Pub Date : 2021-10-01DOI: 10.33545/orthor.2021.v5.i4b.333
Dr. Burhan Bhat, Dr. Ishtiaq Abdullah, Dr. Sulaiman Sath, Dr. zameer Ali, Dr. AR Badoo, Dr. Jabreel Muzaffar, Dawood Khan
Background: Osteoarthritis (OA) is one of the most prevalent conditions resulting to disability particularly in elderly population. Plain radiography remains a mainstay in the diagnosis of OA. Hence; under the light of above mentioned data, the present study was undertaken for assessing radiographic findings in patients with osteoarthritis of knee. Materials and Methods: Present study was conducted on 20 patients with presenting with knee pain and clinical suspicion of osteoarthritis. Detailed radiographic and MR imaging was be done in all subjects. Radiographic examination was done. All radiographs were assigned scores by using the Kellgren-Lawrence scoring system. This summary Kellgren-Lawrence score was based on osteophyte formation, joint space narrowing, sclerosis, and joint deformity characteristics according to the five-level scale defined as follows: grade 0, normal; grade 1, doubtful osteoarthritis; grade 2, minimal osteoarthritis; grade 3, moderate osteoarthritis; or grade 4, severe osteoarthritis. Radiographic findings were compiled as per performa and subjected to analysis using appropriate statistical tests. Results: 20 percent of the patients each showed doubtful and minimal osteoarthritis while the remaining 10 percent of the patients showed moderate osteoarthritis. On MRI examination, no meniscal abnormalities were seen in 25 percent of the patients while Globular intrasubstance abnormalities were seen in 35 percent of the patients. Linear intrasubstance meniscal abnormality was seen in 25 percent of the patients while Tear (displaced/ undisplaced/ complex/ macerated) was seen in 15 percent of the patients. Conclusion: The pathologic changes of pre-radiographic OA can be detected at an earlier stage of the disease through radiographic examination.
{"title":"Assessment of radiographic findings in patients with osteoarthritis of knee","authors":"Dr. Burhan Bhat, Dr. Ishtiaq Abdullah, Dr. Sulaiman Sath, Dr. zameer Ali, Dr. AR Badoo, Dr. Jabreel Muzaffar, Dawood Khan","doi":"10.33545/orthor.2021.v5.i4b.333","DOIUrl":"https://doi.org/10.33545/orthor.2021.v5.i4b.333","url":null,"abstract":"Background: Osteoarthritis (OA) is one of the most prevalent conditions resulting to disability particularly in elderly population. Plain radiography remains a mainstay in the diagnosis of OA. Hence; under the light of above mentioned data, the present study was undertaken for assessing radiographic findings in patients with osteoarthritis of knee. Materials and Methods: Present study was conducted on 20 patients with presenting with knee pain and clinical suspicion of osteoarthritis. Detailed radiographic and MR imaging was be done in all subjects. Radiographic examination was done. All radiographs were assigned scores by using the Kellgren-Lawrence scoring system. This summary Kellgren-Lawrence score was based on osteophyte formation, joint space narrowing, sclerosis, and joint deformity characteristics according to the five-level scale defined as follows: grade 0, normal; grade 1, doubtful osteoarthritis; grade 2, minimal osteoarthritis; grade 3, moderate osteoarthritis; or grade 4, severe osteoarthritis. Radiographic findings were compiled as per performa and subjected to analysis using appropriate statistical tests. Results: 20 percent of the patients each showed doubtful and minimal osteoarthritis while the remaining 10 percent of the patients showed moderate osteoarthritis. On MRI examination, no meniscal abnormalities were seen in 25 percent of the patients while Globular intrasubstance abnormalities were seen in 35 percent of the patients. Linear intrasubstance meniscal abnormality was seen in 25 percent of the patients while Tear (displaced/ undisplaced/ complex/ macerated) was seen in 15 percent of the patients. Conclusion: The pathologic changes of pre-radiographic OA can be detected at an earlier stage of the disease through radiographic examination.","PeriodicalId":151163,"journal":{"name":"National Journal of Clinical Orthopaedics","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114703544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.33545/orthor.2021.v5.i4b.330
Dr. Amit N Rajpal, Dr. Ayon Das, Dr. Arijit Das
