Common Cause Of Fracture Research Articles

Epidemiology of fractures: The role of kick injuries in equine fractures.

Fractures occur commonly in equids and often are associated with complications and a poor outcome. There are no reports on the epidemiology of fractures in a heterogeneous equine population. To study the epidemiology of fractures in a heterogeneous equine population, focusing on differences between fractures resulting from a kick and fractures, resulting from other causes and investigating predictors for recovery. Retrospective case series. Data of all equids presented to the Equine Department, Vetsuisse Faculty, University of Zurich between 1990 and 2014 and diagnosed with a fracture were reviewed and those with a known cause were included in this study. Mann-Whitney and chi-squared tests were used to compare recovery rates of fractures resulting from a kick and fractures resulting from other causes, and a logistic regression was carried out for multivariate analysis of the most important factors affecting recovery. Here, 1144 cases fulfilled the inclusion criteria. Of all fractures (with a known cause), 43.6% were the result of a kick from another equid. Kicks often produced open fractures (44.7%) that involved bones of the limbs (85.6%). Overall recovery was 70.1%. Logistic regression showed that high-grade lameness accompanying the fracture and severe comminution negatively affected recovery. The equids in this study were drawn from a referred population, which likely precluded the inclusion of both minor fractures and catastrophic fractures that necessitated immediate euthanasia. Moreover, many cases were excluded because the cause of the fracture could not be determined from the patient record. Kicks are the most common cause of fractures in a heterogeneous equine population and measures to reduce the incidence of kicks are necessary in group-housing systems.

Assessment of Limb Fractures in Children Below 12 Years of Age

Background: In Iran, trauma is the second cause of mortality after cardiovascular diseases. Since children are known to belong to one of the high-risk age groups, the identification of the prevalent fractures in this age group could aid the identification of causes of fractures as well as damages observed in this group. Methods: In this descriptive cross-sectional study, a total of 5187 patients under 12 years of age, with definitive diagnosis of fractures referred to the Taleghani hospital of Kermanshah, were evaluated and the information was extracted from the patients’ records according to a researcher-built checklist, the validity of which was confirmed by 2 faculty members. The data was analyzed using SPSS v.16 software. Results: The average age of patients was 6.4±5.32 and their hospitalization duration was 1.2±0.98 days. Herein, 3579 patients (67% of the total number of patients) were male and a significant difference was observed between the 2 genders (P < 0.001). Furthermore, 3498 subjects (65.4%) had upper-limb fractures, 1662 subjects (31.2%) had lower-limb fractures, and 182 cases (3.4%) had non-limbic fractures. The most common cause of fracture was falling from a height (77%). Conclusions: The results demonstrate that a high percentage of fractures resulted from falling from a height, in males younger than 12 years old.

Implementation of a fall screening program in a high risk of fracture population.

Falls are the most common cause of fracture in persons with osteoporosis. However, osteoporosis care rarely includes assessment and prevention of falling. We thus sought to assess the feasibility of a fall screening and management program integrated into routine osteoporosis care. The program was developed and offered to patients with osteoporosis or osteopenia seen at an outpatient clinic between May 2015 and May 2016. Feasibility was measured by physical therapist time required to conduct screening and ease of integrating the screening program into the usual clinic workflow. Self-report responses and mobility testing were conducted to describe the fall and fracture risk profile of osteoporosis patients screened. Effects on fall-related care processes were assessed via chart abstraction of patient participation in fall prevention exercise. Of the 154 clinic patients who presented for a clinic visit, 68% met screening criteria and completed in two thirds of persons. Screening was completed in a third of the time typically allotted for traditional PT evaluations and did not interfere with clinic workflow. Forty percent of those screened reported falling in the last year, and over half had two or more falls in the past year. Over half reported a balance or lower extremity impairment, and over 40% were below norms on one or more performance tests. Most patients who selected a group exercise fall prevention program completed all sessions while only a quarter completed either supervised or independent home-based programs. Implementation of a fall risk screening program in an outpatient osteoporosis clinic appears feasible. A substantial proportion of people with osteoporosis screened positive for being at risk of falling, justifying integration of fall prevention into routine osteoporosis care.

