Pub Date : 2018-09-30DOI: 10.17511/ijoso.2018.i03.04
A. Khairnar, Lalit Patil
Introduction: Proximal humerus fractures are often the result of a fall in an osteoporotic patient, but can also occur in young adults due to high energy trauma. They account for 4-5% of all fractures. Over the past few decades, several operative techniques have been described for the treatment of proximal humerus fractures. Currently locking compression plate is gaining popularity. This plate combines the feature of compression of regular plate and locking into one system. Methods: The present study is a prospective study conducted at Department of Orthopedics, S.B.H. GMC Dhule over a period of 2 years from March 2015 to March 2017. Total 34 patients of proximal humerus fracture which were admitted in Orthopedics ward were included in the present study. X ray of proximal humerus was taken and the fractures were classified according to Neer’s classification. All the patients were subjected for open reduction and internal fixation withlocking compression plate i.e. PHILOS (Proximal Humerus Interlocking System). Fracture approached through anterior deltopectoral approach. Post operatively patients were mobilized as early as possible. Patients were followed up and functional outcome was assessed using Neer’s functional scoring system. Mean follow up was 1 year. Results: All the 34 patients of displaced proximal humerus were operated by open reduction and internal fixation using locking compression plate (PHILOS). Among these 19 (55.88%) were males and 15 (44.12%) were females. Age of patients ranged from 29 to 75 years with mean of 52 years. All fractures were classified according to Neer’s functional scoring system. 8 (23.5%) patientswere typeII, 11(32.35%) were type III and 15 (44.11%) were type IV. Functional outcome was assessed using Neer’s functional scoring system. According to Neer’s score 60% of our patients had satisfactory to excellent results and 40% of the patients had unsatisfactory to poor results. Conclusion: According to present study results of locking compression plate, PHILOS, for proximal humerus fracture type II and type III are satisfactory and encouraging in all age groups. Still there is scope to improve results in type IV fractures especially in elderly with osteoporotic bones.
{"title":"Locking compression plate for proximal humerus fracture: A functional outcome analysis","authors":"A. Khairnar, Lalit Patil","doi":"10.17511/ijoso.2018.i03.04","DOIUrl":"https://doi.org/10.17511/ijoso.2018.i03.04","url":null,"abstract":"Introduction: Proximal humerus fractures are often the result of a fall in an osteoporotic patient, but can also occur in young adults due to high energy trauma. They account for 4-5% of all fractures. Over the past few decades, several operative techniques have been described for the treatment of proximal humerus fractures. Currently locking compression plate is gaining popularity. This plate combines the feature of compression of regular plate and locking into one system. Methods: The present study is a prospective study conducted at Department of Orthopedics, S.B.H. GMC Dhule over a period of 2 years from March 2015 to March 2017. Total 34 patients of proximal humerus fracture which were admitted in Orthopedics ward were included in the present study. X ray of proximal humerus was taken and the fractures were classified according to Neer’s classification. All the patients were subjected for open reduction and internal fixation withlocking compression plate i.e. PHILOS (Proximal Humerus Interlocking System). Fracture approached through anterior deltopectoral approach. Post operatively patients were mobilized as early as possible. Patients were followed up and functional outcome was assessed using Neer’s functional scoring system. Mean follow up was 1 year. Results: All the 34 patients of displaced proximal humerus were operated by open reduction and internal fixation using locking compression plate (PHILOS). Among these 19 (55.88%) were males and 15 (44.12%) were females. Age of patients ranged from 29 to 75 years with mean of 52 years. All fractures were classified according to Neer’s functional scoring system. 8 (23.5%) patientswere typeII, 11(32.35%) were type III and 15 (44.11%) were type IV. Functional outcome was assessed using Neer’s functional scoring system. According to Neer’s score 60% of our patients had satisfactory to excellent results and 40% of the patients had unsatisfactory to poor results. Conclusion: According to present study results of locking compression plate, PHILOS, for proximal humerus fracture type II and type III are satisfactory and encouraging in all age groups. Still there is scope to improve results in type IV fractures especially in elderly with osteoporotic bones.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128108281","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 : 2018-09-30DOI: 10.17511/ijoso.2018.i03.03
Dr. J. Ashok Vardhan Reddy, Dr. Sridhar Garikapati
Background: The normal structure of proximal ulna is unique among long bones as described in the literature. Proximal dorsal angulation of ulna (PUDA) was not detailed in standard anatomical textbooks. The identification of PUDA is an important anatomic landmark for surgeons treating proximal ulna fractures, nonunions, malunions or osteotomies of proximal forearm in results of fractures. The study was conducted to identify the PUDA and to measure the distance from tip-to-apex of PUDA in bilateral elbow radiographs. Materials & Methods: The present study was conducted on 56 bilateral elbow radiographs (26 Male, 30 Female), which are obtained from department of radiology. The radiographs were analyzed and measurements were recorded on each radiograph to identify the PUDA, later olecranon tip-to-apex distance of the PUDA was also measured. Results: No significant differences were observed in mean age of male and female patients. The measurements were recorded and entered in standard excel data sheet for analyzing PUDA in various patients. It was identified that 84% of the radiographs presents PUDA. Conclusion: Determination of the PUDA may be helpful in anatomic plating of the ulna for fractures, nonunions or malunions. Side to side correlation of PUDA with gender difference is reliable for recommendation to medical manufacturers for modelling ulna plates and components of artificial elbow joints.