Background: The management of bicondylar fracture of proximal tibia is a challenging task and the objective of treatment is to achieve stable, painless and mobile joint and also to prevent the secondary degeneration of the joint. Dual plating in such fractures is beneficial to address fracture fragments in different planes and also to achieve anatomical reduction under direct vision. The aim of the study was to evaluate the functional results in patients with tibial plateau bicondylar fracture treated by open reduction and internal fixation using dual plate osteosynthesis. Materials and Methods: Patients who underwent dual plate fixation for post-traumatic bicondylar tibial plateau fracture were included in the study. This was a prospective study conducted at a Tertiary care Private Hospital in Kolkata, between August 2017 to May 2020. All patients were followed up at an interval of 2 weeks, 6 weeks, 12 weeks, 6 months, 9 months, 1 year and 1.5 year. Radiological and functional results were classified in four categories as per Rasmussen’s criteria. Results: Outcome at final follow-up was assessed with Rasmussen’s functional grading system. In a total of 40 patients, 24 (60%) patients showed Excellent and 11 (27.5%) patients had Good results whereas 4 (10%) patients had Fair outcome and 1 (2.5%) patient demonstrated Poor surgical result at the final follow-up. Rasmussen’s radiological assessment showed 7 (17.5%) Excellent, 25 (62.5%) Good, 5 (12.5%) Fair and 3 (7.5%) patients with Poor result. At the end of 1.5 year, the average Rasmussen’s functional knee score for 40 patients was 25.85 ± 4.83. Conclusion: Dual plate fixation of intra-articular bicondylar tibial plateau fractures is a safe and effective treatment option as it provides good surgical exposure, less soft tissue injury, rigid fixation, acceptable alignment of articular congruity, reasonable time to union and allows early weight bearing and range of motion of knee with good functional outcome.
{"title":"Intra-articular bicondylar tibial plateau fractures managed surgically by dual plate osteosynthesis: A clinico-radiological and functional outcome evaluation","authors":"Dr. Amit N Rajpal, Dr. Ayon Das, Dr. Arijit Das","doi":"10.33545/orthor.2021.v5.i4b.330","DOIUrl":"https://doi.org/10.33545/orthor.2021.v5.i4b.330","url":null,"abstract":"Background: The management of bicondylar fracture of proximal tibia is a challenging task and the objective of treatment is to achieve stable, painless and mobile joint and also to prevent the secondary degeneration of the joint. Dual plating in such fractures is beneficial to address fracture fragments in different planes and also to achieve anatomical reduction under direct vision. The aim of the study was to evaluate the functional results in patients with tibial plateau bicondylar fracture treated by open reduction and internal fixation using dual plate osteosynthesis. Materials and Methods: Patients who underwent dual plate fixation for post-traumatic bicondylar tibial plateau fracture were included in the study. This was a prospective study conducted at a Tertiary care Private Hospital in Kolkata, between August 2017 to May 2020. All patients were followed up at an interval of 2 weeks, 6 weeks, 12 weeks, 6 months, 9 months, 1 year and 1.5 year. Radiological and functional results were classified in four categories as per Rasmussen’s criteria. Results: Outcome at final follow-up was assessed with Rasmussen’s functional grading system. In a total of 40 patients, 24 (60%) patients showed Excellent and 11 (27.5%) patients had Good results whereas 4 (10%) patients had Fair outcome and 1 (2.5%) patient demonstrated Poor surgical result at the final follow-up. Rasmussen’s radiological assessment showed 7 (17.5%) Excellent, 25 (62.5%) Good, 5 (12.5%) Fair and 3 (7.5%) patients with Poor result. At the end of 1.5 year, the average Rasmussen’s functional knee score for 40 patients was 25.85 ± 4.83. Conclusion: Dual plate fixation of intra-articular bicondylar tibial plateau fractures is a safe and effective treatment option as it provides good surgical exposure, less soft tissue injury, rigid fixation, acceptable alignment of articular congruity, reasonable time to union and allows early weight bearing and range of motion of knee with good functional outcome.","PeriodicalId":151163,"journal":{"name":"National Journal of Clinical Orthopaedics","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128893684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.33545/orthor.2021.v5.i4b.335
Deepak Rajput, Dr. Ankur Bansal, Dr. Kumar Rahul
Background: Idiopathic genu valgum is one of the common deformity encountered in OPD of orthopaedics. After a fair conservative trail to treat the deformity fails, temporary epiphysiodesis become the standard treatment. This deformity can also be treated with several types of osteotomies with additional risk of extensive soft tissue handling, infection, delayed union, non-union, malunion etc. various method of temporary epiphysiodesis are present but most of them are on the principle of compression such as stapling, transphyseal screws fixation etc. On the other hand 8 plate, works on the principle of tension band. Hereby the aim of this study is to see the functional outcome and complications related to 8 plate generated growth modulation. Method: Study design was prospective and interventional, between June 2018 to May 2020.Eight plate was implanted on 16 patients aged between 6 years to 15 