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Article
5 Years Experience in IntracapsularFemoral Neck Fracture Management

Author: Ali H Khudair
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 5-10
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Displaced intracapsular fracture of the femoral neck remain a challenging issue despite the advancement in the ways of treatment .The purpose of this study is to assess the results of different methods of treatment in different age groups.
Methods: This study was conducted over a period from (1998-2004) on 26 patients, with ages of 5 – 85 years with intracapsular fracture of the femoral neck due to different insults in Tikrit teaching hospital. Open reduction and internal fixation was done to those patients of<60 years of age, while uncemented Austin-Moore hemiarthroplasty was conducted in patients of >60 years old. Patients were followed for 6-12 months for any complication.
Results: The main age group among the patients were those >60 years [13 (50%)]. The main cause of fracture was fall from standing position in 19 (73%), were treated by uncemented Austin-Moore prostheses. The main complications were hip and knee pain [8(30.7%) and5 (19.2%)] respectively.
Non-union (11.5%) and avascular necrosis (11.5%) was the commonest complications in young patients, and were treated by internal fixation especially if the time of surgery was delayed over 24 hours.
Conclusion: The reduction and internal fixation will continue to be used as the primary treatment of displaced intracapsular fracture in many younger patients because the benefits of preservation of the normal hip joint which should be done urgently within the first 24 hours. However, if this method of treatment is unsuccessful and requires revision, the risk of early complications is higher and hip function is poor. When hemiarthroplasty is the treatment of choice cemented fixation is preferable.
Key words: intracapsular, fracture, femoral neck


Article
12- SOFT TISSUE RECONSTRUCTION IN SEVERE OPEN LEG FRACTURES (GUSTILO TYPE III)

Authors: ZUHAIR F FATHALLAH --- ALI H KHUDAIR --- MAHMOOD A MAHMOODZ
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2008 Volume: 14 Issue: 2 Pages: 66
Publisher: Basrah University جامعة البصرة

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Abstract

Eighteen patients who sustained severe open leg fractures (Gustilo�s III) were treated in ALBasrahGeneral Hospital and Al-Sadder Teaching hospital between 2007 and 2008. Theywere12 males and 6 females, average age were 25 years. Middle third fractures occurred in 8cases (44.4%) and the comminuted geometry of fracture was in 14 patients (77.7%). All patientswere treated by meticulous wound excision with stabilization of fracture and then wound cover,which is done early in 6 patients (before 7 days) and late in 12 patients (after 7 days). Localmuscle flap was done in 9 patients (50%), local fasciocutanous flap in 6 patients (33.3%) andfree flap in 3(16.7%). The complications occurs more in late local reconstruction as flap infectionin (55.5%), nonunion in (33.3%), flap necrosis in (22.2%) and osteomylitis in (33.3%) while inearly reconstruction it is found only (16.6%) as a complication of each of the above. In muscleflap, flap infection found in (22.2%), flap necrosis in (11.1%) and nonunion in (22.2%) which waslower than other type of reconstruction, the muscle flap was more reliable flap in early period ofreconstructions. In conclusion, primary reconstruction of Gustilo's type III open tibial fractureshad advantages compared with secondary reconstruction.

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