Surgical site infections (SSI) can become surgeon’s nightmare, complicating even a very well done surgical procedure. Therefore, the focus has always been on minimizing the SSIs by targeting the associated risk factors. One of the very challenging factors is Obesity [1]. Abdominal wounds in obese population need special care to prevent infection especially beneath the panniculus – an overhanging “apron” of skin and fatty tissue in the lower abdomen. The incision under the panniculus may create suboptimal environment for wound healing. The moisture and friction between the skin folds may lead to skin inflammation called as Intertrigous dermatitis. Therefore, the incisions are planned to avoid such complications whenever possible. Our novel technique utilizes simple sutures to keep the belly overhang lifted off the underlying skin incision to allow adequate environment for wound healing and wound care [2-9].
{"title":"Novel Surgical Technique to Improve Wound Healing Outcomes of Suprapubic Pfannenstiel Incision Surgical Wounds in Obese Patient","authors":"","doi":"10.33140/ijor.03.04.02","DOIUrl":"https://doi.org/10.33140/ijor.03.04.02","url":null,"abstract":"Surgical site infections (SSI) can become surgeon’s nightmare, complicating even a very well done surgical procedure. Therefore, the focus has always been on minimizing the SSIs by targeting the associated risk factors. One of the very challenging factors is Obesity [1]. Abdominal wounds in obese population need special care to prevent infection especially beneath the panniculus – an overhanging “apron” of skin and fatty tissue in the lower abdomen. The incision under the panniculus may create suboptimal environment for wound healing. The moisture and friction between the skin folds may lead to skin inflammation called as Intertrigous dermatitis. Therefore, the incisions are planned to avoid such complications whenever possible. Our novel technique utilizes simple sutures to keep the belly overhang lifted off the underlying skin incision to allow adequate environment for wound healing and wound care [2-9].","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133225478","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}
Diffuse B-Cell Lymphoma corresponds to the most frequent pathological entity within the spectrum of Non-Hodgkin’s Lymphoma, with reported annual incidence of 24% in the U.S. literature.
弥漫性b细胞淋巴瘤是非霍奇金淋巴瘤谱系中最常见的病理实体，据美国文献报道，其年发病率为24%。
{"title":"Cauda Equina Syndrome as A Clinical Presentation of Extradural Diffuse B-Cell Non-Hodgkin’s Lymphoma: Case Report and Literature Review","authors":"","doi":"10.33140/ijor.03.04.03","DOIUrl":"https://doi.org/10.33140/ijor.03.04.03","url":null,"abstract":"Diffuse B-Cell Lymphoma corresponds to the most frequent pathological entity within the spectrum of Non-Hodgkin’s Lymphoma, with reported annual incidence of 24% in the U.S. literature.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"157 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116415563","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}
Juxtacortical Osteosarcoma (OS) presents with three sub-types. These include parosteal OS, periosteal OS, and Highgrade surface OS. Imaging diagnosis of sub-types of Juxtacortical osteosarcoma is difficult. However, an analysis of 14 cases of these sub-types presents a spectrum of findings in each entity. The analysis of the Site, Transitional zone, Age, Matrix mineralization, Periosteal reaction, and Soft tissue component (STAMPS) are essential in making the final diagnosis and differential diagnosis.
{"title":"Juxtacortical Osteosarcoma-Imaging Spectrum","authors":"Review Article, S. Patnaik, S. Kakarla","doi":"10.33140/ijor.03.03.04","DOIUrl":"https://doi.org/10.33140/ijor.03.03.04","url":null,"abstract":"Juxtacortical Osteosarcoma (OS) presents with three sub-types. These include parosteal OS, periosteal OS, and Highgrade surface OS. Imaging diagnosis of sub-types of Juxtacortical osteosarcoma is difficult. However, an analysis of 14 cases of these sub-types presents a spectrum of findings in each entity. The analysis of the Site, Transitional zone, Age, Matrix mineralization, Periosteal reaction, and Soft tissue component (STAMPS) are essential in making the final diagnosis and differential diagnosis.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122210791","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}
Osteochondral dissecans (OCD)of talus is an uncommon injury is often missed initially. We reported a rare case of OCD of the lateral process of talus involving the subtalar joint in a 34-year-old male. Magnetic resonance imaging exhibited degenerative changes at the subtalar joint, with a 12 × 10 × 15-mm subchondral cystic lesion within the lateral part of talus in the posterior subtalar joint and two osseous loose bodies in the lateral compartment, which were removed through the sinus tarsi approach. A 1.2 × 1.5-cm osteochondral fragment distal to the lateral process of talus was noted intraoperatively. The subchondral cyst was excised and the fragment fixed with a 4-mm partially-threaded cannulated cancellous screw. The foot and ankle disability score improved from 26.0 preoperatively to 92.3 at the 1-year follow-up. Thus, talus OCD is an unusual condition that mandates a thorough clinical and radiological work-up and prompt management.
