{"title":"Calculation of the reference bone mineral density values in North Indian population using phantomless quantitative computed tomography","authors":"M. Al-Mendalawi","doi":"10.4103/JOAS.JOAS_31_18","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_31_18","url":null,"abstract":"","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43304863","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: Lateral epicondylitis responds well to conservative methods of treatment such as drugs, braces and local infiltration of steroids, autologous blood, and platelet-rich plasma. The patients who do not respond to conservative methods become candidates for surgical intervention. In our study, we have performed the Nirschl procedure through a smaller incision. MATERIALS AND METHODS: Our study included 18 patients having lateral epicondylitis treated with an open debridement of extensor carpi radialis brevis using a small incision. In our study, we had six males and 12 females, with 14 patients having involvement on the right side and four patients on the left side. Patients were followed up for a mean period of 28.8 months, and the final outcome was assessed using the QuickDASH score, visual analog scale (VAS), and the Nirschl and Pettrone's grading system. RESULTS: According to the QuickDASH scoring scale, the preoperative mean score improved from 74.4 to 49.7 postoperatively, which is statically significant (P < 0.05). According to the Nirschl and Pettrone's grading system, 14 (77.7%) cases were excellent, 3 (16.7%) were good, and 1 (5.6%) was fair and none had a failure. The mean VAS score for pain at rest improved from 4.7 (range from 3 to 6) preoperatively to 0.7 (range from 0 to 2) at the last follow-up (P < 0.05)). The mean VAS score during daily activities improved from 6.9 (range from 4 to 8) preoperatively to 1.2 (range from 0 to 2) at the last follow-up (P < 0.05). CONCLUSION: Surgical intervention via the Nirschl operative technique is ideal for recalcitrant lateral epicondylitis.
{"title":"Surgical treatment of recalcitrant lateral epicondylitis using a minimal incision technique","authors":"N. Dar, N. Shah, Ilyas Ahmad Shah, W. Iqbal","doi":"10.4103/JOAS.JOAS_27_18","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_27_18","url":null,"abstract":"BACKGROUND: Lateral epicondylitis responds well to conservative methods of treatment such as drugs, braces and local infiltration of steroids, autologous blood, and platelet-rich plasma. The patients who do not respond to conservative methods become candidates for surgical intervention. In our study, we have performed the Nirschl procedure through a smaller incision. MATERIALS AND METHODS: Our study included 18 patients having lateral epicondylitis treated with an open debridement of extensor carpi radialis brevis using a small incision. In our study, we had six males and 12 females, with 14 patients having involvement on the right side and four patients on the left side. Patients were followed up for a mean period of 28.8 months, and the final outcome was assessed using the QuickDASH score, visual analog scale (VAS), and the Nirschl and Pettrone's grading system. RESULTS: According to the QuickDASH scoring scale, the preoperative mean score improved from 74.4 to 49.7 postoperatively, which is statically significant (P < 0.05). According to the Nirschl and Pettrone's grading system, 14 (77.7%) cases were excellent, 3 (16.7%) were good, and 1 (5.6%) was fair and none had a failure. The mean VAS score for pain at rest improved from 4.7 (range from 3 to 6) preoperatively to 0.7 (range from 0 to 2) at the last follow-up (P < 0.05)). The mean VAS score during daily activities improved from 6.9 (range from 4 to 8) preoperatively to 1.2 (range from 0 to 2) at the last follow-up (P < 0.05). CONCLUSION: Surgical intervention via the Nirschl operative technique is ideal for recalcitrant lateral epicondylitis.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43698450","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}
A. Dahuja, Sabyasachi Bhowmik, Rashmeet Kaur, Radhe Shayam, Sandeep Jindal
BACKGROUND: Studies have shown that tranexamic acid reduces blood loss and transfusion need in patients undergoing total hip arthroplasty. However, till date, no study has been large enough to determine definitively whether the drug is safe and effective in total hip arthroplasty. We examined whether intravenous tranexamic acid, when compared with placebo, is safe and effective in total hip arthroplasty. MATERIALS AND METHODS: A prospective, randomized, double blinded study was conducted in a group of 142 patients undergoing total hip arthroplasty divided equally into tranexamic acid group and control group. Our protocol included administration of one dose of 15 mg/kg of TXA (given as infusion over 15 min ) in 100 ml NS just 15 min before incision and the subsequent 8 hourly in TXA group. In control group we have given 100 ml normal saline infusion just before operation and 100 ml NS infusion 8 hourly for 2 days postoperatively. Postoperative blood parameters were recorded. RESULTS: The total postoperative drain output and transfusion requirement was found to be lower in patients who received TXA (352-412 ml) as compared to control group (804-878 ml). We have observed 3 and 4 cases of DVT in TXA and control group respectively. Coagulation profile is least affected in both the groups. CONCLUSION: We conclude that tranexamic acid significantly reduces postoperative blood loss and transfusion requirements during total hip arthroplasty.
