1.Treatment of Middle Third Humeral Shaft Fractures with Anteromedial Plate Osteosynthesis through an Anterolateral Approach
Kumar BS ; Soraganvi P ; Satyarup D
Malaysian Orthopaedic Journal 2016;10(1):38-43
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
2.Is Platelet-rich Plasma Injection more Effective than Steroid Injection in the Treatment of Chronic Plantar Fasciitis in Achieving Long-term Relief?
Soraganvi P ; Nagakiran KV ; Raghavendra-Raju RP ; Anilkumar D ; Wooly S ; Basti BD ; Janakiraman P
Malaysian Orthopaedic Journal 2019;13(3):8-14
Introduction:Plantar fasciitis is characterised by pain in the heel, which is aggravated on weight bearing after prolonged rest. Many modalities of treatment are commonly used in the management of plantar fasciitis including steroid injection. Many studies show that steroid injection provides pain relief in the short term but not long lasting. Recent reports show autologous platelet-rich plasma (PRP) injection promotes healing, resulting in better pain relief in the short as well as long term. The present study was undertaken to compare the effects of local injection of platelet-rich plasma and Corticosteroid in the treatment of chronic plantar fasciitis. Materials and methods:Patients with the clinical diagnosis of chronic plantar fasciitis (heel pain of more than six weeks) after failed conservative treatment and plantar fascia thickness more than 4mm were included in the study. Patients with previous surgery for plantar fasciitis, active bilateral plantar fasciitis, vascular insufficiency or neuropathy related to heel pain, hypothyroidism and diabetes mellitus were excluded from the study. In this prospective double-blind study, 60 patients who fulfilled the criteria were divided randomly into two groups. Patients in Group A received PRP injection and those in Group B received steroid injection. Patients were assessed with visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) score. Assessment was done before injection, at six weeks, three months and six months follow-up after injection. Plantar fascia thickness was assessed before the intervention and six months after treatment using sonography. Results: Mean VAS in Group A decreased from 7.14 before injection to 1.41 after injection and in Group B decreased from 7.21 before injection to 1.93 after injection, at finalfollow-up. Mean AOFAS score in Group A improved from 54 to 90.03 and in Group B from 55.63 to 74.67 at six months’ follow-up. The improvements observed in VAS and AOFAS were statistically significant. At the end of six months’ follow-up, plantar fascia thickness had reduced in both groups (5.78mm to 3.35mm in Group A and 5.6 to 3.75 in Group B) and the difference was statistically significant. Conclusion: Local injection of platelet-rich plasma is an effective treatment option for chronic plantar fasciitis when compared with steroid injection with long lasting beneficial effect.