Nirav Mungalpara

Abstract

Basilar invagination are uncommon syndrome that occurs when the superior part of the odontoid (part of the C2 vertebrae) migrates upward through foramen magnum and that causes bulbomedullary compression. Basilar invagination are divided on bases of that causation in trau matic and other one is developmental. Mostly seen basilar invagination are developmental. Here with describe a case of 13yr old female with developmental craniovertebral junction abnormality in form of congenital atlanto axial dislocation with Platiebasia with basilar invagination which is treated with decompression and occipital plate and screw based posterior fixation with its clinical as well as radiological outcome. Keywords: Basilar invagination, AtlantoAxial dislocation, Platybasia, OC Fusion, Craniovertebral junction anomaly, Brainstem compression.

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Abstract

Aim: Operative treatment of shaft humerus fracture continues to evolve. MIPPO is one of such emerging operative procedure which does give excellent results over conventional ORIF platting. We are comparing overall functional outcome and surgical complexity of MIPPO (Minimal Invasive Percutaneous Plate Osteosynthesis) vs conventional ORIF (Open Reduction and Internal Fixation) by posterior approach in this study. Materials and Methods: A retrospective clinical study was done on 50 patients with shaft  humerus fractures treated with MIPPO anterior bridge plating and posterior  platting by trained single surgeon at a tertiary trauma care centre in the Department of Orthopaedics, BJ medical college, Civil hospital Ahmedabad between October 2016 and May 2018. Follow up data was collected and patients were called for clinical and radiological evaluation. Results:  24 of the 25 (96%) MIPPO patients and 22 of the 25 (88%) ORIF patients achieved union. Average union times for the MIPPO and ORIF groups were 19.3 and 16.1 weeks respectively. At the end functional outcome of both the technique is as follows: the Mayo Elbow Performance Score (MEPS; range 95–100) were 90% in 20 cases (n = 20) operated with conventional ORIF posterior plating and 20 cases operated with MIPPO plating which is excellent scores. Two cases operated with ORIF posterior plating and three cases with MIPPO plating are showing a good MEPS score. Conclusions: Even though MIPPO is surgically demanding, fracture hematoma is not disturbed in it therefore it gives better and fast union than conventional ORIF. Keywords: Conventional ORIF, MIPPO platting, Fracture, Humerus.

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