Functional outcome of management of lower lumbar (L-3 to L-5) burst fractures: A multicentre study of 34 cases
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 2
Abstract
Aim and Objective: Lower lumbar burst fractures are rare entity with most of the literature restricted to small case series. There is no clear cut consensus on the guidelines for management. Here we present functional results of different modalities of treatment of this rare type of spine injury. Material and Methods: The study was conducted at two tertiary care centres over a period of 9 years. Patients with lower lumbar burst fractures were evaluated for associated injuries, modality of treatment, Pain score (VAS) and neurological status (Frankel Grade) at the time of injury and at final follow up were recorded. The final functional outcome was evaluated using Smiley-Webster functional score. Results: A total of 34 patients with an average age of 37.3 years (24 males; 10 females) and a mean final follow up of 27.9 months were enrolled. 21 patients had L3, 8 had L4 and 5 had L5 burst fractures. 10 patients were managed conservatively by brace and 24 underwent surgical intervention. The pain score (VAS) improved from a mean of 8.5 at the time of injury to a mean of 1.6 at final follow up. Patients with neurological injury had on average improvement of one Frankel grade. 88% patients had excellent to good final functional outcome. Conclusion: Lower lumbar burst fractures are high velocity injuries with other non-spinal injuries being associated. Most of the patients have good functional outcome with both conservative as well as surgical intervention. Patients with complete cauda equina have poor outcome with respect to neurological recovery.
Authors and Affiliations
Tarsem Motten, Raghavendra V, Nadeem Ali
Keywords
Related Articles
- EP ID EP501617
- DOI 10.22271/ortho.2017.v3.i2e.41
- Views 101
- Downloads 0
A prospective study of surgical management of the displaced supracondylar fractures of humerus in children with k wire fixation
Background: Supracondylar fractures of humerus is the commonest injury, constitutes about 65.4% of all fractures about the elbow in children. Displaced supracondylar fracture of humerus demand great respect and challengi...
Is thromboprophylaxis really justified among Indian population with femur shaft fractures treated with IM nailing?
Introduction: Venous thromboembolism (VTE), which consists of deep vein thrombosis (DVT) and pulmonary embolism, is one of the most common preventable cause of morbidity and mortality after trauma. Though most of the wes...
Impact of anterior stabilized insert on primary total knee arthroplasty (TKA) with an incompetent posterior cruciate ligament (PCL)
Background: The role of posterior cruciate ligament (PCL) conservation and the choice of the level of constraint of polyethylene insert in total knee arthroplasty (TKA) are still debated. The use of anterior stabilized b...
Evaluation of surgical treatment of inter-condylar humerus fracture with olecranon osteotomy approach
Background: Inter-condylar fracture distal humerus in adults often pose a challenge to orthopaedic surgeons because of the complex anatomy, fracture pattern and limited bone stock of this region. Adequate exposure of the...
Different surgical methods to manage avascular necrosis of head of femur
A prospective study was carried out on 30 patients who underwent core decompression, bipolar hemiarthroplasty, cemented/uncemented Total Hip Replacement in Department of Orthopaedics, NRI Institute of Medical Sciences. T...