Notes

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r treatment of floating elbow injury.
The purpose of this study is to evaluate the functional results of distal humerus fractures which were treated by open reduction and fixation with pre-contoured angular stable plates in young patients, and investigate whether the patients could return to their pre-injury work and patients' financial conditions while they were not working.

The data of 48 patients, ages between 18 and 55years, working in a job and having AO/OTA type C distal humerus fracture were retrospectively evaluated. Mayo Elbow Performance Score (MEPS) was used to determine functional results. Postoperative radiographs were evaluated to determine the rate of union, degenerative changes, malunion and heterotopic ossification. Financial outcome form was constituted by the authors and the patients asked whether she/he could return to their pre-injury works after treatment finished and the financial status of the patients during the treatment and after the treatment.

The mean flexion-extension arc was 114° ± 12°(range 85°-135°) and the n returning to their former works.
Injuries involving upper cervical spine are serious and fatal injuries which are associated with alteration of normal occipital-cervical anatomy. These injuries may result in permanent neurologic deficits or neck deformity if not treated in a timely and appropriate manner.

To evaluate the outcomes of neglected upper cervical spine injuries treated by various methods.

Retrospective study.

Twelve patients attending ER or OPD with a history of neck trauma and who were diagnosed with fractures and fracture dislocations C1 and C2 were included in the study. Fresh injuries sustained within a week were excluded from study. The outcomes were measured in terms of improvement in VAS, ODI Scores and correction of the neck deformity. Surgical parameters like duration of surgery and blood loss were also observed.

Eleven males and one female. The mean age was 40.9 ± 16.9 (07-67years). Eleven patients underwent posterior instrumentation, while one patient was treated anteriorly. The mean delay in presentation was 28 ± 8.67days (15-42days). The mean duration of surgery was 188.3 ± 34.35min (120-240min), average blood loss was 350 ± 111.8ml (150-600ml). The mean VAS improved from 8.45 ± 0.89 to 3.9 ± 0.51 (
 < 0.05). Angiotensin II human research buy The mean ODI Pre-operatively was 88.45 ± 5.89 which improved to 31.9 ± 4.01 (
 < 0.05). The neck deformity/torticollis was corrected in all the patients.

Neglected upper cervical spine injuries are difficult to treat and a posterior approach is helpful in reducing the subluxations indirectly and to obtain a posterior fusion.
Neglected upper cervical spine injuries are difficult to treat and a posterior approach is helpful in reducing the subluxations indirectly and to obtain a posterior fusion.
Suprapatellar nailing of tibial fractures has not been shown to affect short-term knee outcomes, however long-term outcomes are unknown. The purpose of this study was to report long-term patient-reported knee outcomes after suprapatellar nailing.

Thirty-five adult patients with 37 tibial shaft fractures treated with suprapatellar nailing completed the Tegner-Lysholm Knee Score (TLKS) at an average of 5years (range, 4-9years) follow-up.

The median TLKS was 98 (interquartile range, 85-100) Scores were considered excellent in 24 (68%), good in 3 (9%), fair in 3 (9%), and poor in 5 (14%). Based on patient responses, 28 (80%) patients did not have a limp, 32 (91%) ambulated without assistance, 22 (63%) were pain free, 29 (83%) had no knee instability, 30 (86%) endorsed no catching or locking, 27 (77%) could climb stairs with no issue, and 24 (69%) had no problems with squatting. Patients with poor/fair outcomes on the TLKS were more likely to have had a complication [3 (38%) vs. 1 (4%), difference 34%, 95% confidence interval 1-65%] and had no detectable difference in age, gender, open fracture, fracture classification, or worker's compensation.

At long-term follow-up a majority of patients undergoing suprapatellar nailing had good/excellent knee outcomes. Poor/fair knee outcomes were associated with the development of complications.

III, Retrospective cohort study.
III, Retrospective cohort study.
Tibial torsion can be measured by various clinical and radiological methods. Computed tomography (CT) scan measurement is currently the investigation of choice. The purpose of our study was to compare the clinical and CT scan methods to reveal malrotation after nailing of tibia and also to find out if leg position for distal locking has any influence on incidence of malrotation.

We have included 106 patients (21-68years) of tibia nailing, and categorised them as category A (figure of four position
 = 54) and category B (knee straight position
 = 52) based on limb position for distal locking. The plumb line measurement, Thigh Foot Axis (TFA) and CT scan measurement (using new reference line) were documented and compared with the uninjured limb.

We observed plumb line measurement to be the most inaccurate method followed by TFA method. CT scan measurement was the most accurate method showing external rotations (> 10º) in 32 cases (30.1%) and internal rotation (> -10º) in five cases (4.71%). The TFA method had a sensitivity of 44% and specificity of 86% in identifying malrotations. The interobserver reliability for CT scan measurement was 0.96. Even though statistically not significant (
value), figure of four position for distal locking leads to larger number of malrotations (both external and internal rotation).

CT scan is the most accurate method of measuring malrotation. The new reference line used in our study provides accurate measurement of malrotation. The two different positions of leg for distal locking do not have a statistically significant influence on incidence of malrotation.
CT scan is the most accurate method of measuring malrotation. The new reference line used in our study provides accurate measurement of malrotation. The two different positions of leg for distal locking do not have a statistically significant influence on incidence of malrotation.
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