Clausen McLeod (sisterfender1)

Management of the complex non union of tibia is a challenging task due to infection, bony gap, deformity, poor bone quality and poor soft tissue cover at fracture site. The limb reconstruction system (LRS) or Rail fixator has emerged as a viable option for the treatment of the same as it can address most of all above problems. It is more patient friendly and easier to apply in comparison to Ilizarov ring fixator. Twenty two patients (17 males and 5 females) with complex non union of tibia underwent thorough debridement and resection of non viable bone followed by bone transport to fill the gap and then lengthening (8 patients) or acute docking & lengthening (14 patients) by the use of rail fixator. The average time to union, bone gap filled, lengthening achieved, treatment index were measured. The bone and functional outcome assessment was done by ASAMI score. The complications were classified according to Paley's classification. Union without residual infection was achieved in 20 (90.1%) patients while 2 patients had failure. As per ASAMI criteria bone results were excellent in 12 (54.5%), good in 5 (22.7%), fair in 3 (13.6%) and poor in 2 (9.1%). Functional results were excellent in 11 (50%), good in 5 (22.72%), fair in 4 (18.18%) and failure in 2 (9%). Mean treatment duration was 8.2 months (range 7-19 months). Mean follow up duration was 11.3 months (range - 8.3 to 22 months). Average lengthening achieved was 4cm (0-9cm). Treatment index was 2.1month/cm. The monolateral rail fixator is simple, effective, easier to apply and more patient compliant with acceptable functional and radiological outcome. The monolateral rail fixator is simple, effective, easier to apply and more patient compliant with acceptable functional and radiological outcome. Depression is characterized by a persistent state of low mood and aversion to activity affecting a person's thoughts, behavior, feelings and sense of well-being. It has been reported in Orthopaedic trauma patients. Depression is likely to interfere in an individual's ability to sustain a long duration rehabilitation programme leading to poor function and delayed return to a productive lifestyle. The objective of this study was to identify the prevalence and identify factors associated with depression in indoor Orthopaedic trauma patients. This prospective cohort study was conducted on 190 adult Orthopaedic trauma patients enrolled on a randomly selected day of a week subject to written informed consent. Patients with conditions that may preclude assessment of the mental status were excluded from the study. Age, sex, duration since injury, Injury Severity Score (ISS), type of surgery, marital status, insurance coverage, level of education, socioeconomic status, familial support, substance abuse. PHI-101 solubility dmso Hospital anxiety and depression scale (HADS) score and pain score (visual analogue scale) were recorded as soon as the patient was stabilized. Bivariate analyses and Logistic regression were used to identify factors associated with a HADS score of ≥8. Mean age was 33.8 years. One hundred fifty-one (79.47%) patients were males and thirty-nine patients were females (21.53%). A HADS score ≥8 was present in 42.63% enrolled cases. On logistic regression a higher pain score, nuclear family, and female sex were found to be significantly associated with HADS ≥8. Depression is common in indoor Orthopaedic trauma patients. HADS may be used to screen patients for depression and refer patients to a psychiatrist for a definitive diagnosis and management. Depression is common in indoor Orthopaedic trauma patients. HADS may be used to screen patients for depression and refer patients to a psychiatrist for a definitive diagnosis and management. Use of uncemented femoral stems for treating displaced intra capsular hip fractures in elderly is increasing worldwide. The aim of our study is