Print ISSN: 1683-3589

Online ISSN: 2409-501X

Main Subjects : orthopedic

Patterns of Non-union of Femoral Shaft Fracture in Basra Teaching Hospital. A Retrospective review.

Mofeed Yaseen Alwaaly

Basrah Journal of Surgery, 2021, Volume 27, Issue 2, Pages 37-42
DOI: 10.33762/bsurg.2021.131908.1012

Background and objectives: Long bone fractures are witnessed almost every day in the orthopedic practice. Femoral shaft fractures (FSF) generally are due to high energy trauma in working age group. non-union of FSF is not infrequently encountered challenge. This study reviews cases of FSF that ends up with non-union in Basra Teaching Hospital to explore some factors related to non-union.
Patients and methods: A retrospective case series were conducted in Basra Teaching Hospital from January 2012 - June 2014 including 124 patient with FSF. Thirty three patients were identified during the study period (18 months), demographic criteria and injury patterns, initial treatment, early complications, subsequent interventions and fate of the patients are described.
Results: Among 33 patients with nonunion FSF, 23 were males and 10 females, aged from 15 to 60 years (mean = 35). High energy trauma is the chief source of FSF in this analysis .
After 9 - 12 months from initial trauma, patients ends up with non-union, 9 atrophic, 13hypertrophic and 11 infected non-union. Thirty patients underwent revision surgery, with addition of bone graft , three patients no revision surgery, within the study period ( 18 months ), 25achieved successful union or showing signs of progressive union , 3 had united fractures with chronic osteomyelitis , 5 non-united fractures .

Conclusion: nonunion of FSF a great challenge to the orthopedic surgeon and the patient life and development, to overcome this problem both the surgeon and the patient should cooperate to avoid this tragedy story.



Basrah Journal of Surgery, 2021, Volume 27, Issue 1, Pages 59-65
DOI: 10.33762/bsurg.2021.129221.1002

Legg-Calve-Perthes disease is a juvenile idiopathic aseptic, non-inflammatory, osteonecrosis of immature hip in which the blood supply of femoral epiphysis is not sufficient and the bone dies provisionally followed by a subchondral fracture, fragmentation, revascularization and remodeling. It is associated with both substantial hip pain and dysfunction during the disease process as well as later in adulthood. The goals of treatment are to decrease pain, reduce the loss of hip motion, and prevent or minimize permanent femoral head deformity. In the current study, authors evaluated the outcome of proximal femoral varus derotation osteotomy in children with Legg-Calve-Perthes disease.
Material & Methods:
All the children (up to 16 years) presenting with Perthes disease, of both sex and willing to get enrolled in the study and were managed by proximal femoral varus derotation osteotomy were included in the study. Evaluation were done in terms of clinical symptoms and signs, Harris hip score and radiologically with X-rays.
The study results indicated improvement in pain, limp, abduction, internal rotation and Harris Hip Score which was statistically significant in the study subjects.
According to this study, proximal femoral varus derotation osteotomy is an acceptable method for management of patients with Legg-Calve-Perthes disease in all age group of patients. This surgery led to decrease in pain, limping, and increase in range of motion.

Clinical results and functional outcome of humeral shaft fractures treated with MIPO technique

Ashish Jaiman; Rajat Ranjan; Rajesh Kumar Chopra

Basrah Journal of Surgery, 2020, Volume 26, Issue 2, Pages 38-47
DOI: 10.33762/bsurg.2020.127563.1000

The pursuit of anatomical reduction in fracture fixation has been replaced by anatomic alignment and biologic fixation. Minimally invasive plate osteosynthesis (MIPO) is one such biological method.
The aim of this study was to evaluate the clinical results and functional outcome of humeral shaft fractures treated with MIPO technique.
Material and Methods:
A hospital based prospective serial follow up study was conducted. We enrolled 30 patients for our study with displaced humeral shaft fractures, which were fixed by the technique of closed reduction and minimally invasive plate osteosynthesis (MIPO).
Patients were followed-up for a period of 6 months. Different parameters were evaluated at follow up visits. Functional evaluation was done by UCLA (University of California & Los Angeles) scoring for shoulder and Mayo Elbow Performance Score (MEPS) for elbow.
83.33% patients had anatomical alignment at 6 months. 6.67% had less than 5° varus angulation, 10% had less than 5 ° valgus angulation. 5 patients (16.67%) had radial nerve injury. 63.33% patients had excellent UCLA scores at 6 months. Majority of the patients (93.33%) had excellent MEPS scores.
Our study supports that MIPO is a decent method of treating humeral shaft fractures but it requires adequate imaging and surgical experience. Optimum arm function is achieved at an early date with better cosmesis. Suitable healing and low infection rates are obtained with MIPO. Risks of iatrogenic nerve injuries are low if appropriate surgical technique is used.