Zygomatic Fractures: A 10-Year Retrospective Epidemiological Study

Background: Zygomatic fractures are among the most common maxillofacial injuries. Objectives: This study aimed to assess the incidence and causes of zygomatic fractures in patients referring to Tehran Taleghani hospital during a 10-year period. Methods: This descriptive, retrospective, cross-sectional study was conducted on 294 records of patients (248 males and 46 females) with zygomatic fractures selected via census in Tehran Taleghani hospital from 2003 to 2013. Age, gender, cause of fracture, type of treatment modality, and post-operative complications were extracted and reported by using descriptive statistics. Data were analyzed using chi square and Fisher’s exact tests. Results: Most patients were aged 20 - 30 years (n = 121, 42.1%). Car accident (n = 97, 33%), motorcycle accident (n = 89, 30.3%), and fall from height (n = 44, 15.1%) were the most common causes of fractures. The most common associated fracture was mandibular fracture (n = 104, 35.4%). The most common type of zygomatic fracture was zygomaticomaxillary complex (ZMC) fractures (87.3%) treated by open reduction with internal fixation (84.8%). Paresthesia or hypoesthesia of the infraorbital nerve (n = 177, 64.6%) was the most common complication. Periorbital ecchymosis (n = 159, 58%) was the most common ocular complication. Epistaxis (P = 0.01), paresthesia and hypoesthesia of infraorbital nerve (P = 0.016), enophthalmos (P = 0.014), step formation at the inferior orbital rim (P < 0.001), periorbital ecchymosis (P < 0.001), and subconjunctival hemorrhage (P = 0.006) had a higher frequency in ZMC compared to non-ZMC fractures. Conclusions: Zygomatic fractures comprised 22.8% of all maxillofacial injuries and they occurred mainly due to traffic accidents with a higher prevalence in males aged 20 - 30 years. They were mostly treated by open reduction with internal fixation.

Comparison of study of a dynamic condylar screw surgery and distal femoral locking compression plate technique in distal femoral fractures

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;An extensive soft tissue damage, intra articular extension, severe comminution and injury to the quadriceps mechanism make the management of the distal fractures of the femur a significant challenge. The advent of techniques such as dynamic condylar screw surgery and distal femoral locking compression plate technique have improved the, management of these fractures compared to the conventional methods. We in the present study have attempted to compare the outcomes of Dynamic condylar screw surgery and distal femoral locking compression plate technique.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 72 patients over the age of 20 years who sustained simple or compound factures of the lower 1/3rd of femur and admitted into our hospital were included into the study. The patients were divided into 2 groups, one group who underwent Dynamic condylar screw surgery and the other groups were managed by distal femoral locking compression plate technique.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;The most common cause of fracture was road traffic accidents, involving both two wheelers as well as four wheelers (51.4%). 19.4% of the patients had a fall from height and 13.9% had a fall from standing height. The mean operative time in DCS was about 121 minutes in comparison to 118 minutes in the LCP. The average hospital stay and the no of RBCs used were comparable in both the cases. Although the mean number of days for full weight bearing as well as the average time of union of the fracture was marginally lower in LCP than in DCS, it was not significant. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;It is therefore observed that both condylar screw and the locking plate are very similar in their performance and satisfaction to the patients, although distal femoral locking plate is better in comminuted distal fracture compared to the dynamic condylar screw fracture management.&lt;/span&gt;&lt;/p&gt;

Evaluation of Stainless Steel Intermaxillary Fixation Screws in Treatment of Favorable Mandibular Fractures