{"title":"Osteochondritis Dissecans of Lateral Process of Talus Involving the Subtalar Joint: An Unusual Case","authors":"","doi":"10.33140/ijor.03.03.10","DOIUrl":"https://doi.org/10.33140/ijor.03.03.10","url":null,"abstract":"Osteochondral dissecans (OCD)of talus is an uncommon injury is often missed initially. We reported a rare case of OCD of the lateral process of talus involving the subtalar joint in a 34-year-old male. Magnetic resonance imaging exhibited degenerative changes at the subtalar joint, with a 12 × 10 × 15-mm subchondral cystic lesion within the lateral part of talus in the posterior subtalar joint and two osseous loose bodies in the lateral compartment, which were removed through the sinus tarsi approach. A 1.2 × 1.5-cm osteochondral fragment distal to the lateral process of talus was noted intraoperatively. The subchondral cyst was excised and the fragment fixed with a 4-mm partially-threaded cannulated cancellous screw. The foot and ankle disability score improved from 26.0 preoperatively to 92.3 at the 1-year follow-up. Thus, talus OCD is an unusual condition that mandates a thorough clinical and radiological work-up and prompt management.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132294308","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}
Background: Breast cancer (BC) is a common cancer in women worldwide and leading cause of bone metastasis (BM). This study reveals the incidence of bone metastases and the most frequent BM sites secondary to BC in Khartoum Oncology Hospital. Materials and method: Retrospective study in Khartoum oncology hospital of medical record from January 2019 to September 2019. Demographic and clinical information extracted from the medical records of eligible patients in the last 5 years 2015-2019 included age, sex, social habits, duration of breast cancer, duration of treatment and location of bone metastasis. Statistical analyses were performed using SPSS, Version 22.0. (IBM, USA). Results: From all patients diagnosed with BC, 3.03% had developed BM out of whom 50% of patients developed bone metastases in 2-5 years of diagnosis of BC and 39.7% in less than 2 year of diagnosis. The median age was 54 years (range 28-78). The most common site is lumbar vertebrae (48.8%), followed by thoracic vertebrae (32.9%), pelvis 34 (32.9%), sternum (27.1%), ribs (25.7%), femur (15.7%), skull (15.7%), clavicle (14.3%), sacral vertebrae (14.3%), cervical vertebrae (12.8%), hummers (11.4%), and tibia (4.3%). Right side BC contribute to 57.1% of BM whereas left side BC to 40%. The duration of BC significantly correlates to number of distant bone metastases (P = 0.006). Conclusion: The most common site of BM in BC patients is lumbar vertebrae, the duration of BC affects development of BM, Exploring the knowledge of patient populations prone to develop bone metastasis helps in further intervention and management.
{"title":"Frequency Distribution of Bone metastasis in Breast cancer: A retrospective study in Khartoum Oncology Hospital 2019","authors":"","doi":"10.33140/ijor.03.03.07","DOIUrl":"https://doi.org/10.33140/ijor.03.03.07","url":null,"abstract":"Background: Breast cancer (BC) is a common cancer in women worldwide and leading cause of bone metastasis (BM). This study reveals the incidence of bone metastases and the most frequent BM sites secondary to BC in Khartoum Oncology Hospital. Materials and method: Retrospective study in Khartoum oncology hospital of medical record from January 2019 to September 2019. Demographic and clinical information extracted from the medical records of eligible patients in the last 5 years 2015-2019 included age, sex, social habits, duration of breast cancer, duration of treatment and location of bone metastasis. Statistical analyses were performed using SPSS, Version 22.0. (IBM, USA). Results: From all patients diagnosed with BC, 3.03% had developed BM out of whom 50% of patients developed bone metastases in 2-5 years of diagnosis of BC and 39.7% in less than 2 year of diagnosis. The median age was 54 years (range 28-78). The most common site is lumbar vertebrae (48.8%), followed by thoracic vertebrae (32.9%), pelvis 34 (32.9%), sternum (27.1%), ribs (25.7%), femur (15.7%), skull (15.7%), clavicle (14.3%), sacral vertebrae (14.3%), cervical vertebrae (12.8%), hummers (11.4%), and tibia (4.3%). Right side BC contribute to 57.1% of BM whereas left side BC to 40%. The duration of BC significantly correlates to number of distant bone metastases (P = 0.006). Conclusion: The most common site of BM in BC patients is lumbar vertebrae, the duration of BC affects development of BM, Exploring the knowledge of patient populations prone to develop bone metastasis helps in further intervention and management.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121833163","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}
