عامين بعد الجراحة مما يقترح استعمال التمارين لفترة طويلة . هناك تحسن ملحوظ بعد مرور سنتين على العمل الجراحي لكسور عنق الفخذ داخل المحفظة من حيث النتائج السريرية و الشعاعية, بالإضافة إلى تحسن في الفعاليات اليومية الروتينية (الوظيفية) للمريض مقارنة مع نفس الشريحة من المرضى بعد مرور سنة على العمل الجراحي. يعتبر التدبير الباكر و الحركة الباكرة ما أمكن لتقوية عضلات الطرفين السفليين و تحسين حركة المفاصل المجاورة, غياب الاذيات المرافقة, فترة الاستشفاء الأقل زمناً, تكنيك العمل الجراحي و تقنياته , العناية الطبية و تشجيع الفعاليات الفيزيائية من أهم العوامل التي ساعدت على تقييم الإنذار و التنبؤ به و بالتالي الحصول على مانصبو إليه من نتائج وظيفية جيدة.
The study included 25 patients were followed up for two years joined together. The number of females ranged from 18 patients percentage of 72%, the number of males ranged 7 patients by 28%. The incidence of these fractures in women more than men by 3/1, especially in the seventh and eighth decades where we note in this Study, a good results in females. Muscular weakness occur after surgery due to lack of use, and muscular weakness continue for a period of two years after the surgery, which suggests the use of exercise for a long time . There is a noticeable improvement in two years after the surgery for intracapsul femoral neck fractures within the portfolio in terms of clinical and functional findings, in addition to the improvement in activities of daily routine (functional) for the patient compared to the same segment of the patients one year after surgery. The early treatment and movement as possible to strengthen the muscles of the lower limbs and improve the adjacent joint movement, the absence of lesions associated , the period of hospitalization least for so, technique of surgery, medical care and physical activities encourage are the most important facturs that have helped to warning and predictable, then we get agood results as we wont.
References used
GRUNER A., HOTZ T., REILMANN H., Die periprothetische Fraktur. Der Unfallchirurg, 2004, 107,35-49
PEICHA G., CLEMENT H.G W., Vermeidbare Fehler und Komplik -ationen bei Osteosynthesen. Sympomed, München 2000,S. 333-344
BRADY O.H., GARBUZ D.S., DUNCAN C.P.,Classification of the hip. Orthop Clin N Am, 1999, 30,215-220
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THA as a primary management for acute fractures around the hip should
generally be reserved to a very selected few patients where the general
condition, life expectancy, age, bone quality, pathological changes, type of
injury...
Primary THA for a
cute fractures around the hip done with proper
patient selection under the proper condition, and requirements can result
in good clinical results with excellent short-term survival of the
prosthesis.
Background: Kid's body has major ability for remodeling and correcting all of
displacement that could happened on fractures.There is many ways for treatment of these
fracture,we can put them in tow guidelines:
Surgical treatment, conservative trea
tment.
Aim: Comparison between conservative treatment result and result of surgical
treatment via ESIN in treatment of midshaft forearm fractures in children, and chose the
best method that achieve healing in fast time and with less complications.
Methods: the study included 40 kids ,that have been chosen in random way from
children that came to the ER and clinics in Alassad and Tishreen university hospitals in
time between 2012 and 2017,with age of 9 to 14 years.
Results: The results were similar between conservative treatment and surgical
treatment via esin according to healing ,time at hospital ,and costs .time to return to daily
life is shorter in surgical treatment. complications were found in two methods but there
were no effect on the extremity or the child.
Closed reduction and percutaneous pin fixation is considered
standard management for displaced supracondylar fractures of the
humerus in children. However, controversy exists regarding whether
to use pins from the lateral side or medial and latera
l side of the
elbow for fixation .
We performed this research to know the results of two ways of
treatment and to compare : 1- the risk of iatrogenic ulnar nerve
injury caused by pin fixation . 2- quality of fracture reduction in
terms of radiographic outcomes . 3- compare function of the elbow
and other surgical complications caused by pin fixation between two
ways.
The research has been done in Alassad University Hospital in Lattakia, from January 2009 to January 2011 and included 80 pseudophakic eyes of 80 patients ] 36 (45.0%) belonged to male sex and 44 (55.0%) females[ older than 15 years having PCO with
decreased best corrected Visual Acuity (VA) of two or more Snellen’s chart line. Before laser treatment, the VA was assessed and all patients were examined on slit lamp for IOP and to rule out the causes for reduced vision other than PCO. Then 2-3 mm size capsulotomy was done with Q-switched Nd: YAG Laser, with Abraham’s posterior capsulotomy lens, after topical anesthesia, by using minimum amount of energy and fewest numbers of pulses. Patients were followed for assessment of best corrected VA and for possible complications just after laser and at the end of 1st week, 2nd week and the 4th week. The post-laser treatment was advised in accordance with complications to each patient.
The types of PCO were fibrosis in 54 (67.5%) eyes, Elschnig pearls in 16 (20 %) eyes and wrinkling in 10 (12.5%) eyes. Pre-laser visual acuity was CF-6/60 in 42 (52.5%) eyes, 6/36-6/24 in 23 (28.75%) eyes and 6/18-6/12 in 15 (18.75%) eyes. Post-laser VA was improved to 6/9-6/6 in 60 (75%) eyes. Out of 80 patients, 10 (12.5%) eyes developed the complications due to YAG laser which included IOL pitting in 4 (5%) eyes, raised IOP in 1 (1.25%), uveitis in 2 (2.5%), iris bleeding (hyphema) in 1 (1.25%), vitreous in anterior chamber in 1 (1.25%), and cystoids macular edema (CME) in 01(1.25%) eye. None of the eye developed sight threatening complications like retinal detachment or macular hole. The 20 (25%) eyes did not achieve the significant improvement because of pre-existing pathology in the posterior segment that was not diagnosed at the time of screening due to thick PCO.
This means that Nd: YAG laser capsulotomy is effective and convenient method for doing capsulotomy in all types of PCO. It is free from the risk of endophthalmitis found in surgical capsulotomy.
The intraarticular fracture of distal end of radius have bad returns more than extra articular fractures whereform the range of motion in flexion and extension, radial variance and ulnar variance of the joint. Shortness of the radius and the directio
n of articular surface of the radius should be corrected. The integrity of radial articular surface play an important rule in determining results. Displacement of the articular surface more than 1 mm cause an obstinate pain and synarthrophysis thereafter. More than 92% of the patients with disalignment of articular surfaces with space more than 2 mm end with arthrosis in the radial carpal joint. Through examening patients with union with shortness of radius more than 2 mm, we notices recuction of the wrist range of motion ) flextion-extention- pronation -supination) more than patients without shortness. Also we couldnt find sufficient statitics about the pain during motion.
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