years suffering from genu valgum deformity. Plate was implanted over distal femur medially. Patients were evaluated pre-operatively and post-operatively by determining various joint angles both clinically and radiologically. Following are the various joint angles evaluated: All these paraments were recorded in each follow up and data collected was analyzed statistically. Result: 16 patients were included in the study with a median follow up of 16 months. Out of 16 patients operated 6 were females. A mean pre-operative and post-operative tibio femoral axis were recorded. We observed a p-value of 0.001 which is statistically significant. Conclusion: Growth modulation using 8 plate method proves to be an effective method for correcting genu valgum deformity in skeletally immature patients. It is a reversible procedure and surgeon friendly and at the same time 8 plate adjust dynamically to the ever changing physeal anatomy.
{"title":"Functional outcome of temporary hemiepiphysiodesis by using 8 plate in patients with genu valgum deformity","authors":"Deepak Rajput, Dr. Ankur Bansal, Dr. Kumar Rahul","doi":"10.33545/orthor.2021.v5.i4b.335","DOIUrl":"https://doi.org/10.33545/orthor.2021.v5.i4b.335","url":null,"abstract":"Background: Idiopathic genu valgum is one of the common deformity encountered in OPD of orthopaedics. After a fair conservative trail to treat the deformity fails, temporary epiphysiodesis become the standard treatment. This deformity can also be treated with several types of osteotomies with additional risk of extensive soft tissue handling, infection, delayed union, non-union, malunion etc. various method of temporary epiphysiodesis are present but most of them are on the principle of compression such as stapling, transphyseal screws fixation etc. On the other hand 8 plate, works on the principle of tension band. Hereby the aim of this study is to see the functional outcome and complications related to 8 plate generated growth modulation. Method: Study design was prospective and interventional, between June 2018 to May 2020.Eight plate was implanted on 16 patients aged between 6 years to 15 years suffering from genu valgum deformity. Plate was implanted over distal femur medially. Patients were evaluated pre-operatively and post-operatively by determining various joint angles both clinically and radiologically. Following are the various joint angles evaluated: All these paraments were recorded in each follow up and data collected was analyzed statistically. Result: 16 patients were included in the study with a median follow up of 16 months. Out of 16 patients operated 6 were females. A mean pre-operative and post-operative tibio femoral axis were recorded. We observed a p-value of 0.001 which is statistically significant. Conclusion: Growth modulation using 8 plate method proves to be an effective method for correcting genu valgum deformity in skeletally immature patients. It is a reversible procedure and surgeon friendly and at the same time 8 plate adjust dynamically to the ever changing physeal anatomy.","PeriodicalId":151163,"journal":{"name":"National Journal of Clinical Orthopaedics","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127032896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.33545/orthor.2021.v5.i4a.318
Dr. Prabhav Tijoriwala, D. Patel, Dr. Sunny Patel, Dr. Ekta Mehta, Dr. Janak Rathod
Introduction: Anterior bridge plating with minimally invasive technique for type A shaft humeral fractures is reported as an acceptable less traumatic and reproducible procedure by several authors. We have evaluated the clinical, radiological, and functional outcome of such fractures in twenty patients, all of which were managed with dynamic compression plate over an average follow- up period of 12 months. Though open reduction and plating technique of humerus shaft fracture is prevailing, this technique also gives favorable outcome. Materials and Methods: Twenty patients with type a humerus shaft fractures were managed by anterior bridge plating using MIPO technique between March 2017 to November 2019 were included in this series. All cases were treated with closed reduction and 10-12 whole 4.5mm dynamic compression plate fixation over anterior aspect in bridging mode using the MIPO technique. The dominant side, gender ratio, surgery time, and fracture union time, and complications were noted. The UCLA shoulder and Mayo elbow performance scores were used for assessing the shoulder and elbow function. Results: Of the Twenty patients in the study, ten were males and ten were females. The mean age was 34.3 years (range 18 to 85 years) twelve out of twenty patients (60%) had the dominant side fractured. Mean surgical time in minutes was 88.98 (range: 50 to 150 minutes). The mean fracture union (radiological) time was 14.3 weeks (range: 10–16 weeks) and clinical union time was 10.4 week. However Shoulder function was excellent in 20 cases (100%) on the UCLA score. Conclusion: This study confirmed a high overall rate of union and excellent functional outcomes. Mini incision anterior bridge technique for type A fracture shaft humerus gives good functional results and should be considered as an effective, cosmetically advanced surgical option in the treatment of type A humeral shaft fractures. It is a safe and less time consuming method for type a humeral shaft fractures when the surgeon is experienced in the technique. clinical, radiological, and functional outcomes of this mini invasive technique for humerus fracture over a minimum follow-up of 2 year and 8 months. Our study is about AOOTA type a shaft humerus fracture.