Introduction: Diaphyseal fractures of the femur and tibia are common worldwide with an increased incidence in lowand middle-income countries and are an immense economic burden on the populace. Locked intramedullary nailing is not readily available. We explore the challenges of starting this kind of procedure in a developing country setting. Methods: We study the first 45 consecutive cases of locked intramedullary nailing of the femur and tibia in the Cape Coast Teaching Hospital of the Central Region of Ghana from the period of 2016 to 2019. Results: There were 29 Males and 16 Females with a mean age of 39.8 years and with 76% being in the informal sector of the economy. Road traffic accidents were the commonest cause of injury accounting for 68.9% of fractures. There were 24 femur and 21 Tibia fractures with 51%, 16% and 33% being type A, B and C fractures respectively. Most patients presented within 24 hours of injury and the average waiting time before surgery was 6.1 days. All cases were done via ante grade nailing with an average operating time of 199 minutes for the femur and 147 minutes for the tibia. Average time on admission before discharge was 12.5 days. Conclusion: It is possible to consistently perform locked IM nailing for femur and Tibia diaphyseal fractures even in deprived environments but the surgical teams will require adequate training in the use of specialized equipment and health systems must provide for funding for orthopaedic instrumentation and implants so that these procedures can be undertaken in a timely fashion avoiding complications.
{"title":"Peculiarities of Locked Intramedullary Nailing in A Deprived Setting","authors":"","doi":"10.33140/ijor.03.03.01","DOIUrl":"https://doi.org/10.33140/ijor.03.03.01","url":null,"abstract":"Introduction: Diaphyseal fractures of the femur and tibia are common worldwide with an increased incidence in lowand middle-income countries and are an immense economic burden on the populace. Locked intramedullary nailing is not readily available. We explore the challenges of starting this kind of procedure in a developing country setting. Methods: We study the first 45 consecutive cases of locked intramedullary nailing of the femur and tibia in the Cape Coast Teaching Hospital of the Central Region of Ghana from the period of 2016 to 2019. Results: There were 29 Males and 16 Females with a mean age of 39.8 years and with 76% being in the informal sector of the economy. Road traffic accidents were the commonest cause of injury accounting for 68.9% of fractures. There were 24 femur and 21 Tibia fractures with 51%, 16% and 33% being type A, B and C fractures respectively. Most patients presented within 24 hours of injury and the average waiting time before surgery was 6.1 days. All cases were done via ante grade nailing with an average operating time of 199 minutes for the femur and 147 minutes for the tibia. Average time on admission before discharge was 12.5 days. Conclusion: It is possible to consistently perform locked IM nailing for femur and Tibia diaphyseal fractures even in deprived environments but the surgical teams will require adequate training in the use of specialized equipment and health systems must provide for funding for orthopaedic instrumentation and implants so that these procedures can be undertaken in a timely fashion avoiding complications.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131251867","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}
In an Orthopaedic Resident’s life - during his tenure of residency, moments of achievement Are-Thesis Acceptance and Result of Final Examinations. Year 2020 starting with thesis acceptance and beginning of Final PG exam preparations, little did we know what was in the store ahead.
{"title":"An Orthopaedic Resident-Reporting LIVE from COVID-19 Battlefield; Lessons Learnt!!","authors":"","doi":"10.33140/ijor.03.03.08","DOIUrl":"https://doi.org/10.33140/ijor.03.03.08","url":null,"abstract":"In an Orthopaedic Resident’s life - during his tenure of residency, moments of achievement Are-Thesis Acceptance and Result of Final Examinations. Year 2020 starting with thesis acceptance and beginning of Final PG exam preparations, little did we know what was in the store ahead.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115857229","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}
In the pathogenesis of typical scoliosis, as a three-dimensional deformation, the process of formation of its horizontal component is of particular interest. From the point of view of the functional anatomy of the vertebral complex, appearance of this component is directly related to the work of the transverso-spinal muscles. Thus, their contraction on the left side results in a rotational displacement of the vertebral bodies to the right, and the same phenomenon on the right causes a left-sided rotation of the main bone elements of the supporting column of the spine. It has already been shown that longterm asymmetric contraction of these muscles is a key at the subclinical stage of the transition of a healthy spine to the “scoliotic” status [1-3]. The method of blood serum bioassay (BT SC) has confirmed our assumption that among the participants in the pathogenesis of progressive scoliosis there are so-called neuropeptide factors of postural asymmetry (FPA), which have an ability to lateralize the activity of motor neurons in the spinal cord. These were natural regulators - oxytocin and arginine-8-vasopressin, and this ability appears in a case of a multiple increase in their concentration. Determination of their quantitative characteristics using ELISA showed high correlations between the levels of these factors and the process of spinal column deformation at the pre-and subclinical stages of scoliosis development.