Background: Numerous methods have been described for achievement of Intermaxillary fixation in the treatment of fractures of facial skeleton. Conventional methods like Erich arch bars and eyelet wires are currently the most common methods for achieving intermaxillary fixation (IMF), however, they have their own disadvantages. Since 1989, IMF using intraoral self-tapping IMF screws has been introduced for treatment of mandibular fractures. The aim of this study was to evaluate the efficacy, advantages, disadvantages and potential complications associated with using of self-tapping IMF screws in the treatment of mandibular fractures. Material and Methods: Twenty patients with favorable mandibular fractures, attended to Oral and Maxillofacial Surgery unit, AL-yarmuk Teaching Hospital between November 2014 and October 2015, they were treated with IMF screws. The parameters considered were duration of the procedure, perforations in the gloves, patient acceptance, oral hygiene, iatrogenic dental injuries, mouth opening, healing outcome, occlusal discrepancy and needle stick injuries during IMF. Results: The patients included in this study were 20 (17 males and 3 females). The extremes of age in this study ranged from 12 to 37 years. Three patients had 2 fracture lines. Assault was the most common cause of fractures. The most common site of fracture was the body and parasymphysis regions. Two screws (2.5%) from 80 screws became loosened. One patient (5%) ended with malunion and malocclusion. One patient (5%) developed infection at screw site. Three patients (15%) developed screws soft tissue burying. Conclusion: IMF screws considered to be a useful modality of treatment to establish maxillomandibular fixation. It is safe, and time-sparing technique; however, it is not without limitations or potential consequences in which the surgeon must be aware of in order to provide safe and effective treatment.

Trends in mandibular fractures: A comparison of two cohorts of patients in the same institution 10 years apart

Background: The fractures of the mandible are common facial injuries, and their consequences have remained a burden in dental and oral surgery practice. To review patients with mandibular fractures at our institution over a 4-year time frame of 10 years apart between 1997–2000 and 2011–2014 and compare the trends in the number of cases. Materials and Methods: The hospital register and case notes of the patients with mandibular fractures were retrospectively reviewed to obtain relevant information concerning the socio-demographic data and clinical characteristics of the fractures. Results: There was a reduction in the number of patients and fractures when the 2011 study (168 patients and 239 fractures) was compared with the 1997 study (358 patients and 474 fractures), and this was significant (P = 0.001). Road traffic accidents were the most common cause of fractures; motorcycle-related traffic accidents were more frequent in the years 1997–2000 (n = 128, 35.7%) than that in the years 2011–2014 (n = 11, 6.6%); vehicular road traffic accidents were more common in the years 2011–2014 (n = 123, 73.2%) than that in the years 1997–2000 (n = 153, 42.7%), and these were significant (P = 0.001). Mandibular fractures were more of isolated fractures and less associated with concomitant injuries in the 2011 study than that in the 1997 study (P = 0.001). There was a significant reduction of complications in the 2011 study (P = 0.001). Conclusion: This study has shown that the frequency of mandibular trauma has changed significantly over the past decade, which may be explained in terms of the ban on the use of motorcycle for public transportation.

Epidemiological assessment of maxillofacial fractures in the inhabitants of Lower Silesia, Poland in 2002–2006 – Pattern of maxillofacial fracture

Abstract Introduction This study is a continuation of research on maxillofacial traumatology conducted by the Maxillofacial Surgery Department of the Medical University in Wroclaw, Poland. Since 1956, a statistical review of maxillofacial fractures has been kept in 5 or 10-year periods of reference. Such an analysis is useful in identifying the frequency of the phenomenon, deciding on suitable treatment precautions, verifying treatment methods, and analyzing costs and losses incurred as a result of absence at work due to maxillofacial fractures. The sociological aspect of these studies includes indicating the sources of adverse social phenomena. Aim The aim of this epidemiological study was to analyze maxillofacial fractures among the inhabitants of Lower Silesia treated in the Maxillofacial Surgery Department of Wroclaw Medical University in 2002–2006. Material and methods The study was based on clinical documentation of 937 patients in whom dependencies between chosen parameters were identified. To evaluate the type of fracture, the classification of fractures developed by Samolczyk-Wanyura was adopted. Results and discussion The most common causes of fractures in both sexes were assaults (57.1%) and motor vehicle accidents (16.8%). Almost 50% fewer fractures were work related in comparison with other authors’ data from previous years, and the greatest number of maxillofacial fractures was reported in young males from urban backgrounds aged 18–25. The most frequent type of fracture was mandibular fracture. Conclusions It was concluded that the main causes of maxillofacial fractures were related with assault and motor vehicle accidents. This means that violence is a very serious social problem.