{"title":"Radiographic study of proximal ulna dorsal angulation in south Indian population","authors":"Dr. J. Ashok Vardhan Reddy, Dr. Sridhar Garikapati","doi":"10.17511/ijoso.2018.i03.03","DOIUrl":"https://doi.org/10.17511/ijoso.2018.i03.03","url":null,"abstract":"Background: The normal structure of proximal ulna is unique among long bones as described in the literature. Proximal dorsal angulation of ulna (PUDA) was not detailed in standard anatomical textbooks. The identification of PUDA is an important anatomic landmark for surgeons treating proximal ulna fractures, nonunions, malunions or osteotomies of proximal forearm in results of fractures. The study was conducted to identify the PUDA and to measure the distance from tip-to-apex of PUDA in bilateral elbow radiographs. Materials & Methods: The present study was conducted on 56 bilateral elbow radiographs (26 Male, 30 Female), which are obtained from department of radiology. The radiographs were analyzed and measurements were recorded on each radiograph to identify the PUDA, later olecranon tip-to-apex distance of the PUDA was also measured. Results: No significant differences were observed in mean age of male and female patients. The measurements were recorded and entered in standard excel data sheet for analyzing PUDA in various patients. It was identified that 84% of the radiographs presents PUDA. Conclusion: Determination of the PUDA may be helpful in anatomic plating of the ulna for fractures, nonunions or malunions. Side to side correlation of PUDA with gender difference is reliable for recommendation to medical manufacturers for modelling ulna plates and components of artificial elbow joints.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"240 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121429842","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 : 2018-09-30DOI: 10.17511/ijoso.2018.i03.06
Dr.P.Gopinath Menon, Dr. Rahul Sreenivasan Thokaloath
Background: Congenital Talipes Equino Varus (CTEV) is a congenital complex deformity. Pirani scoring system is most commonly used for classification. In the Ponseti technique of management, those undergoing tenotomy had higher hindfoot score compared to the non-tenotomy group. Hence evaluation of the factor in hindfoot score of the Pirani scoring system, which can predict the need for tenotomy later is important. Materials and Methods: Hind Foot Score of Pirani Scoring System in the treatment of CTEV by Ponseti Method of serial manipulative corrective casting was evaluated on 40 Infants (up to 1 year of age) with 59 idiopathic clubfeet presenting to orthopedic surgery department of Sri Ramachandra medical college and research institute between June 2010 to June 2012. Results: 51 out of the 59 clubfeet (40 patients) underwent tenotomy [86%]. The mean initial modified Pirani score in the tenotomy group was 4.90, and in a non-tenotomy group, it was 2.44 (p<0.005). The mean hindfoot score in tenotomy and the non-tenotomy group was 2.70 and 1.38 respectively (p <0.005). All children with the rigidity of equinus less than one were corrected by serial casting alone. 98% of clubfeet with the rigidity of equinus score 1 underwent tenotomy. The combination of the severity of posterior crease and rigidity of hindfoot showed 100% with maximum score 2 underwent tenotomy while all below 1.5 scores got corrected by casting alone. Conclusions: Initial rigidity of equinus and severity of posterior crease of hindfoot score of the Pirani scoring system help us in predicting the need for tenotomy later. Combined score of the rigidity of equinus and severity of posterior crease can predict the need for tenotomy better than the emptiness of heel combinations. As the equinus deformity increases to a maximum and posterior crease become severe, then tenotomy is required. Level of evidence: Level 1 High-quality prospective study. The study was started before the first patient enrolled. All patients were enrolled at the same point in their disease with ≥80% follow-up of enrolled patients.
