Management of Compound Metatarsal Fractures under Tamil Nadu Accident and Emergency Care Initiative

A. Subramanian, V. Sengodan
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Abstract

Ab s t r Ac t Introduction: Metatarsal fractures are common among foot injuries. This study aimed to evaluate and analyze the functional outcomes of compound metatarsal fractures using the anterograde retrograde fixation technique under the Tamil Nadu Accident and Emergency Care Initiative. Materials and methods: This is a prospective study done on patients admitted with compound metatarsal fractures in emergency orthopedic unit, Government Coimbatore Medical Hospital under Tamil Nadu Accident and Emergency Care Initiative between January 2020 and December 2020. The displaced compound metatarsal fractures are treated with limited internal fixation using Kirschner’s wires within the golden period of 6 hours and they were covered under Government of Tamil Nadu Chief Minister’s Comprehensive Health Insurance Scheme–Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (TNCMCHIS-AB-PMJAY). Anterograde retrograde technique was used for the fixation of compound metatarsal fractures. Results: The American Orthopaedic Foot and Ankle Society score was used to assess the functional outcome of compound metatarsal fractures. Good results were observed in 32 patients and excellent results were observed in 5 patients. Fair results were seen in three patients. Conclusion: The compound undisplaced metatarsal fractures can be treated conservatively. The displaced metatarsal fractures need limited internal fixation with Kirschner’s wires. The Tamil Nadu accident and emergency care initiative provide early treatment and early discharge of the patients. The health department is no more an expenditure department for the government since it generates money from TNCMCHIS– AB-PMJAY which is very useful for the patients from below poverty line.
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泰米尔纳德邦事故和紧急护理倡议下的复合性跖骨骨折管理
导读:跖骨骨折在足部损伤中很常见。本研究旨在评估和分析泰米尔纳德邦事故和紧急护理倡议下使用顺行逆行固定技术治疗复合跖骨骨折的功能结果。材料和方法:这是一项前瞻性研究,研究对象是2020年1月至2020年12月在泰米尔纳德邦事故和紧急护理倡议下的哥印拜陀政府医院急诊骨科收治的复合跖骨骨折患者。移位的复合跖骨骨折在6小时的黄金时间内使用克氏针进行有限内固定治疗,并在泰米尔纳德邦政府首席部长综合健康保险计划(tncmchis - b - pmjay)下进行保险。采用顺行逆行技术固定复合跖骨骨折。结果:采用美国骨科足踝学会评分评估复合跖骨骨折的功能结局。良32例,优5例。在3例患者中观察到良好的结果。结论:复合跖骨未移位骨折可保守治疗。移位的跖骨骨折需要用克氏针进行有限内固定。泰米尔纳德邦的事故和紧急护理倡议提供早期治疗和病人的早期出院。卫生部门不再是政府的支出部门,因为它从TNCMCHIS - AB-PMJAY中获得资金,这对贫困线以下的患者非常有用。
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