Nanotechnology Treatment Options for Osteoporosis and Its Corresponding Consequences.

Unfortunately, osteoporosis, as a worldwide disease, is challenging human health with treatment only available for the symptoms of osteoporosis without managing the disease itself. Osteoporosis can be linked as the common cause of fractures and increased mortality among post-menopausal women, men, and the elderly. Regrettably, due to osteoporosis, incidents of fractures are more frequent among the presented populations and can be afflictive for carrying out everyday life activities. Current treatments of osteoporosis encompass changing lifestyles, taking orthopedic drugs, and invasive surgeries. However, these treatment options are not long lasting and can lead to complications after post-surgical life. Therefore, to solve this impairment, researchers have turned to nanotechnologies and nanomaterials to create innovative and alternative treatments associated with the consequences of osteoporosis. This review article provides an introduction to osteoporotic compression vertebral fractures (OVCFs) and current clinical treatments, along with the rationale and efficacy of utilizing nanomaterials to modify and improve biomaterials or instruments. The methods of applying bioactive agents (bone morphogenetic protein-2 (BMP-2), parathyroid hormone 1-34 (PTH 1-34)), as well as 3D printing will be presented from an osteoporosis treatment perspective. Additionally, the application of nanoparticles and nanotube arrays onto the current surgical treatments and orthopedic drug administration methods addressed will show that these systems reinforce a better mechanical performance and provide precise and slow-releasing drug delivery for better osseointegration, bone regeneration, and bone strength. In summary, nanomaterials can be seen as an alternative and more effective treatment for individuals with osteoporosis.

Physiotherapy Maneuver Is Critical to Recover Mouth Opening After Pediatric Trauma

A restricted mouth opening (MO) is predominantly a complication of maxillofacial trauma in pediatric patients and develops in 4 to 26.2% of cases. The purpose of the present study was to quantitatively investigate the influence of patient demographic data, fracture characteristics, and regular vigorous physiotherapy, with either voluntary or forcible MO exercises, on the recovery of a post-traumatic restricted MO in pediatric patients. A prospective cohort study was performed of pediatric patients with maxillofacial injuries who had been referred to Al-Zahraa and El-Fayoum Hospitals from 2013 to 2015. The predictive variables were patient demographic data, fracture characteristics, and regular vigorous physiotherapy. The patients were treated with a closed technique. The MO measurements were the clinical outcome variables and were recorded at the first week and then monthly for 12months. Regular vigorous physiotherapy was performed until the patients had returned to their preoperative MO. The data were tabulated and statistically analyzed. Eighty-six patients were enrolled in the present study. Males predominated. Falls were the most common cause of fracture. Condylar fractures had the greatest incidence. A restricted MO occurred in 81 patients. The results showed no interaction between MO recovery and age, gender, etiology, or fracture site. After physiotherapy, the patients had returned to their preoperative MO at the fourth month, with the measurements fixed at normal values at the sixth month. The recovery rate was nonlinear, with faster improvement in the months closest to the injury. Physiotherapy is more critical in the recovery of the MO and prevention of bony ankylosis than patient data or fracture characteristics in pediatric trauma. We highly advocate the performance of voluntary mouth exercises, even in the absence of fracture. Forcible MO exercises are mandatory to recover a restricted MO. These exercises should be performed under close supervision of the patient's surgeon with the parents motivated to cooperate for at least 6months.

The effect of early versus delayed surgical debridement on the outcome of open long bone fractures at Bugando Medical Centre, Mwanza, Tanzania.

