Plating versus Ilizarov Technique for Complex Tibial Plateau Fractures: A Comparative Study on Functional Outcome and Patient Satisfaction

ObjectiveTo compare clinical and functional outcomes and complications of open reduction internal fixation (ORIF) by plating and Ilizarov technique in complex tibial plateau fractures. MethodsThis study is a randomized clinical trial accompanying 56 patients having Schatzker type V and VI tibial plateau fractures. We divided patients into two groups for management. Group I; open reduction internal fixation versus Ilizarov technique (Group II). We conducted at the Orthopedics Department, Jinnah post-graduate medical centre, Karachi, from April-2018 to Oct2020. The endpoint assessed patients’ satisfaction and clinical and functional outcomes up to an 18-month follow-up. ResultsThe aetiology of tibial fracture was mainly road traffic accidents (RTA); 17 (70.9%) in ORIF versus 23 (71.8%) in the Ilizarov group. According to clinical outcomes, excellent extension lag was achieved in 100% of patients in both groups. Most patients had excellent knee flexion, thigh atrophy and instability outcomes (54.1% vs 59.37%, 87.5% vs 81.2% and 83.3% vs 87.5%). The functional outcome assessment was done and recorded for 18 months of follow-up. There was no significant difference in normal walking, stair climbing, squatting, jumping and duck walking between the groups. The overall rate of complications was similar; 11 (45.8%) in ORIF versus 17 (53.12%) in the Illizarov group (p-value 0.78). ConclusionOur study concludes that there is an excellent clinical and functional outcome found in both procedures.   DOI: https: //doi. Org/10.59564/amrj/01.01/008

Socio-Economic Factors of Depression Among Women in Selected Districts of Gilgit-Baltistan, Pakistan

This study titled as Socio-economic Factors of Depression among Women in Selected Districts of Gilgit-Baltistan, Pakistan, was carried out with Mixed Method Research (MMR) approach under the concurrent triangulation strategy of analysis. For quantitative data, a self-designed structured questionnaire was used to collect data about socio-economic profile of the respondents whereas Diagnostic Statistical Manual (DSM) was applied to diagnose the women with depression. Severity of depression was assessed on the basis of DSM severity scale. Chi square test was applied to find out association between socio-economic variables and depression. Qualitative data was managed manually using interview guide. Both quantitative data and qualitative data were triangulated for comparison to see similarities and dissimilarities therein. The study population included 450 women, out of whom 300 had depression while the rest 150 respondents were non-depression respondents who were interviewed for the sake of comparison. Mean age of the respondents was 35.4 years (SD±11.61). Ninety seven percent had moderate depression. Bivariate analysis showed that depression in sampled women was significantly associated with domestic violence, household debt, polygamy of husbands, emotional abuse, early marriage, non-cordial relationship with in-laws and lack of freedom in the context of spending. The emerging themes of qualitative data during the in-depth interview were almost the same except the hiding of information about their illness from community and other family members. The reason for such act was to avert socially and culturally induced phenomena. The matching qualitative themes included early marriage, domestic abuse, economic difficulties, suicidal behaviour and distortion in social relationships among depressed women. In a nut shell, all the emerging themes were in congruence with the quantitative findings except hiding of depression. The study recommends the inculcation of massive awareness regarding the negative bearings of depression and also generation of socio-economic opportunities for women in Gilgit-Baltistan (GB).