Department of Orthopedics

Comparison of functional outcome of femur intertrochanteric fracture fixation with hemiarthroplasty and proximal femoral nailsystems

2026-08-28T15:46:28Z

Comparison of functional outcome of femur intertrochanteric fracture fixation with hemiarthroplasty and proximal femoral nailsystems Tallapureddy Pranav Teja Introduction: Intertrochanteric femur fractures represent a significant health challenge in the elderly population, associated with considerable morbidity, mortality, and socioeconomic burden. While proximal femoral nail (PFN) systems are widely accepted as the standard treatment for these fractures, hemiarthroplasty has emerged as an alternative approach, particularly for elderly patients with osteoporotic bone. Despite ongoing debate regarding the optimal management strategy, comparative studies evaluating functional outcomes between these two approaches remain limited. This study aimed to compare the functional outcomes, pain control, and rehabilitation milestones between hemiarthroplasty and PFN for the treatment of intertrochanteric femur fractures in elderly patients. Methods: This prospective comparative study included 50 patients with intertrochanteric femurfractures, divided equally between hemiarthroplasty (n=25) and PFN (n=25) groups. Demographic data, operative parameters, and hospital stay duration were recorded. Functional outcomes were assessed using the Harris Hip Score at 1, 3, and 6 months postoperatively. Pain was evaluated using the Visual Analog Scale (VAS) at the same intervals. Time to fully weight-bearing was documented for all patients. Statistical analysis was performed using appropriate tests with significance set at p<0.05. Results: The groups were comparable regarding age, gender distribution, comorbidities, and BMI.Operative time was significantly shorter in the PFN group (71.6±13.9 vs. 81.3±12.6 minutes, p=0.01), while hospital stay was similar between groups. The PFN group demonstrated significantly lower painscores at all follow-up intervals (p<0.05). At 1 month, functional outcomes favored hemiarthroplasty, with all patients achieving fair Harris Hip Scores compared to poor scores in the PFN group. However, by 3 months, the PFN group showed better improvement (p=0.02), and at 6 months, the PFN group demonstrated superior outcomes with 56% achieving excellent scores versus 24% in the hemiarthroplasty group (p=0.006). Patients in the hemiarthroplasty group achieved fully weight-bearing status significantly earlier than those in the PFN group (7.28±1.79 vs. 9.32±1.95 weeks, p<0.001). Conclusion: While hemiarthroplasty offers advantages in terms of earlier weight-bearing and better initial functional scores, PFN provides superior outcomes in terms of operative efficiency, pain control, and mid-term functional recovery. The optimal treatment approach should be individualized based on patient characteristics, fracture pattern, and rehabilitation potential. For patients with good rehabilitation potential and reasonable life expectancy, PFN may offer better overall functional outcomes despite delayed weight-bearing.

A prospective study on functional outcome of surgical management of acetabular fractures

2026-08-28T15:35:11Z

A prospective study on functional outcome of surgical management of acetabular fractures Sudev Raghunathan Background: Acetabular fractures represent complex injuries that present significant management challenges. This prospective study evaluates the functional outcomes of surgical management of acetabular fractures at a tertiary care center and identifies factors influencing these outcomes. Methods: Thirty-one patients with acetabular fractures who underwent surgical management between 2023 and 2025 were enrolled in this prospective study. Fractures were classified according to the Judet-Letournel system, and functional outcomes were assessed using the modified Merle d’Aubigne score at presentation, 6 weeks, 3 months, and 6 months post-surgery. Demographic data, fracture characteristics, surgical approaches, complications, and associated injuries were documented. Statistical analysis was performed to identify factors associated with functional outcomes. Results: The study cohort comprised predominantly young adult males (71%), with road traffic accidents being the primary mechanism of injury (71%). Posterior column fractures and anterior column fractures with associated pubic rami fractures (25.8% each) were the most common patterns, followed by posterior wall fractures (19.4%). Associated posterior hip dislocations were present in 25.8% of cases. The Kocher-Langenbeck approach was most frequently employed (45.2%), followed by the modified Stoppa approach (32.3%). Functional assessment revealed progressive improvement, with all patients demonstrating poor scores at presentation, progressing to 51.6% excellent and 48.4% moderate outcomes by 6 months. Complications were observed in 19.4% of patients, with hip stiffness being the most common (9.7%). Age, fracture pattern, associated dislocation, surgical approach, and post-surgery follow-up significantly influenced functional outcomes, while the presence of complications also showed a significant association (p=0.03). Conclusion: Surgical management of acetabular fractures yields favorable functional outcomes, with progressive improvement over time. Most demographic and fracture characteristics significantly influenced outcomes, and the results support the efficacy of tailored surgical approach selection and meticulous technique. The findings highlight the importance of extended rehabilitation and careful management of complications to optimize functional recovery.