{"title":"Anterior bridge plating with mini incision MIPO technique for type a humerus diaphyseal fractures","authors":"Dr. Prabhav Tijoriwala, D. Patel, Dr. Sunny Patel, Dr. Ekta Mehta, Dr. Janak Rathod","doi":"10.33545/orthor.2021.v5.i4a.318","DOIUrl":"https://doi.org/10.33545/orthor.2021.v5.i4a.318","url":null,"abstract":"Introduction: Anterior bridge plating with minimally invasive technique for type A shaft humeral fractures is reported as an acceptable less traumatic and reproducible procedure by several authors. We have evaluated the clinical, radiological, and functional outcome of such fractures in twenty patients, all of which were managed with dynamic compression plate over an average follow- up period of 12 months. Though open reduction and plating technique of humerus shaft fracture is prevailing, this technique also gives favorable outcome. Materials and Methods: Twenty patients with type a humerus shaft fractures were managed by anterior bridge plating using MIPO technique between March 2017 to November 2019 were included in this series. All cases were treated with closed reduction and 10-12 whole 4.5mm dynamic compression plate fixation over anterior aspect in bridging mode using the MIPO technique. The dominant side, gender ratio, surgery time, and fracture union time, and complications were noted. The UCLA shoulder and Mayo elbow performance scores were used for assessing the shoulder and elbow function. Results: Of the Twenty patients in the study, ten were males and ten were females. The mean age was 34.3 years (range 18 to 85 years) twelve out of twenty patients (60%) had the dominant side fractured. Mean surgical time in minutes was 88.98 (range: 50 to 150 minutes). The mean fracture union (radiological) time was 14.3 weeks (range: 10–16 weeks) and clinical union time was 10.4 week. However Shoulder function was excellent in 20 cases (100%) on the UCLA score. Conclusion: This study confirmed a high overall rate of union and excellent functional outcomes. Mini incision anterior bridge technique for type A fracture shaft humerus gives good functional results and should be considered as an effective, cosmetically advanced surgical option in the treatment of type A humeral shaft fractures. It is a safe and less time consuming method for type a humeral shaft fractures when the surgeon is experienced in the technique. clinical, radiological, and functional outcomes of this mini invasive technique for humerus fracture over a minimum follow-up of 2 year and 8 months. Our study is about AOOTA type a shaft humerus fracture.","PeriodicalId":151163,"journal":{"name":"National Journal of Clinical Orthopaedics","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131843156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.33545/orthor.2021.v5.i4a.325
Dr. Ahmad Shakir Turkey Alawadi, Dr. Yaman Ahmad Kadhim, Dr. Hamed Gata Hassen
We study the use of paternal fresh allograft in pediatric massive bony loss (post benign bone tumor resection) with a graft type of combined Cortico-cancellous and cancellous bone, with a good result of rapid and complete union with no recurrence with in 2years of follow up, with no any sign of local or systemic rejection. Study of 2 patients, one of an osteoblastoma in female of 9 years old in shaft femur and the second case was an aneurysmal bone cyst (ABC) in male of 11 years old in distal third of fibula where in both do enbloc resection for a big bony lesions in such young age group, the defect was 8cm in the female and 9 cm in male case. We reconstruct these defects by the fresh non-frozen paternal allograft which still not widely used method and we add the use of Combined Cortico-cancellous and cancellous bone graft of iliac crest area which was not used or mentioned before in literatures and we do internal fixation in both and we wash the graft 2 times pre and post application in the gap with a normal saline for each case, follow up by monthly x-ray films till healing. Was conclusive and more than expected regarding healing rate and union which was 6month in female case and 5 month in male and no complication in such big bony graft mass. In Followed up of 2 years no recurrance was seen and both donors and without any disability nor morbidity.