BackgroundUrgent surgical debridement of open long bone fractures is of paramount importance for prevention of subsequent infection. Due to limited information on the timing of this surgical procedure in Mwanza, Tanzania; the present study was conducted to evaluate the effect of early versus delayed surgical debridement on the outcome of open long bone fractures.MethodsA prospective cohort study involving 143 patients with open long bone fractures admitted at Bugando Medical Centre (BMC) between December 2014 and April 2015 was conducted. Patients were stratified into two main groups basing on whether they presented at BMC and operated early (within 6 h) or late (more than 6 h). Socio-demographic and clinical information were collected using structured questionnaire. Analysis was done using STATA software version 11.ResultsThe male to female ratio was 1.6: 1, with most of the patients being in their third decade of life (30.8 %). Road traffic accident (RTA) was the most common cause of fractures (67.8 %). Majority of patients, 91 (63.6 %) had Gustillo-Anderson grade II and the timing of debridement was significantly associated with this grading (p-value = 0.05). Nine (6.3 %) patients developed surgical site infection (SSI) and the median length of hospital stay (LOS) (interquartile range) was 7 (5–10) days, ranging from 3 to 35 days. SSI was found more in the late group compared to the early group [7.5 % (6/80) versus 4.8 % (3/63) respectively, p-value = 0.503)] and LOS was also longer in the late group compared to the early group [7 (6–11.5) days and 6 (5–10) days respectively, p-value = 0.06]. Pseudomonas aeruginosa was the predominant bacteria causing SSI.ConclusionsOpen long bone fracture injuries due to RTA are common at BMC. The risk of developing SSI in this setting is low and comparable to many other countries. Despite the fact that there was no statistical significant difference between early versus delayed debrided groups on SSI and LOS stays; the need for prompt surgical intervention in both groups should be an enduring focus to maintain these favorable outcomes.

Minimally invasive plate osteosynthesis in the treatment of proximal humeral shaft fractures

Introduction The treatment for proximal humeral shaft fracture is still controversial, attributed to the multiplicity of treatment options. The aim of this study was to evaluate the results of minimally invasive plate osteosynthesis (MIPO) in the treatment of proximal humeral shaft fractures. Patients and methods Between February 2007 and November 2011, 20 patients with displaced fracture of the proximal one-third shaft of the humerus were treated using the MIPO technique. The average age of the patients was 45.3 years, and there were 13 male and seven female patients. Eleven (55%) patients had AO (AO Foundation is a medically guided, not-for-profit organization led by an international group of surgeons specialized in the treatment of trauma and disorders of the musculoskeletal system) type 12C fractures. The right humerus was fractured in 11 (55%) patients. Falls were the most common cause of fracture in eight (40%) patients. Follow-up was carried out regularly with radiography and measurement of range of movement of the elbow. Results All fractures healed in an average time of 10.35 weeks within an average follow-up of 23.46 months. Surgery was performed on average 1.75 days after injury. Fractures were fixed using dynamic compression plating in 12 cases and locked plating in eight cases. The average range of elbow range of motion was 123 degrees; 12 (60%) patients were able to achieve full elbow extension at last follow-up. The average extension lag was 5.25°. The average range of elbow flexion was 128.25°. Six complications occurred in our cases. There were two cases of shoulder impingement. One patient developed deep infection. Three (15%) patients had postoperative radial nerve injuries. All of them recovered spontaneously. Conclusion Although MIPO is technically demanding, it is a safe and efficient procedure for the treatment of humeral shaft fracture. Adequate healing and low complication rate can be obtained if the appropriate surgical technique is used. Elbow flexion contracture can be regarded as a possible complication that can be avoided by the use of early adequate elbow rehabilitation protocol.

Suppression of Evi1 promotes the osteogenic differentiation and inhibits the adipogenic differentiation of bone marrow-derived mesenchymal stem cells in vitro.