{"title":"Evaluation of hind foot score of Pirani scoring system in treatment of congenital talipes equinovarus by Ponseti method","authors":"Dr.P.Gopinath Menon, Dr. Rahul Sreenivasan Thokaloath","doi":"10.17511/ijoso.2018.i03.06","DOIUrl":"https://doi.org/10.17511/ijoso.2018.i03.06","url":null,"abstract":"Background: Congenital Talipes Equino Varus (CTEV) is a congenital complex deformity. Pirani scoring system is most commonly used for classification. In the Ponseti technique of management, those undergoing tenotomy had higher hindfoot score compared to the non-tenotomy group. Hence evaluation of the factor in hindfoot score of the Pirani scoring system, which can predict the need for tenotomy later is important. Materials and Methods: Hind Foot Score of Pirani Scoring System in the treatment of CTEV by Ponseti Method of serial manipulative corrective casting was evaluated on 40 Infants (up to 1 year of age) with 59 idiopathic clubfeet presenting to orthopedic surgery department of Sri Ramachandra medical college and research institute between June 2010 to June 2012. Results: 51 out of the 59 clubfeet (40 patients) underwent tenotomy [86%]. The mean initial modified Pirani score in the tenotomy group was 4.90, and in a non-tenotomy group, it was 2.44 (p<0.005). The mean hindfoot score in tenotomy and the non-tenotomy group was 2.70 and 1.38 respectively (p <0.005). All children with the rigidity of equinus less than one were corrected by serial casting alone. 98% of clubfeet with the rigidity of equinus score 1 underwent tenotomy. The combination of the severity of posterior crease and rigidity of hindfoot showed 100% with maximum score 2 underwent tenotomy while all below 1.5 scores got corrected by casting alone. Conclusions: Initial rigidity of equinus and severity of posterior crease of hindfoot score of the Pirani scoring system help us in predicting the need for tenotomy later. Combined score of the rigidity of equinus and severity of posterior crease can predict the need for tenotomy better than the emptiness of heel combinations. As the equinus deformity increases to a maximum and posterior crease become severe, then tenotomy is required. Level of evidence: Level 1 High-quality prospective study. The study was started before the first patient enrolled. All patients were enrolled at the same point in their disease with ≥80% follow-up of enrolled patients.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127224360","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 : 2018-09-30DOI: 10.17511/ijoso.2018.i03.05
S. Prabhu, G. Abraham, B. N. Jayant
Background: Liver is the most frequently injured solid intra abdominal organ in abdominal trauma. Exsanguination is the main cause of death due to liver trauma. Although non-operative management of hepatic trauma has been utilized with increasing frequency a significant percentage of unstable liver trauma still require operative treatment. The aim of the present study was to examine the results of the operative treatment of patients with unstable liver trauma and prevent prolonged hospital stay. Patients admitted following Liver Trauma in the department of General Surgery, MOSC medical college Hospital, Kolenchery duringthe two year period from January 2013 to January 2015 were included in the study. Methods: This was a retrospective study of patients with Hepatic trauma admitted to the department of General Surgery, MOSC Medical College Hospital, Kolenchery, Ernakulam from January 2013 to January 2015. The diagnosis of Liver trauma was made pre-operatively with imageology and assessed clinically prior to surgery. Severity of liver injury was graded, treatment details collected and factors contribution to prolonged hospital stay were noted. These patients were later followed up for a period of one year. Results: During the two year period, 105 patients who were diagnosed to have liver injury were included in the study. Age varied from 1275 years. Males outnumbered females (88.5% vs. 11. 43 %). 93 patients were with blunt abdominal trauma (88.5%). 66(62.85%) patients were in shock when they presented to the ER. 36 (37.15%) patients were haemodynamically stable. 57 patients (54.28%) had associated injuries like multiple rib fractures and splenic injuries. Exploratory laparotomy and control of bleeding, hepatorapphy and local debridement was done. Nine patientsrequired relaparotomy and omental packing. Fifteen patients succumbed to liver injury. The postoperative period was delayed in those patients who had other visceral injury. Follow up of cases for a period of 1 year was done and there was no late complication like intra-abdominal abscess, coagulopathy, bile leak or hepatic abscess. Conclusion: Emergency laparotomy with hemostasis and repair liver injury in unstable cases and select stable cases savestime and life of the patient, it is cost effective and hospital stay and systemic complications are minimal