{"title":"Combined Cortico-cancellous and cancellous fresh paternal allograft in defect post resection of benign bone tumors of long bones in children, review of literatures with two cases study","authors":"Dr. Ahmad Shakir Turkey Alawadi, Dr. Yaman Ahmad Kadhim, Dr. Hamed Gata Hassen","doi":"10.33545/orthor.2021.v5.i4a.325","DOIUrl":"https://doi.org/10.33545/orthor.2021.v5.i4a.325","url":null,"abstract":"We study the use of paternal fresh allograft in pediatric massive bony loss (post benign bone tumor resection) with a graft type of combined Cortico-cancellous and cancellous bone, with a good result of rapid and complete union with no recurrence with in 2years of follow up, with no any sign of local or systemic rejection. Study of 2 patients, one of an osteoblastoma in female of 9 years old in shaft femur and the second case was an aneurysmal bone cyst (ABC) in male of 11 years old in distal third of fibula where in both do enbloc resection for a big bony lesions in such young age group, the defect was 8cm in the female and 9 cm in male case. We reconstruct these defects by the fresh non-frozen paternal allograft which still not widely used method and we add the use of Combined Cortico-cancellous and cancellous bone graft of iliac crest area which was not used or mentioned before in literatures and we do internal fixation in both and we wash the graft 2 times pre and post application in the gap with a normal saline for each case, follow up by monthly x-ray films till healing. Was conclusive and more than expected regarding healing rate and union which was 6month in female case and 5 month in male and no complication in such big bony graft mass. In Followed up of 2 years no recurrance was seen and both donors and without any disability nor morbidity.","PeriodicalId":151163,"journal":{"name":"National Journal of Clinical Orthopaedics","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124942745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.33545/orthor.2021.v5.i4b.331
Dr. Paresh V Patil, Dr. Mithilesh A Nikam, Dr. P. Senthil Kumar
Introduction: The calcaneus is the largest tarsal bone and the most commonly fractured. Calcaneal fractures account for about 2% of all fractures, with 75 percent of these being intra-articular. Anatomic restoration in intra-articular calcaneal fractures was not always associated with a positive outcome in terms of quality of life, hence the best treatment option is still up for debate. Open reduction and internal fixation (ORIF) is considered an exemplary modality for treating calcaneal fractures. Soft tissue complications after ORIF procedures, on the other hand, have been reported to be as high as 30%. Scholars have advocated external fixation, percutaneous cannulated cancellous screw fixation, and Schanz pin assisted reduction and fixation as minimally invasive methods to reduce postoperative problems. In the present study, we aim to study the outcome of intra-articular calcaneum fractures treated with percutaneous cannulated cancellous screws V/S open reduction internal fixation with calcaneum plates. Materials and Methods: 22 patients with intra-articular calcaneum fracture (with displacement > 2mm) were recruited for the study after taking informed written consent. Patients were divided randomly into 2 groups; Group A were treated with minimally invasive percutaneous cannulated cancellous (CC) screw fixation. While patients in Group B were treated with open reduction internal fixation (ORIF) with plating. The study was a randomized controlled trial conducted at Krishna Institute of Medical Sciences, Karad during the period of May-2020 to May-2021. Pre-operative and post-operative Bohler’s angles were calculated using PACS, functional outcome was assessed at 6 months post-operatively using AOFAS score and post operative pain was assessed using VAS score. Results: The present study indicated no significant difference in the post-operative maintenance of Bohler’s angle when operated by either of the techniques. But, functional outcome in terms of AOFAS score when assessed at the end of 6 months indicated an excellent and good outcome in patients operated with cannulated cancellous screws as compared to patients operated with ORIF with calcaneum plating. Post operative complications were reported significantly high in group of patients operated with ORIF with plating as compared to percutaneous CC screw group patients. Conclusion: Percutaneous minimally invasive fixation using cannulated cancellous screws are better choice than ORIF with calcaneum plating due to lesser post operative pain and soft tissue complications, better functional outcome in terms of AOFAS score and lesser implant related soft tissue complications.
