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Background: Implant for fixation of neglected fracture lateral condyle humerus remains an issue of controversy. This study compares the clinical and radiological outcome of fixation with Kirschner wire (K-wire) and with cancellous screw (CS) in neglected fracture lateral condyle humerus Materials and Methods: 42 patients of neglected lateral condyle humerus fracture, treated either by open reduction and internal fixation (ORIF) with K-wire or ORIF with CS were included in study. The comparisons were made in term of slab immobilization time, union time, improved range of motion (ROM), final achieved carrying angle, and functional outcome measured by Liverpool Elbow Score (LES) Results: There were 22 patients in Group I with mean age 7.8 years and 20 patients in Group II with mean age 7.3 years. Mean delay in presentation was 12.9 versus 15.6 weeks (P > 0.05). Mean followup was 26.9 versus 26.7 months. Mean duration of immobilization was 11.6 versus 9.4 weeks (P < 0.001). Improved carrying angle was 6.8° versus 9.7° (P < 0.05). Mean gain in ROM was 17.7° versus 27.5° (P < 0.05). Mean LES was 8.15 versus 8.18 (P > 0.05). Premature closure of physis was observed in two patients. Pin tract infection was seen in three of Group I (P > 0.05) Conclusion: There was no difference in LES, irrespective of implant used. Screw was better in terms of duration of slab, improvement in carrying angle and ROM [ABSTRACT FROM AUTHOR]

Background: Implant for fixation of neglected fracture lateral condyle humerus remains an issue of controversy. This study compares the clinical and radiological outcome of fixation with Kirschner wire (K-wire) and with cancellous screw (CS) in neglected fracture lateral condyle humerus. Materials and Methods: 42 patients of neglected lateral condyle humerus fracture, treated either by open reduction and internal fixation (ORIF) with K-wire or ORIF with CS were included in study. The comparisons were made in term of slab immobilization time, union time, improved range of motion (ROM), final achieved carrying angle, and functional outcome measured by Liverpool Elbow Score (LES). Results: There were 22 patients in Group I with mean age 7.8 years and 20 patients in Group II with mean age 7.3 years. Mean delay in presentation was 12.9 versus 15.6 weeks (P > 0.05). Mean followup was 26.9 versus 26.7 months. Mean duration of immobilization was 11.6 versus 9.4 weeks (P < 0.001). Improved carrying angle was 6.8° versus 9.7° (P < 0.05). Mean gain in ROM was 17.7° versus 27.5° (P < 0.05). Mean LES was 8.15 versus 8.18 (P > 0.05). Premature closure of physis was observed in two patients. Pin tract infection was seen in three of Group I (P > 0.05). Conclusion: There was no difference in LES, irrespective of implant used. Screw was better in terms of duration of slab, improvement in carrying angle and ROM. [ABSTRACT FROM AUTHOR]

Background: Gentle passive manipulation and casting by the Ponseti method have become the preferred method of treatment of clubfoot presenting at an early age. However, very few studies are available in literature on the use of Ponseti method in older children. We conducted this study to find the efficacy of Ponseti method in treating neglected clubfoot, which is a major disabler of children in developing countries. Materials and Methods: 41 clubfeet in 30 patients, presenting after the walking age were evaluated to determine whether the Ponseti method is effective in treating neglected clubfoot. This is a prospective study. Pirani and Dimeglio scoring were done for all the feet before each casting to monitor the correction of deformity. Quantitative variables were expressed as mean ± standard deviation and compared between preoperative and postoperative followup using the paired t-test. Also, the relation between the Pirani and Dimeglio score, and age at presentation with the number of casts required was evaluated using Pearson's correlation coefficient. No improvement in Dimeglio or Ponseti score after 3 successive cast was regarded as failure of conservative management in our study. Results: The mean age at presentation was 3.02 years (range 1.1 - 10.3 years). The mean followup was 2.6 years (range 2-3.9 years). The mean number of casts applied to achieve final correction were 12.8 casts (range 8-18 casts). The mean time of immobilization in cast was 3.6 months. The mean Dimeglio score before treatment was 15.9 and after treatment were 2.07. The mean Pirani score was 5.41 before treatment and 0.12 after treatment. All feet (100%) achieved painless plantigrade feet without any extensive soft tissue surgery. 7 feet (17%) recurred in our average followup of 2.6 years. Conclusions: Painless, supple, plantigrade, and cosmetically acceptable feet were achieved in neglected clubfeet without any extensive surgery. A fair trial of conservative Ponseti method should be tried before resorting to extensive soft tissue procedure. [ABSTRACT FROM AUTHOR]

Background: Medial close wedge, lateral open wedge, dome and "V" osteotomies are the commonly to correct the genu valgum (GV) deformity. However, the ideal method for the correction of coronal plane deformity is controversial. This prospective study is to evaluate the functional and radiological result of supracodylar "V" osteotomy to correct GV deformity. Materials and Methods: "V" osteotomy was done in all patients with clinically significant GV deformity and was fixed with crossed K-wires. Weight-bearing mobilization was started after radiological union. Patients were evaluated for correction in different clinical and radiological parameters. The function of the knee was assessed by Bostman's score. The subjective score was used to assess the parent's satisfaction after the procedure. Results: 187 limbs with genu valgum deformity (47 males and 71 females) were included in this study. We observed a significant improvement in the mean intermalleolar distance, clinical and radiological tibiofemoral angle and lateral distal femoral angle, from 17.3 to 3.9 cm, 23.8°to–4.5°, 25.6° to 6.1°, 76.6° to 88.4°, respectively. The mean Bostman score improved from 20.6 to 28.1. The parent's satisfaction assessed subjectively was 95.3 points. Conclusion: This osteotomy along with the fixation with K-wires is a safe, effective, reproducible technique with a short learning curve and a procedure requiring no repeat surgery for implant removal, with good functional results, and without major complications. [ABSTRACT FROM AUTHOR]