{"title":"Liver injuries- a tertiary rural medical college hospital experience","authors":"S. Prabhu, G. Abraham, B. N. Jayant","doi":"10.17511/ijoso.2018.i03.05","DOIUrl":"https://doi.org/10.17511/ijoso.2018.i03.05","url":null,"abstract":"Background: Liver is the most frequently injured solid intra abdominal organ in abdominal trauma. Exsanguination is the main cause of death due to liver trauma. Although non-operative management of hepatic trauma has been utilized with increasing frequency a significant percentage of unstable liver trauma still require operative treatment. The aim of the present study was to examine the results of the operative treatment of patients with unstable liver trauma and prevent prolonged hospital stay. Patients admitted following Liver Trauma in the department of General Surgery, MOSC medical college Hospital, Kolenchery duringthe two year period from January 2013 to January 2015 were included in the study. Methods: This was a retrospective study of patients with Hepatic trauma admitted to the department of General Surgery, MOSC Medical College Hospital, Kolenchery, Ernakulam from January 2013 to January 2015. The diagnosis of Liver trauma was made pre-operatively with imageology and assessed clinically prior to surgery. Severity of liver injury was graded, treatment details collected and factors contribution to prolonged hospital stay were noted. These patients were later followed up for a period of one year. Results: During the two year period, 105 patients who were diagnosed to have liver injury were included in the study. Age varied from 1275 years. Males outnumbered females (88.5% vs. 11. 43 %). 93 patients were with blunt abdominal trauma (88.5%). 66(62.85%) patients were in shock when they presented to the ER. 36 (37.15%) patients were haemodynamically stable. 57 patients (54.28%) had associated injuries like multiple rib fractures and splenic injuries. Exploratory laparotomy and control of bleeding, hepatorapphy and local debridement was done. Nine patientsrequired relaparotomy and omental packing. Fifteen patients succumbed to liver injury. The postoperative period was delayed in those patients who had other visceral injury. Follow up of cases for a period of 1 year was done and there was no late complication like intra-abdominal abscess, coagulopathy, bile leak or hepatic abscess. Conclusion: Emergency laparotomy with hemostasis and repair liver injury in unstable cases and select stable cases savestime and life of the patient, it is cost effective and hospital stay and systemic complications are minimal","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133422879","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 : 2018-06-30DOI: 10.17511/ijoso.2018.i02.03
Niravkumar Moradiya, N. Shah, Parth A Joshi, Poojan A Joshi
Objective: In this study we report the functional outcome of patients with intercondylar distal humerus fractures treated by precontoured angular stable anatomical locking plates in inverted Y fashion, using a standard approach. Materials and Methods: A total number of 24 patients with AO type C closed intercondylar distal humerus fractures were operated with open reduction through an olecranon osteotomy approach and internal fixation using two plates in inverted-Y fashion. Patients were followed at 4 weeks, 6 weeks, 12 weeks and thereafter every 6 months. They were evaluated using the Mayo Elbow performance index and Riseborough and Radin Score. Results: There were 9 (37.5%) men and 15 (62.5%) women with mean age of 46.72 years.79.17% of the cases were following fall and rest following Motor vehicle accident. AO type C2 fractures accounted for 45.83% of cases; type C3 fractures accounted for 33.33% of cases and type C1 accounted for 20.84%. According the Riseborough and Radin criteria, the results were Good in 14(58.33%) of patients, Fair in 9(37.50%) and Poor in 1(4.17%). According to MEPI, we had Excellent results in 5(20.83%), Good in 12(50%), Fair in 6(25%) and Poor in 1(4.17%) patients. The mean MEPI was 82±18.Thus according to MEPI, we achieved excellent to good results in ~70% of patients with 100% union rate and complications less than 13%. Conclusion: Intercondylar fractures of humerus treated by Dual plating in inverted Y-fashionoffers a reliable and stable fixation permitting early mobilization and comparable functional outcome with good union rates. Contribution by Authors: Niravkumar Moradiya contributed to the study design, implementation of the research, verification of the analytical methods, supervised the findings of this work and to the writing of the manuscript. Niravkumar Moradiya and Neel Shah operated all the patients. Parth Joshi, Pujan Joshi and Neel Shah assessed follow up of patients and their functional outcome. Parth Joshi and Pujan Joshi collected data and analysed it. All authors discussed the results and contributed to the final manuscript.