{"title":"Percutaneous cannulated cancellous screw fixation v/s open reduction and internal fixation with plating for intra-articular calcaneal fractures","authors":"Dr. Paresh V Patil, Dr. Mithilesh A Nikam, Dr. P. Senthil Kumar","doi":"10.33545/orthor.2021.v5.i4b.331","DOIUrl":"https://doi.org/10.33545/orthor.2021.v5.i4b.331","url":null,"abstract":"Introduction: The calcaneus is the largest tarsal bone and the most commonly fractured. Calcaneal fractures account for about 2% of all fractures, with 75 percent of these being intra-articular. Anatomic restoration in intra-articular calcaneal fractures was not always associated with a positive outcome in terms of quality of life, hence the best treatment option is still up for debate. Open reduction and internal fixation (ORIF) is considered an exemplary modality for treating calcaneal fractures. Soft tissue complications after ORIF procedures, on the other hand, have been reported to be as high as 30%. Scholars have advocated external fixation, percutaneous cannulated cancellous screw fixation, and Schanz pin assisted reduction and fixation as minimally invasive methods to reduce postoperative problems. In the present study, we aim to study the outcome of intra-articular calcaneum fractures treated with percutaneous cannulated cancellous screws V/S open reduction internal fixation with calcaneum plates. Materials and Methods: 22 patients with intra-articular calcaneum fracture (with displacement > 2mm) were recruited for the study after taking informed written consent. Patients were divided randomly into 2 groups; Group A were treated with minimally invasive percutaneous cannulated cancellous (CC) screw fixation. While patients in Group B were treated with open reduction internal fixation (ORIF) with plating. The study was a randomized controlled trial conducted at Krishna Institute of Medical Sciences, Karad during the period of May-2020 to May-2021. Pre-operative and post-operative Bohler’s angles were calculated using PACS, functional outcome was assessed at 6 months post-operatively using AOFAS score and post operative pain was assessed using VAS score. Results: The present study indicated no significant difference in the post-operative maintenance of Bohler’s angle when operated by either of the techniques. But, functional outcome in terms of AOFAS score when assessed at the end of 6 months indicated an excellent and good outcome in patients operated with cannulated cancellous screws as compared to patients operated with ORIF with calcaneum plating. Post operative complications were reported significantly high in group of patients operated with ORIF with plating as compared to percutaneous CC screw group patients. Conclusion: Percutaneous minimally invasive fixation using cannulated cancellous screws are better choice than ORIF with calcaneum plating due to lesser post operative pain and soft tissue complications, better functional outcome in terms of AOFAS score and lesser implant related soft tissue complications.","PeriodicalId":151163,"journal":{"name":"National Journal of Clinical Orthopaedics","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116437456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.33545/orthor.2021.v5.i4a.323
D. Vn, D. Mj, Dr. V. P. Singh
The motion in the lumbar spine is divided between five motion segments, although a disproportionate amount of the motion is in the lower segments (L3-L4 and L4-L5). The two lowest discs (L4-L5 and L5-S1) take the most strain and are the most likely to herniate. This can cause lower back pain and possibly numbness that radiates through the leg and down to the foot (sciatica). Written informed consent for participation in the study was obtained from all the subjects. After the patient’s informed consent was obtained, 150 patients with lumbar disc prolapse were subjected to epidural steroid infiltration out of which 101 underwent IL procedure and 49 underwent TF epidural steroid injections under the fluoroscopic guidance according to surgeons preference. As per my study out of the total 150 patients, 105(70%) improved in their symptoms only with epidural steroid and 45 patients (30%) proceeded to surgery, which was statistically significant.
