No abstract available.
Fractures, Bone*

Scapulo-thoracic dissociation is an infrequent injury resulting from high energy trauma which is often associated with severe neurological and vascular injuries which may be unrecognised at the time of presentation. A 24 year-old female presented with bilateral rib fractures, pneumothorax, liver and kidney injuries following a road traffic accident. She also sustained fractures of her right scapula, odontoid, right transverse processes of the thoracic and lumbar vertebrae and a closed fracture of her right femur. Her right upper limb was later noted to be flail and pulseless, due to complete right brachial plexus injury, scapula-thoracic dissociation and subclavian artery avulsion. We managed the upper limb injuries non-operatively, and focused on resuscitation of the patient. Early exploration of the complete brachial plexus injury was not undertaken in spite of the possible associated poor functional outcome as there was no life-threatening indication.
Fractures, Bone

Introduction: Complex pelvic fracture, which has a very high mortality and even higher morbidity, needs internal fixation surgery as an integral part for its management. It was necessary to conduct a study regarding outcome of complex pelvic fractures after internal fixation surgery. Material & Method: Twenty-six patients with complex pelvic fractures that had been treated with internal fixation surgery during 2011-2014 were enrolled. These patients had an open pelvic fractures or Tile type B or C pelvic fracture who had undergone internal fixation surgery with at least 6 months follow-up. Evaluation of the morbidity and functional scoring was performed using Majeed and Hannover Score. Results and Discussions: Average of age was 31 years old and follow up time was 25 months. There were 7 patients with open pelvic fracture and 19 with closed fracture. Excellent Majeed Score were found on 78.6% cases in Tile B fractures and 50% in Tile C. Good Hannover Score was found in 64.3% Tile B cases and 80% Tile C cases. Fracture type was statistically insignificant with acquired sexual dysfunction (p>0.05), but significant with the chronic pain (p=0,.017). We also found that urogenital injury is associated with sexual dysfunction (p=0.005). Conclusions: The outcome of complex pelvic fracture after internal fixation surgery was excellent. More than 90% patients got an excellent and good result on Majeed Score, and also very good and good result on Hannover Score.
Fractures, Bone

Background: Treatment of humeral shaft fractures has been a subject of debate for many decades. Even though a large majority of humeral shaft fractures can be treated by non operative methods, few conditions like open fractures, polytrauma, ipsilateral humeral shaft and forearm fractures require surgical intervention. The goal of treatment of humeral shaft fractures is to establish union with an acceptable humeral alignment and to restore the patient to pre-injury level of function. The objective was to assess the incidence of radial nerve palsy, non-union and mean time required for in anteromedial plate osteosynthesis with anterolateral approach and also to measure the functional outcome of this procedure. Method: A prospective study was conducted in the Department of Orthopaedics, PESIMSR, Kuppam, Andhra Pradesh, from August 2012 to August 2015 with a total of 54 patients who were operated with anteromedial plate osteosynthesis were included in the study. RodriguezMerchan criteria was used to grade the functional outcome. Results: Of the 54 patients, 28 (58.85%) were in the age group of 30-40 years. The most common fracture pattern identified was A3 type (48.14%).The mean (+ SD) duration of surgery for anteromedial humeral plating was 53 ± 5.00 minutes. The time taken for the fracture to unite was less than 16 weeks in the majority or 50 patients (92.59%). Four (7.40%) patients had delayed union. There was no incidence of iatrogenic radial nerve palsy. Rodriguez – Merchan criteria showed that 37(68.51%) of the patients had good and 12 (22.22%) had excellent functional outcome. Key Words: Humeral shaft fractures; Plate osteosynthesis; Antero-lateral approach
Fractures, Bone

No abstract available.
Fractures, Bone*

No abstract available in English.
Fractures, Bone

Upper femoral fracture occurs in all ages but most common in elderly due to stumble. 14 cases of upper femoral fracture treated by porous splint AO were studied to evaluate the bone contiguity and mechanical rehabilitation. Results: good (all patients): certain bone contiguity; axis direct bone; normal fold of hip joint.
Fractures, Bone ; Femoral Fractures ; therapeutics

Background: Post-menopausal women experiences changes in estrogen levels affecting body metabolism, which may lead to weight gain and obesity. Moreover, one of the most prevalent diseases among this group is osteoporosis. However, the relationship between fat mass and its protective property remains unclear. This study assesses the correlation of fat mass with bone mineral density (BM) and 10-year FRAX based fracture probability among Filipino women. Methods: A cross-sectional review of records of post-menopausal Filipino women who underwent whole body bone mineral densitometry scans via dual-energy X-ray absorptiometry (DXA) between January 1, 2015, and December 31, 2018 in the Radioisotope Laboratory of the Philippine General Hospital was done. Pearson correlation and simple linear regression analyses were done to determine the correlation between the two outcomes – BMD and 10-year FRAX based fracture probability. Results: A total of 258 postmenopausal women were included in the analysis. There was a weak positive correlation of fat mass with BMD of L1-L4 vertebrae (R-score of 0.318), BMD of femoral neck (R-score of 0.3937) and hips (R - score of 0.3031). The 10-year FRAX based fracture probability for both hip and osteoporotic had very weak and weak negative correlation, respectively (R-score of - 0.06752 and - 0.29017). Conclusion Despite having varying available, data on the protective effects of fat mass on fracture protection, this study showed that fat mass has a poor correlation with BMD and reduction in FRAX probability.
Postmenopause ; Bone Density ; Fractures, Bone

No abstract available.
Forearm ; Fractures, Bone

PURPOSE: The goal of this study using the biomechanical test was to evaluate the mechanical stability of the bone-plate fixation system according to changes of the fracture gap sizes and widths. MATERIALS AND METHODS: For mechanical test, four types with different fracture models simulating the clinical situations were constructed depending on the gap size (FGS, mm) and the gap width (FGW, %) at the fracture site: 0 mm/0%, 1 mm/100%, 4 mm/100%, 4 mm/50%. For analyzing the effects of fracture gap on the biomechanical stability of the bone-plate fixation system, 4-point bending test was performed under all same conditions. RESULTS: It was found that the fracture gap sizes of 1 and 4 mm decreased mechanical stiffness by about 50~60% or more. Furthermore, even without fracture gap size, 50% or more fracture gap width considerably decreased mechanical stiffness and suggested the possibility of plate damage through strain results. CONCLUSION: Our findings suggested that at least 50% contact of the fracture faces in a fracture surgery would be maintained to increase the mechanical stability of the bone-plate fixation system.
Fractures, Bone ; Sprains and Strains