{"title":"Early functional outcome of intercondylar humerus fractures fixed with precontoured dual plating in inverted Y-Fashion","authors":"Niravkumar Moradiya, N. Shah, Parth A Joshi, Poojan A Joshi","doi":"10.17511/ijoso.2018.i02.03","DOIUrl":"https://doi.org/10.17511/ijoso.2018.i02.03","url":null,"abstract":"Objective: In this study we report the functional outcome of patients with intercondylar distal humerus fractures treated by precontoured angular stable anatomical locking plates in inverted Y fashion, using a standard approach. Materials and Methods: A total number of 24 patients with AO type C closed intercondylar distal humerus fractures were operated with open reduction through an olecranon osteotomy approach and internal fixation using two plates in inverted-Y fashion. Patients were followed at 4 weeks, 6 weeks, 12 weeks and thereafter every 6 months. They were evaluated using the Mayo Elbow performance index and Riseborough and Radin Score. Results: There were 9 (37.5%) men and 15 (62.5%) women with mean age of 46.72 years.79.17% of the cases were following fall and rest following Motor vehicle accident. AO type C2 fractures accounted for 45.83% of cases; type C3 fractures accounted for 33.33% of cases and type C1 accounted for 20.84%. According the Riseborough and Radin criteria, the results were Good in 14(58.33%) of patients, Fair in 9(37.50%) and Poor in 1(4.17%). According to MEPI, we had Excellent results in 5(20.83%), Good in 12(50%), Fair in 6(25%) and Poor in 1(4.17%) patients. The mean MEPI was 82±18.Thus according to MEPI, we achieved excellent to good results in ~70% of patients with 100% union rate and complications less than 13%. Conclusion: Intercondylar fractures of humerus treated by Dual plating in inverted Y-fashionoffers a reliable and stable fixation permitting early mobilization and comparable functional outcome with good union rates. Contribution by Authors: Niravkumar Moradiya contributed to the study design, implementation of the research, verification of the analytical methods, supervised the findings of this work and to the writing of the manuscript. Niravkumar Moradiya and Neel Shah operated all the patients. Parth Joshi, Pujan Joshi and Neel Shah assessed follow up of patients and their functional outcome. Parth Joshi and Pujan Joshi collected data and analysed it. All authors discussed the results and contributed to the final manuscript.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"220 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114984231","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 : 2018-06-30DOI: 10.17511/ijoso.2018.i02.06
Dr. J. Ashok Vardhan Reddy, Dr. Sridhar Garikapati
Introduction: Osteoarthritis (OA) is the common cause of musculoskeletal disability and pain. Osteoarthritis (OA) is a chronic disease characterized by a loss of articular cartilage and changes of the subchondral bone. Lower levels of vitamin D were associated with greater knee pain, poor quadriceps function with poor physical function. Several studies have documented that vitamin D supplementation increases muscle strength, improve physical performance, and decreases risk of falls among older people with low level of serum vitamin D. Materials &Methods: This present study was conducted at the outpatient clinic of the Department of Orthopedics at Maheswara Medical College & Hospital, Sangareddy during a February–December 2017 study period.The inclusion criteria were that the participants had symptomatic knee OA and low vitamin D status (25(OH)D < 30 ng/mL). Results: Data were analyzed using SPSS Statistics version 22 (SPSS, Inc., Chicago, IL, USA). Comparisonof baseline vs. post-vitamin Dsupplementation data was performed by paired t-test. One-way repeated-measurement ANOVA was used to test the time differences in muscle strength and physical performance. A p-value less than 0.05 for differences and the values were considered to be statistically significant. Dominant grip strength (p = 0.01) and overall physical performance, such as gait speed (p < 0.001), TUGT (p < 0.001), STS (p < 0.001), and 6MWT (p < 0.001), significantly improved after vitamin. Conclusion: Nevertheless, vitamin D supplementation is a safe and inexpensive way to improve muscle strength and physical function in this population. Based on these findings, we recommend vitamin D supplementation in knee OA patients that have poor physical function.