{"title":"Clinical profile of patients with lumbar disc prolapse","authors":"D. Vn, D. Mj, Dr. V. P. Singh","doi":"10.33545/orthor.2021.v5.i4a.323","DOIUrl":"https://doi.org/10.33545/orthor.2021.v5.i4a.323","url":null,"abstract":"The motion in the lumbar spine is divided between five motion segments, although a disproportionate amount of the motion is in the lower segments (L3-L4 and L4-L5). The two lowest discs (L4-L5 and L5-S1) take the most strain and are the most likely to herniate. This can cause lower back pain and possibly numbness that radiates through the leg and down to the foot (sciatica). Written informed consent for participation in the study was obtained from all the subjects. After the patient’s informed consent was obtained, 150 patients with lumbar disc prolapse were subjected to epidural steroid infiltration out of which 101 underwent IL procedure and 49 underwent TF epidural steroid injections under the fluoroscopic guidance according to surgeons preference. As per my study out of the total 150 patients, 105(70%) improved in their symptoms only with epidural steroid and 45 patients (30%) proceeded to surgery, which was statistically significant.","PeriodicalId":151163,"journal":{"name":"National Journal of Clinical Orthopaedics","volume":"60 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129520328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.33545/orthor.2021.v5.i4a.328
Dr. Prabhav Tijoriwala, D. Patel, Dr. Sunny Patel, Dr. Ekta Mehta, Dr. Dharmesh Machhar, Dr. Janak Rathod
Background: Femoral neck fractures are one of the problems in clinical treatment. The prognosis is uncertain. Currently, no internal fixation method is superior to other internal fixation methods in the treatment of femoral neck fractures. Therefore, the internal fixation system needs to be further explored. The aim of this study was to compare clinical outcomes of femoral neck dynamic Hip screw system and multiple cannulated compression screws in the treatment of femoral neck fractures. Methods: This randomized control trial was conducted in the Department of Orthopedics, SURAT Municipal Institute of Medical Science, Surat. Results: 6 months Post operatively Harris Hip score evaluations clearly state DHS as a superior implant to cancellous screws. Also, there was 1 fixation failure in DHS group whereas there were 3 fixation failure in Cannulated screw groups. The surgery duration, radiation time and blood loss were significantly low with cannulated cancellous screws. Conclusion: The results of present study support the hypothesis that DHS is a better implant than CC screws in management of fracture neck femur in young adults in pauwels type II and III in terms of functional outcome but complication rate does not depend on the implant selection, however a longer follow up will consolidate these results. Although the surgery duration, radiation time, blood loss and infection rate is more in DHS. It gives a better result than CC screws based on radiological union and functional status of the patients.
{"title":"A comparision and analysis of dynamic hip screw v/s multiple cannulated cancellous screws for neck femur fractures in young Indian population","authors":"Dr. Prabhav Tijoriwala, D. Patel, Dr. Sunny Patel, Dr. Ekta Mehta, Dr. Dharmesh Machhar, Dr. Janak Rathod","doi":"10.33545/orthor.2021.v5.i4a.328","DOIUrl":"https://doi.org/10.33545/orthor.2021.v5.i4a.328","url":null,"abstract":"Background: Femoral neck fractures are one of the problems in clinical treatment. The prognosis is uncertain. Currently, no internal fixation method is superior to other internal fixation methods in the treatment of femoral neck fractures. Therefore, the internal fixation system needs to be further explored. The aim of this study was to compare clinical outcomes of femoral neck dynamic Hip screw system and multiple cannulated compression screws in the treatment of femoral neck fractures. Methods: This randomized control trial was conducted in the Department of Orthopedics, SURAT Municipal Institute of Medical Science, Surat. Results: 6 months Post operatively Harris Hip score evaluations clearly state DHS as a superior implant to cancellous screws. Also, there was 1 fixation failure in DHS group whereas there were 3 fixation failure in Cannulated screw groups. The surgery duration, radiation time and blood loss were significantly low with cannulated cancellous screws. Conclusion: The results of present study support the hypothesis that DHS is a better implant than CC screws in management of fracture neck femur in young adults in pauwels type II and III in terms of functional outcome but complication rate does not depend on the implant selection, however a longer follow up will consolidate these results. Although the surgery duration, radiation time, blood loss and infection rate is more in DHS. It gives a better result than CC screws based on radiological union and functional status of the patients.","PeriodicalId":151163,"journal":{"name":"National Journal of Clinical Orthopaedics","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123854659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.33545/orthor.2021.v5.i4b.396
