Search

Introduction: Distal femoral physeal fractures are commonly observed in children with open growth plates who experience direct trauma. Biplane fractures have been documented, but triplane fractures are exceedingly rare. We present the case of a 17-year-old male with an immature skeletal structure who sustained a direct blow to his right knee in a road traffic accident, leading to this uncommon injury. Case presentation: The patient underwent a knee X-ray initially, followed by a CT scan for a more detailed assessment. The CT scan confirmed the diagnosis of a distal femoral physeal triplane fracture. Subsequently, open reduction and internal fixation were performed using a lateral parapatellar approach. Discussion: Distal femoral physeal triplane fractures are infrequently reported in medical literature, highlighting the rarity of this injury. Accurate diagnosis necessitates meticulous radiological examination, with CT scans being particularly useful. Treatment involves achieving anatomical alignment and stabilizing the fracture with screws or K-wires. Given the potential complication of limb length discrepancy, long-term monitoring until skeletal maturity is crucial. Conclusion: This clinical case highlights the scarcity of documentation in the literature of distal femur physeal triplaner and underscores the significance of precise radiological evaluation for accurate diagnosis. Early surgical intervention, along with careful long-term monitoring, can help mitigate potential complications and ensure favorable outcomes in these rare cases.

Background: Fracture of distal radius may be stable that is extra-articular, non-comminuted without distal radio ulnar joint disruption or unstable that is intra-articular, comminuted displaced with distal radio ulnar joint disruption. Complications of unstable fractures are shortening due to bone loss or due to resorption of the cancellous bone from metaphysis, resistant deformity, residual pain, late collapse, radio carpal arthritis and gross functional impairment. Aims and Objective: The purpose of this study to compare the relative efficacy of external fixation versus plating with regard to functional and radiological outcome. Materials and Methods: Total of 60 patients having intraarticular distal end radius fracture were included in this study and was equally divided into two groups, one group treated by external fixator other group with volar locking compression plate with or without augmentation by k-wire. Follow-up was done after 2 weeks, 4 weeks, 6 weeks and 3 ,6 and 12 months. The radiological evaluation was performed with Sarmiento’s Modification of Lindstrom’s Criteria. With the Modified Mayo Wrist Score, the patient’s functional outcomes were assessed and both groups were compared. Results: In this study we found that volar plate group had good to excellent outcome in 73% cases and 07% with fair outcome however with external fixator group found good to excellent in 50% cases and poor in 17% cases. Conclusion: In our study, we showed that the use of an external fixator and a volar locking plate for the treatment of intraarticular distal radial fractures were reliable. The relative simplicity of use, low surgical exposure, and decreased surgical trauma are benefits of external fixation. Despite these volar locking plates augmented with or without k wire had a good to excellent results in terms of early rehabilitation and less complications related to wrist joint. External fixator with ligamentotaxis provide significant good results in communited intraarticular distal end radius fracture.

Transfusion-related acute lung injury (TRALI), a life-threatening condition, remains an under reported complication, especially among neonates postexchange transfusion for unconjugated hyperbilirubinemia. Appropriate recognition and prompt treatment change the prognosis for good. The present case emphasizes that TRALI must be kept as a differential diagnosis in previously well neonates presenting with sudden onset hypoxia within or during 6 h of transfusion with evidence of bilateral infiltrates on a frontal chest radiograph, and no evidence of circulatory overload, left atrial hypertension, or pre-existing respiratory distress before transfusion. We report the rare occurrence of TRALI and its successful management with supportive hemodynamic management and corrective ventilator strategies.

Background: Increased body weight, repeated micro trauma and work on hard surfaces are the risk factors for plantar fasciitis. Platelet rich plasma (PRP) can be injected to various tissues where it releases high amounts of platelet derived growth factors that increases growth and healing process. Low level laser therapy (LLLT) is an alternative treatment that uses low power lasers. Potential benefits in reducing the pain and spasm. Methodology: Patients between 18 to 60 years were included in this prospective randomized controlled trial. Diagnosis made mainly on clinical grounds. We divided our patients in two groups randomly using simple number random method. GROUP-A patients treated with PRP along with laser therapy. GROUP-B treated with laser therapy only. We used visual analogue scale (VAS) and foot and ankle disability (FAD) index for assessment of pain relief during follow up. Results: 88 patients were included in this study. The VAS score was significantly (P

Background: Increased risk of proximal humerus fractures are seen in elderly group as their bones are osteoporotic or brittle. Mode of trauma in elderly patients with severe osteoporosis, fractures usually resulted from low velocity indirect trauma while high velocity trauma like road traffic accident was the cause of these fractures in younger age group. Surgery can be an option to obtain a better functional outcome or when a complex fracture needs to be fixed. With the advantages and the paucity of data on the functional outcome and efficacy of the following internal fixation with the PHILOS plate for displaced proximal humerus fractures in mind, the present study was planned. Methodology: Patients who fulfilled the selection criteria were informed about the study and were then enrolled. Following the surgery, patients were followed up regularly at six weeks, three months, and six months. Final outcome was analyzed by Constant Shoulder Score. Christopher Constant, with the help of the late Alan Murley during the years 1981–1986, devised the Constant Score, which was first presented in a university thesis in 1986 and whose methodology was later published in 1987. Results: A total of 30 patients sustained with proximal humerus fractures were studied. In this study of final assessment were Found 73.2 % good to excellent outcome by using the Constant Shoulder Score. Conclusion: Following this study, the inference can be drawn that proximal humerus internal locking system for the management of proximal humerus fractures give a good functional outcome in most patients. Hence PHILOS plate application for fixation of fracture proximal humerus in elderly patients hence allowing early mobilization of the shoulder.