{"title":"A study of effect of Vitamin D supplementation inOsteoarthritis patients","authors":"Dr. J. Ashok Vardhan Reddy, Dr. Sridhar Garikapati","doi":"10.17511/ijoso.2018.i02.06","DOIUrl":"https://doi.org/10.17511/ijoso.2018.i02.06","url":null,"abstract":"Introduction: Osteoarthritis (OA) is the common cause of musculoskeletal disability and pain. Osteoarthritis (OA) is a chronic disease characterized by a loss of articular cartilage and changes of the subchondral bone. Lower levels of vitamin D were associated with greater knee pain, poor quadriceps function with poor physical function. Several studies have documented that vitamin D supplementation increases muscle strength, improve physical performance, and decreases risk of falls among older people with low level of serum vitamin D. Materials &Methods: This present study was conducted at the outpatient clinic of the Department of Orthopedics at Maheswara Medical College & Hospital, Sangareddy during a February–December 2017 study period.The inclusion criteria were that the participants had symptomatic knee OA and low vitamin D status (25(OH)D < 30 ng/mL). Results: Data were analyzed using SPSS Statistics version 22 (SPSS, Inc., Chicago, IL, USA). Comparisonof baseline vs. post-vitamin Dsupplementation data was performed by paired t-test. One-way repeated-measurement ANOVA was used to test the time differences in muscle strength and physical performance. A p-value less than 0.05 for differences and the values were considered to be statistically significant. Dominant grip strength (p = 0.01) and overall physical performance, such as gait speed (p < 0.001), TUGT (p < 0.001), STS (p < 0.001), and 6MWT (p < 0.001), significantly improved after vitamin. Conclusion: Nevertheless, vitamin D supplementation is a safe and inexpensive way to improve muscle strength and physical function in this population. Based on these findings, we recommend vitamin D supplementation in knee OA patients that have poor physical function.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"4651 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129129480","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 : 2018-06-30DOI: 10.17511/ijoso.2018.i02.01
Dr Pranav K Dave, Dr. Puranik M, Dr. Jain M, Dr. Mishra R, Dr. Jain Singhai M, Dr. Lakra R, Dr. Rajak Y, Dr. Wandre A, Dr. Satpathy S, D. Bs
………………………………………………………………………………………………………………………............... Abstract Primary carcinoma of thyroid presenting as mandibular metastasis is a rare incidence. Most of the time patient presents with various other symptoms due to hematogenous spread of primary neoplasm. We are presenting a rare case where metastatic lesion of mandible was the presenting feature and the patient was then subsequently diagnosed to have primary follicular carcinoma of thyroid. primary thyroid malignancy with mandibular and calvarial metastases was raised. Sub sequently ultrasound of left mandibular region revealed large soft tissue mass lesion with increased vascularity on colour Doppler. Ultrasound of thyroid revealed bulky left lobe having heterogeneous echotexture and scattered macro calcifications. No significant cervical lymphadenopathy was seen. X ray skull lateral view also revealed lytic lesion in occipital region. Ultrasound guided Fine needle aspiration cytology (FNAC) was performed from left mandibular lesion as well as lesion in left lobe of thyroid. Microscopic examination revealed features offollicular thyroid carcinoma (FTC) at both sites consistent with primary FTC with metastatic mandibular lesion. FNAC revealed - moderate cellularity with large number of follicular epithelial cells present predominantly in micro-follicles, few in large groups and crowded in syncitial sheets, few follicular cells show intra nuclear inclusion. Moderate degree of anisonucleosis, prominence of nuclei and irregularity of nuclear margin suggestive of follicular metastasis to the mandible and follicular carcinoma from left lobe of thyroid
