R Sahaya Jose

Abstract

Aim: To compare the effectiveness of peppering technique with single injection technique by using steroid along with local anaesthetic injection in the treatment of chronic lateral epicondilitis(LE) of Elbow. Materials and Methods: In this prospective randomized study, conducted among 66 patients. All patients were divided into two equal groups: peppering technique group (PRI) and single injection technique group (SNI), based on the injection technique. The patients in both groups were treated with local injection of a steroid(1ml Methylprednisolone) and local-anesthetic agent(1ml lignocaine). The effect was measured by change in elbow pain intensity as per Visual Analogue Scale (VAS) for pain. We included patients with Chronic LE of at least 6months duration while patients who have taken previous local steroid injections and uncontrolled diabetes were excluded. Patients were followed up at 2weeks, 6weeks and 6months. The Statistical Package for the Social Sciences (SPSS) version 24 software was used for all statistical calculations. Results: In this study, 66 patients were included (34 male & 32 female) with the most affected between 30-60 years. In our study, there was considerably lesser VAS score at 2 weeks, at 6 weeks and at 6 months follow-ups in both the groups comparing to the pre-injection VAS. At 6-months, the good results were 90%(n=30) in the PRI group compared to 72%(n=24) in SNI group. Thus the success rate for Peppering technique is significantly higher than the single-injection technique. Conclusion: In our study we conclude that peppering injection technique is better than single injection technique in terms of reduced pain which was assessed by VAS in the treatment of chronic lateral epicondylitis of elbow in the long-term follow up. Keywords: Tennis elbow treatment, Local injection, Corticosteroid, Chronic lateral epicondylitis, Peppering technique

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Background and Objectives: The aim of this study is to assess the functional outcome of dynamic hip screw and Proximal Femoral Nailing in intertrochanteric fractures using Harris hip score. Materials and Methods: In our prospective study, we compare the functional outcome in intertrochanteric fractures between dynamic hip screw and proximal femoral nailing. 70 patients with Intertrochanteric fracture femur were included in this study. 35 patients were treated with DHS and 35 patients with PFN, respectively. In both the groups, patients were evaluated for postoperative functional outcome by using Harris hip score. The Data was analyzed by SPSS 16.00 version. Unpaired t test applied to find the statistical significance between the groups. P value less than 0.05 is considered statistically significant. Results: Our results show dynamic hip screw has 14.29% of excellent results, whereas proximal femoral nailing has 40% excellent results. Among 70 patients with intertrochanteric fractures, patients developed less complication in PFN group (20%) than DHS group (40%). PFN had shown excellent Harris hip score in all type of intertrochanteric fractures than DHS group. Conclusion: In this present study we assessed the functional outcome of dynamic hip screw and Proximal Femoral Nailing in intertrochanteric fractures using Harris hip score. In view of negligible complications and superior functional outcome, we suggest that Proximal Femoral Nailing is asuitable device for both stable and unstable intertrochanteric fractures than dynamic hip screw.   Keywords: Dynamic hip screw, Intertrochanteric fracture, Proximal femoral nailing, Harris Hip Score, Boyd and Griffin’s classification.

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Introduction and Objectives: The Purpose of this study is to assess the Radiological outcome of Total Hip Arthroplasty in Displaced fracture Neck of femur. Materials and Methods: 22 patients of displaced intracapsular neck of femur fracture were included in this study of which 14 patients managed through cemented and 8 managed through Uncemented Total Hip Arthroplasty, respectively. In this study patients operated with uncemented implants were assessed for radiological outcome by utilizing Andrew Whaley and Daniel et al and Engh’s criteria while patients operated with cemented implants were assessed for radiological outcome by utilizing De Lee and Charnley criteria and Gruen Zone Criteria. The Data was analyzed by SPSS 20.00 using Chi-square test. Results: In our study period no loosening of acetabular or femoral components were noticed. Acetabular cup inclination was normal in 77%, vertical in 14% and horizontal in 9%. Position of the stem of femoral component was neutral in 73% with 13.5% of varus and valgus each. No vertical subsidence and no migration of acetabular cup was seen in our study. There was 4.5% i.e., one patient developed Type II Heterotopic ossification. Conclusion: The results of this study shows that Total Hip Arthroplasty gave better results in Displaced Intracapsular Neck of femur fractures radiologically. Also there was no loosening of Acetabular component or migration of acetabular cup and cup position was normal in 77% cases. Femoral stem position was Neutral in 73% of cases with no vertical subsidence and no femoral component loosening. Keywords: Total hip arthroplasty, Radiological outcome, Neck of femur fracture.

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Introduction and Objectives: The Aim of this study is to evaluate the Short Term Functional Outcome of Unipolar and Bipolar hemiarthroplasty in Intracapsular neck of femur fracture. Materials and Methods: 40 patients with Intracapsular fracture neck of femur were included in this study. 20 patients were treated with unipolar hemiarthroplasty and 20 patients with bipolar hemiarthroplasty, respectively. In both the groups, patients were evaluated for functional outcome by using Harris hip score. The Data was analysed by SPSS 20.00 using Chi-square test. Results: Our overall mean Harris hip score pre operatively for unipolar hemiarthroplasty was 36.2 and bipolar hemiarthroplasty was 39.1 which increased to 81.8 for unipolar and 85.05 for bipolar hemiarthroplasty respectively, with p-value of Conclusion: The results of our study shows that uncemented bipolar hemiarthroplasty gave better results when compared with uncemented unipolar hemiartheoplasty. Our results also shows that, cemented bipolar hemiarthroplasty gave better results when compared with cemented unipolar hemiarthroplasty clinically. Thus, Bipolar hemiarthroplasty did better when compared with unipolar hemiarthroplasty in general. Keywords: Unipolar hemiarthroplasty, Bipolar hemiarthroplasty, Fracture neck of femur, Harris hip score.

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