Osteoporosis (OP) is considered a complex disease with a strong genetic impact, mainly affecting post-menopausal women and is also a common cause of fracture. Elucidating the molecular mechanisms that regulate the osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs) is crucial to developing treatment strategies to combat OP. In the present study, we found that ectopic viral integration site‑1 (Evi1) was highly expressed during the process of adipogenesis of rat BMSCs. Notably, Evi1 levels markedly increased on day 3 of adipogenic differentiation following the addition of adipogenic induction supplements. In addition, we interfered with the expression of the Evi1 gene in the adipogenesis of BMSCs by supplementing adenoviral plasmids and measured the expression levels of bone sialoprotein (BSP), osteocalcin (OCN), osteopontin (OPN), peroxisome proliferator‑activated receptor γ2 (PPARγ2) and lipoprotein lipase (LPL) by RT-qPCR and western blot analysis. The mRNA and protein levels of osteogenic and adipogenic markers in the BMSCs were up‑ and downregulated, respectively following the silencing of siEvi1. Our experimental results substantiate that the suppression of Evi1 in BMSCs by RNA interference inhibits adipogenic differentiation, while it promotes osteogenic differentiation. The results from our study demonstrated that the Evi1 gene may be targeted as a therapeutic strategy for promoting bone formation.

Epidemiology of pediatric hand fractures presenting to a university hospital in Central Saudi Arabia.

Objectives:To investigate the epidemiology of pediatric hand fractures and to provide recommendations regarding prevention.Methods:Medical records and x-rays were retrospectively reviewed for age at the time of injury, gender, fracture pattern, place where the injury occurred, and mechanism of injury. The study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia between January 2005 and December 2011.Results:Of 361 cases reviewed, there were 291 (80.6%) male and 70 (19.4%) female patients. Most (46.2%) were in the age group of 13-18 years. For age group 1-4 years, the most common place of occurrence was at home (81.3%) and for the group 13-18 years, outdoors was the place of occurrence (64.7%). Females were mostly injured at home while males had similar distribution of indoor and outdoor injuries. The most common causes of fractures were: door slams in the 1-8 years age group; falls at home, in the 9-12 years age group; and both falls at home and sports in the oldest age group (13-18 years). The little finger ray are the most frequently injured part of the hand followed by the middle finger.Conclusion:Our series showed that most hand fractures in children occurred at home, which requires reevaluation of home settings. Implementation of safety measures during sports activities are relevant in the oldest age group.

Fracture Occurrence Pattern in Animals

The overall incidence of fracture was recorded as 0.95 per cent for all species of animals. The incidence of fracture in dog was 0.76 per cent. Dog was observed as the most common species presented with a fracture followed by goat and other species. The mean age was recorded to be 26.32±5.14 months. Fifteen animals (78.95%) were noticed in age group of 12–36 months. Majority of animals were non-descript (42.10%). Fracture was recorded more in male animals (77.78%). An automobile accident (42.10%) emerged to be the major cause of fracture, whereas a fall from height (31.58%) was second common cause of fracture. The femur was found to be the most common bone (47.37%) involved in the fracture, seconded by tibia-fibula (36.84%), which was followed by radius-ulna (15.79%). The radiographic examination conducted in two orthogonal views revealed that 14 (73.68%) fractures were multiple whereas, 5 (26.32%) fractures were comminuted.

Prevalence of different kinds of maxillofacial fractures and their associated factors are surveyed in patients.

Introduction:Nowadays maxillofacial fractures have increased. In this study prevalence of different kinds of maxillofacial fractures and their associated factors are surveyed in patients referred to Imam Khomeini Hospital, Urmia in 2011.Methods:The study was across-sectional observational study. 637cases of patients with a confirmed diagnosis of maxillofacial fractures in 2011 referred to Imam Khomeini Hospital, Urmia and their data records were analyzed using SPSS software and chi-square tests.Results:In this study, 457 patients were male and 178 were female and the mean age was 14.47±26.68 years. Falling was the most common cause of fractures after accidents and assaults were the most common causes. The most common site of nasal fractures was about 66.4% and then fractures in several places about 14.9% and mandibular 7.1%.Conclusions:Based on the results obtained in the present study with other studies in this area it is concluded that maxillofacial fractures in males and in 20 to 30 years of age is prevalent and is mostly due to falling and road accidents and are further seen in nasal bone and mandible.