{"title":"Unusual presentation of follicular thyroidcarcinomaas mandibular metastasis","authors":"Dr Pranav K Dave, Dr. Puranik M, Dr. Jain M, Dr. Mishra R, Dr. Jain Singhai M, Dr. Lakra R, Dr. Rajak Y, Dr. Wandre A, Dr. Satpathy S, D. Bs","doi":"10.17511/ijoso.2018.i02.01","DOIUrl":"https://doi.org/10.17511/ijoso.2018.i02.01","url":null,"abstract":"………………………………………………………………………………………………………………………............... Abstract Primary carcinoma of thyroid presenting as mandibular metastasis is a rare incidence. Most of the time patient presents with various other symptoms due to hematogenous spread of primary neoplasm. We are presenting a rare case where metastatic lesion of mandible was the presenting feature and the patient was then subsequently diagnosed to have primary follicular carcinoma of thyroid. primary thyroid malignancy with mandibular and calvarial metastases was raised. Sub sequently ultrasound of left mandibular region revealed large soft tissue mass lesion with increased vascularity on colour Doppler. Ultrasound of thyroid revealed bulky left lobe having heterogeneous echotexture and scattered macro calcifications. No significant cervical lymphadenopathy was seen. X ray skull lateral view also revealed lytic lesion in occipital region. Ultrasound guided Fine needle aspiration cytology (FNAC) was performed from left mandibular lesion as well as lesion in left lobe of thyroid. Microscopic examination revealed features offollicular thyroid carcinoma (FTC) at both sites consistent with primary FTC with metastatic mandibular lesion. FNAC revealed - moderate cellularity with large number of follicular epithelial cells present predominantly in micro-follicles, few in large groups and crowded in syncitial sheets, few follicular cells show intra nuclear inclusion. Moderate degree of anisonucleosis, prominence of nuclei and irregularity of nuclear margin suggestive of follicular metastasis to the mandible and follicular carcinoma from left lobe of thyroid","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130136227","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 : 2018-06-30DOI: 10.17511/ijoso.2018.i02.05
Dr. Wadhawan Gaurav, Dr. Vyas K.C.
Incarcerated inguinal hernia is a common diagnosis in patients presenting with a painful and not reducible groin mass. Sliding hernias are supposed to be more anatomically challenging for a surgeon than an uncomplicated inguinal hernias. The anatomical and physiological concept of sliding inguinal hernia is frequently misunderstood by surgeons of all levels of experience. Except in sliding hernia, the sigmoid colon is uncommonly found in an inguinal hernia.
{"title":"Incarcerated sigmoid colon with gangrenous appendices epiploicae:A rare case report","authors":"Dr. Wadhawan Gaurav, Dr. Vyas K.C.","doi":"10.17511/ijoso.2018.i02.05","DOIUrl":"https://doi.org/10.17511/ijoso.2018.i02.05","url":null,"abstract":"Incarcerated inguinal hernia is a common diagnosis in patients presenting with a painful and not reducible groin mass. Sliding hernias are supposed to be more anatomically challenging for a surgeon than an uncomplicated inguinal hernias. The anatomical and physiological concept of sliding inguinal hernia is frequently misunderstood by surgeons of all levels of experience. Except in sliding hernia, the sigmoid colon is uncommonly found in an inguinal hernia.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130899021","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 : 2018-06-30DOI: 10.17511/ijoso.2018.i02.04
Sidharth S. Jain, D. C. Gupta, M. Jain
Objective: There are several types of treatment modalities recommended for wrist ganglions. The purpose of this study was to evaluate the effectiveness of cyst aspiration and methyl prednisolone acetate injection by using double IV cannula, as a new technique involar ganglia treatment. Methodology: The study involves total of 24 patients who received treatment by aspiration and methyl prednisolone injection into the cavity. Two IV cannulas are pricked to the cystic cavity. Cyst fluid is drained by the distally placed IV cannula meanwhile injecting methyl prednisolone by proximally placed IV cannula. The patient records and follow-up reports are retrospectively investigated. The patient age, sex, site of the cyst, the treatment that was applied, adjacency to the artery and the nerves and recurrence are recorded. Results: The study involved 24 patients that received aspiration treatment for volar ganglion cysts between June 2011 and July 2014. Patients mean follow up time was 2.4 ±0.2 years. There were 16 (63.3%) female and 8 (36.6%) male subject with volar wrist ganglia. The mean age of the patients was 30.63±6.8 years. This study didn’t reportany complication related to methyl prednisolone injection and arterial ischemia. Recurrence was observed in 4 (16.6%) patients. Conclusion: This method is found to be associated with lower recurrence rate than other aspiration therapy. We highly recommend to use IV cannula needle for ganglionic cyst aspiration and methyl prednisolone injection in treatment of volar ganglia prior to any surgical intervention.