{"title":"Factors of Postural Asymmetry (FPA) At The Pre- and Subclinical Stages of the Develop-ment of 3D Deformity of the Vertebral Complex","authors":"","doi":"10.33140/ijor.03.03.05","DOIUrl":"https://doi.org/10.33140/ijor.03.03.05","url":null,"abstract":"In the pathogenesis of typical scoliosis, as a three-dimensional deformation, the process of formation of its horizontal component is of particular interest. From the point of view of the functional anatomy of the vertebral complex, appearance of this component is directly related to the work of the transverso-spinal muscles. Thus, their contraction on the left side results in a rotational displacement of the vertebral bodies to the right, and the same phenomenon on the right causes a left-sided rotation of the main bone elements of the supporting column of the spine. It has already been shown that longterm asymmetric contraction of these muscles is a key at the subclinical stage of the transition of a healthy spine to the “scoliotic” status [1-3]. The method of blood serum bioassay (BT SC) has confirmed our assumption that among the participants in the pathogenesis of progressive scoliosis there are so-called neuropeptide factors of postural asymmetry (FPA), which have an ability to lateralize the activity of motor neurons in the spinal cord. These were natural regulators - oxytocin and arginine-8-vasopressin, and this ability appears in a case of a multiple increase in their concentration. Determination of their quantitative characteristics using ELISA showed high correlations between the levels of these factors and the process of spinal column deformation at the pre-and subclinical stages of scoliosis development.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"36 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114132341","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}
Ketamine is a general anesthetic, non-competitive antagonist of NMDA receptors with analgesic properties. The efficacy of ketamine treatment of acute postoperative and chronic pain, has a moderate degree and evidence and is considered third-line drug [1].
{"title":"Epidural Ketamine in FBSS: An Effective Long-Term Therapeutic Option For Unresponsive Pain","authors":"","doi":"10.33140/ijor.03.03.03","DOIUrl":"https://doi.org/10.33140/ijor.03.03.03","url":null,"abstract":"Ketamine is a general anesthetic, non-competitive antagonist of NMDA receptors with analgesic properties. The efficacy of ketamine treatment of acute postoperative and chronic pain, has a moderate degree and evidence and is considered third-line drug [1].","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117179831","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}
Venous thromboembolism is a rare surgical complication after shoulder replacement surgery. Most common seen for those who underwent for lower limb reconstruction such as: total hip or knee arthroplasty as well as orthopaedic trauma surgery in general. we report one case of 56-year-old male known to have diabetes mellitus and hypertension who had an isolated proximal humerus fracture. He underwent for reverse shoulder arthroplasty and the patient had an uneventful day of surgery. On postoperative day 2, patient started to have lightheadedness with decreased oxygen saturation. He denied any history of chest pain or shortness of breath. Patient was put on 2L oxygen face mask. Patient was evaluated by the medical team. CT spiral was done and it revealed bilateral small filling defects involving the right lower pulmonary artery and the left upper lobar pulmonary artery. Patient was started on anticoagulant therapy with improvement in his condition.
{"title":"Bilateral Pulmonary Embolism After Reverse Total Shoulder Arthroplasty: A Case Report","authors":"","doi":"10.33140/ijor.03.03.02","DOIUrl":"https://doi.org/10.33140/ijor.03.03.02","url":null,"abstract":"Venous thromboembolism is a rare surgical complication after shoulder replacement surgery. Most common seen for those who underwent for lower limb reconstruction such as: total hip or knee arthroplasty as well as orthopaedic trauma surgery in general. we report one case of 56-year-old male known to have diabetes mellitus and hypertension who had an isolated proximal humerus fracture. He underwent for reverse shoulder arthroplasty and the patient had an uneventful day of surgery. On postoperative day 2, patient started to have lightheadedness with decreased oxygen saturation. He denied any history of chest pain or shortness of breath. Patient was put on 2L oxygen face mask. Patient was evaluated by the medical team. CT spiral was done and it revealed bilateral small filling defects involving the right lower pulmonary artery and the left upper lobar pulmonary artery. Patient was started on anticoagulant therapy with improvement in his condition.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131679407","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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