Clinical evaluation of the modified tension band wiring technique for the fractured patella

The patella is of importance for the extension of the knee joint. It increases the force of the quadriceps apparatus by improving the leverage. In addition, it protects the anterior articular surface of the distal femur against external violence, but may easily be injured due to its unprotected position.Several methods of internal fixation of fractured patella have been advocated. This dissertation is directed towards the clinical evaluation of the modified tension band wiring technique for the fractured patella. Fall in the same plane is the most common cause of fractures of the patella. Vertical incision is more helpful to mobilize the patient early. Early mobilization of the knee restores quadriceps power and range of knee motion within a short period. Excellent range of movement was achieved in 70% of cases. Early and continuous physiotherapy following the modified tension band wiring technique is of paramount importance in determining the end results. Modified tension band wiring is therefore the choice of treatment for the fracture patella.

Management of Nonunion of Tibia by Ilizarov Technique

This prospective study was carried out during the period of January 2007 to December 2011 in Mymensingh Medical College Hospital and other private clinics of Mymensingh town to assess the results of Ilizarov technice for nonunion of the tibia. Here total operated patient were 30, of them 24 were male and 6 were female. 10 cases are hypertrophic, 8 cases are atrophic and 12 cases are infected nonunion. In this series age of the patients was 10 ? 60 years. Motor vehicle accident was the commonest cause of fracture found in 66.67% cases. Second most common cause of injury was fall from height. Among 30 patients proximal corticotomy was done in 24 patient and distal corticomy in 2 patient. Union time was 4-12 months. Among 30 patients 27 were united at initial procedure. From nonunited 3 cases again refreshening of the ends along with bone grafting was done and ultimately 2 were united and 1 remains nonunited. In this series limb length discrepancy reduced to maximum 1.5 cm with contralateral limbs. Average total hospital stay was 15 days. Pin site infection and pain were the commonest complications in our study. Close adherences to Ilizarov principles make it now possible to successfully treat a most of orthopaedic conditions that previously were fraught with high morbidity rates and poor results. DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16697 Community Based Medical Journal 2013 July: Vol.02 No 02: 41-45

Anaesthetic management of patients with hip fractures: an update

Although the annual incidence of hip fracture in the UK appears to be decreasing, the number of patients sustaining a hip fracture annually is predicted to increase in line with the ageing demography of the population, from 77 000 cases in 2009 towards 100 000 cases in 2033, with concomitant increases in inpatient financial costs from £0.8 billion to £2.7billion (inflation adjusted) over the same time period (outpatient and social costs double these figures). 1 Three-quarters of hip fractures occur in women, and the median age at fracture is 84 yr. Hip fracture is more common in Northern compared with Southern Europeans, and is becoming more prevalent among the nonEuropean population as increased wealth improves longevity. Simple mechanical falls from standing height in patients with preexisting osteoporosis are the most common cause of fracture; patients are often prone to falling, and are more likely to fall in future after hip fracture fixation. Approximately 98% of hip fractures are

Comparative analysis of trends in the treatment of mandibular fractures

The purpose of this study was to comparatively analyze trends in the treatment of mandibular fractures. A retrospective review of records of patients treated for mandibular fractures at our department over a 5-year period (2007–2011) was done. Data collected included age, gender, etiology, anatomical site of fracture and treatment method used. There were 406 mandibular fractures in 335 patients. Males constituted 73.7% (n=247) and females 26.3% (n=88); male:female ratio of 2.8:1. Age range was 1–72 years, with mean age of 28.5. Patients of 21–30 years of age sustained the most mandibular fractures. Road traffic accidents (43.6%) were the most common cause of fractures, followed by falls (40.0%). The most common site of mandibular fracture was the condyle (36.2%), followed by symphysis/parasymphysis (23.9%). Majority (92.5%) of the fractures were treated by open approach. However, comparative data with other studies worldwide revealed that some centers treated majority of their patients by closed approach. The choice of either closed or open approach methods of treatment of mandibular fractures depended mainly on availability of resources and the socioeconomic situations in different countries.