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  1. Fulltext Open reduction and Internal Fixation of Displaced Proximal Humerus Fractures with AO Stainless Steel T-Plate
    Hussain S, Gul M, Dhar S
    Malays Orthop J, 2014 Mar;8(1):8-13.
    PMID: 25279078 DOI: 10.5704/MOJ.1403.011
    BACKGROUND: Proximal humeral fractures are considered the last unsolved fractures in orthopaedics. The treatment is controversial and various operative modalities have been reported in the literature. The aim of the present study was to evaluate functional outcome and complication rate after open reduction and internal fixation of displaced proximal humerus fractures by proximal humerus AO stainless steel T-plate. Twenty-five (25) patients with displaced proximal humerus fractures treated with proximal humerus T-plate between May 2005 and June 2008 were included in the study. Fractures were classified according to the Neer classification into displaced 2-part, 3-part, and 4-part fractures. Patients were followed-up for a minimum period of two years. Functional evaluation was done according to the Neer scoring system. Scores were compared with other studies in the literature using similar implant. Twenty patients had 2-part fracture, four had 3-part fracture, and one had 4-part fracture. Eighty-eight [88% (n = 22)] patients had good to excellent result, eight [8% (n = 2)] had fair, and four [4% (n = 1)] had poor result. Difference in Neer's score between 2-part and 3-part fractures was not significant. Complications encountered in this series were screw backout in 8% (n = 2), superficial infection in 12% (n = 3), and avascular necrosis in 4% (n = 1) of cases. We conclude that proximal humerus AO T- plate is a cheap and easily available implant, aspects which are particularly relevant in third world countries like India. It gives reliable fixation for 2-part and 3-part fractures. Its use in more complicated fracture patterns of 4-part fractures is not recommended.

    KEY WORDS: Proximal humerus fractures, proximal humerus stainless steel T-plate, unstable fracture.

  2. Fulltext Surgical Management of Freiberg Disease by Dorsal Closing Wedge Osteotomy
    Dhar SA, Mir NA, Dar TA
    Malays Orthop J, 2020 Nov;14(3):161-165.
    PMID: 33403078 DOI: 10.5704/MOJ.2011.025
    Introduction: The purpose of the study was to assess the efficacy of the dorsal closing wedge osteotomy for the treatment of Freiburg's infraction.

    Material and Methods: Twenty patients with Freiburg's infraction were admitted at our hospital over a period of six years. Patients with a normal plantar contour of the metatarsal head were included. All patients underwent a dorsal closing wedge osteotomy of the metatarsal.

    Results: The mean Leeds Movement Performance Index (LMPI) score was 84 (range 70-86). The mean metatarsal shortening was 2mm. the passive flexion restriction was 16° and extension restriction was 10°. Also, a strong negative correlation was found between Smillie classification and American Orthopaedic Foot and Ankle Score (AOFAS) final score (r's = -0.85, P < .001).

    Conclusion: The dorsal closing wedge osteotomy is an efficient and reproducible method for the management of Freiburg's infraction.

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