Evaluation of clinical outcome of arthroscopic rotator cuff repair

2026-08-28T15:24:13Z

Evaluation of clinical outcome of arthroscopic rotator cuff repair Saragur Anand D Background: Rotator cuff pathology represents one of the most common causes of shoulder pain and dysfunction, significantly impacting patients' quality of life. Arthroscopic techniques have revolutionized rotator cuff repair, potentially offering advantages in surgical precision and post-operative recovery. Objective: To examine the functional outcomes of arthroscopic rotator cuff repair in terms of pain relief, range of motion, time to return to daily activities, length of hospital stay, and patient satisfaction at sequential follow-up evaluations. Methods: This prospective study included 22 patients who underwent arthroscopic rotator cuff repair between May 2023 and June 2024. Patients with full-thickness and partial- thickness tears confirmed by MRI were included. Functional outcomes were assessed using UCLA and Constant-Murley scores, along with VAS pain scores at 6 weeks, 3 months, and 6 months postoperatively. Results: The study population had an equal gender distribution with most patients aged 41- 50 years (36.4%). Supraspinatus was the most commonly affected tendon (77.3%), with complete tears predominating (86.4%). At 6 months, UCLA scores showed significant improvement with 63.6% achieving good outcomes compared to 86.4% poor outcomes preoperatively (p<0.001). Similarly, Constant scores improved from predominantly poor preoperatively (86.4%) to good or excellent at 6 months (100%) (p<0.001). VAS pain scores decreased from 6.09±0.75 at 6 weeks to 1.5±1.0 at 6 months (p<0.001). The mean hospital stay was 5 days, with return to daily activities at 9.64±2.01 days. Patients with traumatic tears demonstrated significantly better UCLA scores than those with degenerative tears (p=0.01). Conclusion: Arthroscopic rotator cuff repair provides excellent clinical outcomes with significant improvements in functional scores and minimal complications. While both single- row and double-row techniques yield satisfactory results, repair strategy should be tailored to tear characteristics and tissue quality. The significant association between traumatic etiology and superior functional outcomes highlights tissue quality as a critical determinant of healing potential and functional recovery.

Study of proximal tibia intraarticular fracures schatzker type 5 and 6 treated with or without 3d printing model” – a comparative study

2026-08-28T15:13:25Z

Study of proximal tibia intraarticular fracures schatzker type 5 and 6 treated with or without 3d printing model” – a comparative study Rahul Shenoy A Introduction: Complex intra-articular fractures of the proximal tibia (Schatzker types V and VI) present significant challenges in orthopaedic trauma management. Three-dimensional (3D) printing technology has emerged as a potential tool to enhance preoperative planning and surgical execution for these complex fractures. This study aimed to compare the surgical outcomes of proximal tibial Schatzker type V and VI fractures treated with or without the aid of 3D-printed models. Methods: A prospective comparative study was conducted with 40 patients presenting with Schatzker type V and VI proximal tibial fractures, divided equally into a 3D print group (n=20) and a conventional treatment control group (n=20). Patient demographics, fracture characteristics, and surgical parameters including operating time, blood loss, fluoroscopy exposure, and number of implant trials were recorded and analysed. Results: Both groups had comparable demographic and fracture characteristics. The 3D print group demonstrated significantly shorter mean surgical time (110.2±19.3 vs. 142.5±34.04 minutes; p=0.001), reduced intraoperative blood loss (275±109.4 vs. 370±155.1 ml; p=0.03), and decreased fluoroscopy exposure (0.22±0.15 vs. 0.34±0.06 mSv; p=0.002) compared to the control group. Most notably, 70% of cases in the 3D print group required zero implant trials compared to only 10% in the control group (p<0.001). Conclusion: The use of 3D-printed models for preoperative planning in Schatzker type V and VI proximal tibial fractures significantly improves surgical efficiency by reducing operating time, blood loss, radiation exposure, and implant trials. These findings suggest that 3D printing technology represents a valuable adjunct in the management of complex proximal tibial fractures, potentially improving both the process and outcomes of surgical management for these challenging injuries.