{"title":"Aspiration and methylprednisolone injection to the cavity with IV cannula needle in the treatment of volar wrist ganglia","authors":"Sidharth S. Jain, D. C. Gupta, M. Jain","doi":"10.17511/ijoso.2018.i02.04","DOIUrl":"https://doi.org/10.17511/ijoso.2018.i02.04","url":null,"abstract":"Objective: There are several types of treatment modalities recommended for wrist ganglions. The purpose of this study was to evaluate the effectiveness of cyst aspiration and methyl prednisolone acetate injection by using double IV cannula, as a new technique involar ganglia treatment. Methodology: The study involves total of 24 patients who received treatment by aspiration and methyl prednisolone injection into the cavity. Two IV cannulas are pricked to the cystic cavity. Cyst fluid is drained by the distally placed IV cannula meanwhile injecting methyl prednisolone by proximally placed IV cannula. The patient records and follow-up reports are retrospectively investigated. The patient age, sex, site of the cyst, the treatment that was applied, adjacency to the artery and the nerves and recurrence are recorded. Results: The study involved 24 patients that received aspiration treatment for volar ganglion cysts between June 2011 and July 2014. Patients mean follow up time was 2.4 ±0.2 years. There were 16 (63.3%) female and 8 (36.6%) male subject with volar wrist ganglia. The mean age of the patients was 30.63±6.8 years. This study didn’t reportany complication related to methyl prednisolone injection and arterial ischemia. Recurrence was observed in 4 (16.6%) patients. Conclusion: This method is found to be associated with lower recurrence rate than other aspiration therapy. We highly recommend to use IV cannula needle for ganglionic cyst aspiration and methyl prednisolone injection in treatment of volar ganglia prior to any surgical intervention.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132723933","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 : 1900-01-01DOI: 10.17511/ijoso.2021.i02.02
Dr. K K Saravanan, Dr. Mohamed Mubarak Ali V A
Introduction: Acute pancreatitis is one of the most common cause of acute abdominal pain with awide range of presentation from mild to multi-organ failure; hence we intended to study the clinicalprofile of acute pancreatitis in our study. Methods: All subjects admitted with acute pancreatitisabove the age of 18 years; both male and female willing to participate were included in the study.60 subjects were studied where males dominate the study. Results: Alcohol intake and gall stonebeing the etiological cause for the illness. Conclusion: The recovery rate was 95% with no mortalitywas observed in our study.
{"title":"Clinical Profile and Outcome of Acute Pancreatitis in Rural Population in South India","authors":"Dr. K K Saravanan, Dr. Mohamed Mubarak Ali V A","doi":"10.17511/ijoso.2021.i02.02","DOIUrl":"https://doi.org/10.17511/ijoso.2021.i02.02","url":null,"abstract":"Introduction: Acute pancreatitis is one of the most common cause of acute abdominal pain with awide range of presentation from mild to multi-organ failure; hence we intended to study the clinicalprofile of acute pancreatitis in our study. Methods: All subjects admitted with acute pancreatitisabove the age of 18 years; both male and female willing to participate were included in the study.60 subjects were studied where males dominate the study. Results: Alcohol intake and gall stonebeing the etiological cause for the illness. Conclusion: The recovery rate was 95% with no mortalitywas observed in our study.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128118994","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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