Dr. Roshan I, Dr. Rajashekhara G, D. Gh, Dr. Mahesh G
{"title":"Functional outcome following arthroscopic ACL reconstruction using 4 stranded hamstring autograft and preservation of hamstring graft at tibial insertion","authors":"Dr. Roshan I, Dr. Rajashekhara G, D. Gh, Dr. Mahesh G","doi":"10.33545/orthor.2021.v5.i4b.396","DOIUrl":"https://doi.org/10.33545/orthor.2021.v5.i4b.396","url":null,"abstract":"","PeriodicalId":151163,"journal":{"name":"National Journal of Clinical Orthopaedics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130191557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.33545/orthor.2021.v5.i4a.326
Dr. Jacob Ipe, D. Ba, D. S. Reddy, Dr.M.Abhinandan Reddy
The purpose of this study is to evaluate the functional outcome as well as radiological outcome of distal metaphyseal tibial fractures treated with intramedullary interlocking nail after 6 months post surgery in terms of degree of functionality preserved and degree of malalignment respectively. This was an observational study conducted with 38 patients. Data was retrieved from the MRD. Patients were clinically assessed at 6 months interval and as and when needed by Karlstorm and Orleud Score. Fracture alignment post operatively and radiological union in two standard perpendicular (AP & Lateral) views were assessed. In patients operated in the past, their immediate post-operative and 6 month follow up x-ray was accessed. Functionality was assessed by available information in the patient chart and from present followup. 6 cases (20%) had excellent results, 16 cases (55%) had good results, 7 cases (24%) had fair result (satisfactory/moderate) mostly for minor complaints of knee pain, ankle stiffness. 7 patients were unavailable for assessment of functionality. 1 patient had expired due to natural causes in conclusion Interlocking Intramedullary Nailing for Distal Metaphyseal Tibial Fractures is an acceptable line as it helps with early mobilization of the patient which helps in healing of the fracture and prevents joint stiffness thereby restoring complete motion. The construct is biomechanically stable. Fibular fixation with rush nails predisposed to delayed union, hence plating is recommended or revision of rush nailing to plating when feasible.
{"title":"Distal metaphyseal tibial fractures: Is an IMIL nail an adequate implant? An observational study on the functional and radiological outcome","authors":"Dr. Jacob Ipe, D. Ba, D. S. Reddy, Dr.M.Abhinandan Reddy","doi":"10.33545/orthor.2021.v5.i4a.326","DOIUrl":"https://doi.org/10.33545/orthor.2021.v5.i4a.326","url":null,"abstract":"The purpose of this study is to evaluate the functional outcome as well as radiological outcome of distal metaphyseal tibial fractures treated with intramedullary interlocking nail after 6 months post surgery in terms of degree of functionality preserved and degree of malalignment respectively. This was an observational study conducted with 38 patients. Data was retrieved from the MRD. Patients were clinically assessed at 6 months interval and as and when needed by Karlstorm and Orleud Score. Fracture alignment post operatively and radiological union in two standard perpendicular (AP & Lateral) views were assessed. In patients operated in the past, their immediate post-operative and 6 month follow up x-ray was accessed. Functionality was assessed by available information in the patient chart and from present followup. 6 cases (20%) had excellent results, 16 cases (55%) had good results, 7 cases (24%) had fair result (satisfactory/moderate) mostly for minor complaints of knee pain, ankle stiffness. 7 patients were unavailable for assessment of functionality. 1 patient had expired due to natural causes in conclusion Interlocking Intramedullary Nailing for Distal Metaphyseal Tibial Fractures is an acceptable line as it helps with early mobilization of the patient which helps in healing of the fracture and prevents joint stiffness thereby restoring complete motion. The construct is biomechanically stable. Fibular fixation with rush nails predisposed to delayed union, hence plating is recommended or revision of rush nailing to plating when feasible.","PeriodicalId":151163,"journal":{"name":"National Journal of Clinical Orthopaedics","volume":"396 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132018816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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