A Prospective Study of Sarmiento’s Functional Cast Bracing Technique In Management Of Closed Tibial Shaft Fractures
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
Thirty five patients with diaphyseal fractures of the tibia were treated with use of functional cast bracing technique, between September 2014 and august 2016 at RIMS Hospital, Imphal. Patients aged between 17 to 75 years were included in the study. After the initial treatment in casuality, a long leg cast was applied to the affected leg and closed reduction was attempted. On satisfactory reduction, the patients were admitted and allowed partial weight bearing as comfortable and tolerable by the patients. After confirming the clinical and radiological signs of callus formation, the long leg cast was replaced with a functional cast brace, which facilitated the movements at the knee and ankle joints. Active range of motion exercises with partial weight bearing was encouraged. The patients were followed up regularly on opd basis, and assesed for union clinically and radiologically. In the present study, the mean age of the patients was 48 years, with even distribution of males and females. RTA was the most common mode of injury accounting for 29(82.65%) cases. Spiral fractures – accounted for 14(40%) fractures. The average time of application of the functional cast brace was 4.07 weeks after the injury. the Mean healing time for complete union of fracture was 18.42 weeks.The mean shortening at union was 6.73mm. 89 % fractures healed with a shortening of 10mm or less. Of the 35 fractures showing complete union, 14(40%) fractures united with varus angulation, with a mean varus angulation of 5.5 degree and 8(22.8%) fractures united with valgus angulation, with a mean valgus angulation of 5.18 dgree . 13 fractures united with no angulation in the coronal plane,7(20%) fractures united with anterior angulation, with a mean anterior angulation 4.64 degree and 12 (34.28%)fractures united with posterior angulation with a mean posterior angulation of 5.91 degree. 16 fractures united with no angulation in sagittal plane. The magnitude of angular deformity and shortening in fractures treated with functional cast bracing technique were within acceptable limits, as evident by the assessment of mean shortening and mean angular deformity and its comparison with the results of other similar studies. These findings appear to support our concept that function of the extremity is beneficial to osteogenesis and that closed, minimally displaced diaphyseal tibial fractures can be satisfactorily stabilized and managed using the functional cast bracing method.
Authors and Affiliations
Dr. Rohan Maske, Prof. S. Nongthon Singh, Prof. A. Mahendra Singh, Prof. S. N. Chishti, Assistant Prof. Roel Langshong, Dr. Pranav Masatwar, Dr. Sagnik Mukherjee, Dr. Wobemo Lotha
Keywords
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- EP ID EP595486
- DOI 10.9790/0853-160304105113
- Views 56
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