1.Olecranon Osteotomy Approach for Complex AO-13C Fractures of Distal Humerus: A Prospective Analysis of 24 Cases
Malaysian Orthopaedic Journal 2019;13(1):30-35
Introduction: Olecranon osteotomy is well described approach for complex intra-articular distal humeral fractures. In this study, we investigated the usefulness and complications of olecranon osteotomy approach for such fractures. We hypothesise that outcome is comparable in young adults and middle age group and also functional outcome is independent of fracture subtype following surgical fixation. Materials and Methods: Between December 2012 and September 2015, twenty-four adult patients (male: 15, female: 9) having mean age of 41.4 years with closed intra-articular fracture (AO-13C) were surgically managed using olecranon osteotomy approach and were followed-up for a mean of 28.5 months (range: 22-35 months). Functional outcome was measured using Mayo Elbow Performance Score (MEPS) and complications were observed. Statistical analysis was done using Student t-test and Kruskal Wallis test. Results: All fractures united by the end of three months. Mean elbow flexion achieved was 123°, mean extension lag was 9° and mean active arc of motion was 114°. Mean MEPS was 87 (excellent: 8, good: 14, fair: 1 and poor: 1). Post-operative transient ulnar nerve palsy was noted in two cases, heterotopic ossification (HO) was in one case, infection in two cases, implant prominence in five and elbow stiffness in three cases. Motion arc was higher in young adults and MEPS was comparable in both age group. Functional outcome was also dependent on fracture subtype. Conclusion: The olecranon osteotomy approach for distal humerus fractures had good functional outcome with fewer complications. Joint congruity and fixation could easily be assessed intraoperatively.
2.Predicting Quadruple Semitendinosus Graft Size for Anterior Cruciate Ligament Reconstruction by Patient Anthropometric Variables: A Cohort Study of 280 Cases
Singhal D ; Kanodia N ; Singh R ; Singh SK ; Agrawal S
Malaysian Orthopaedic Journal 2021;15(No.3):71-77
Introduction: Pre-operative identification of patients with
inadequate hamstring graft for anterior cruciate ligament
reconstruction is still a subject of interest. The purpose of
this study is to correlate dimension of a harvested
dimensions graft with patient physical anthropometric
variables.
Materials and methods: This cohort study included 280
patients (male = 226, female = 54) scheduled for primary
anterior cruciate ligament (ACL) reconstruction.
Interrelationships between quadruple semitendinosus (ST)
graft and anthropometric parameters (age, sex, height,
weight, and BMI) were assessed using Pearson Correlation
test and regression analysis. Difference among gender was
analysed using Mann Whitney and t test. The observed graft
diameter was also compared with the literature using Bland
– Altman plot.
Results: Mean age of cohort was 29 years (range, 17-50
years), mean height was 1.69m (range, 1.6-1.9m), mean
weight was 75 kg (range, 50-116kg) and mean BMI was
26kg/m2 (range 16.65-40.40kg/m2). Mean quadruple length
of harvested ST graft was 7cm (7.1±0.6 cm, range, 5.6-
8.8cm) and mean diameter was 8mm (8.2±0.8mm, range,
6.5-10mm). Only height and weight were significantly
correlated with graft length and diameter in both sex (p value
<0.05). Female, compared to male, had significantly smaller
(p<0.0001) and thinner graft (p<0.0001). There was a strong
agreement between the literature and our observed graft
diameter, but with an overestimated graft diameter in 18.5%
of the cases.
Conclusion: Among anthropometric parameter, only height
and weight had moderate positive correlation with graft
diameter. Males had longer and wider ST graft in contrast to
age-matched female group.