背景:研究表明氨甲环酸可减少全髋关节置换术患者的失血量和输血需求。然而，到目前为止，还没有足够大的研究来确定该药物在全髋关节置换术中是否安全有效。我们研究了静脉注射氨甲环酸与安慰剂相比，在全髋关节置换术中是否安全有效。材料与方法:对142例全髋关节置换术患者进行前瞻性、随机、双盲研究，随机分为氨甲环酸组和对照组。我们的方案包括在切口前15分钟在100 ml NS中给予一剂15mg /kg的TXA(在15分钟内输注)，TXA组随后8小时。对照组术前滴注生理盐水100 ml，术后2 d滴注生理盐水100 ml，每次8小时。记录术后血液参数。结果:与对照组(804-878 ml)相比，接受TXA治疗的患者(352-412 ml)术后总排液量和输血需要量较低。我们在TXA组和对照组分别观察到3例和4例DVT。两组的凝血指标受影响最小。结论:我们的结论是氨甲环酸可以显著减少全髋关节置换术后的出血量和输血需求。
{"title":"Antifibrinolytic in reducing postoperative blood loss in total hip replacement and its effect on coagulation profile: A prospective randomized study","authors":"A. Dahuja, Sabyasachi Bhowmik, Rashmeet Kaur, Radhe Shayam, Sandeep Jindal","doi":"10.4103/joas.joas_2_18","DOIUrl":"https://doi.org/10.4103/joas.joas_2_18","url":null,"abstract":"BACKGROUND: Studies have shown that tranexamic acid reduces blood loss and transfusion need in patients undergoing total hip arthroplasty. However, till date, no study has been large enough to determine definitively whether the drug is safe and effective in total hip arthroplasty. We examined whether intravenous tranexamic acid, when compared with placebo, is safe and effective in total hip arthroplasty. MATERIALS AND METHODS: A prospective, randomized, double blinded study was conducted in a group of 142 patients undergoing total hip arthroplasty divided equally into tranexamic acid group and control group. Our protocol included administration of one dose of 15 mg/kg of TXA (given as infusion over 15 min ) in 100 ml NS just 15 min before incision and the subsequent 8 hourly in TXA group. In control group we have given 100 ml normal saline infusion just before operation and 100 ml NS infusion 8 hourly for 2 days postoperatively. Postoperative blood parameters were recorded. RESULTS: The total postoperative drain output and transfusion requirement was found to be lower in patients who received TXA (352-412 ml) as compared to control group (804-878 ml). We have observed 3 and 4 cases of DVT in TXA and control group respectively. Coagulation profile is least affected in both the groups. CONCLUSION: We conclude that tranexamic acid significantly reduces postoperative blood loss and transfusion requirements during total hip arthroplasty.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42909139","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}
We report the case of a 66-year-old female who sustained a closed ankle fracture dislocation of her right ankle (Weber B; AO 44-B3.2). She underwent an open reduction with internal fixation, complicated with a small, superficial wound dehiscence during the initial follow-up. One month after surgery, she developed inflammatory signs on her right ankle, but disregarded them. One week later, she was admitted into the emergency department with infection of her ankle's osteosynthesis, and a necrotizing fasciitis of her left upper limb, neck, and thorax. The patient underwent multiple surgical interventions for the removal of osteosynthesis hardware, fasciotomies, consecutive debridements, and finally a below-the-knee amputation. Streptococcus pyogenes was identified in several cultures as the responsible agent, and directed antibiotic treatment was performed. However, despite all treatments, the patient's clinical status progressively worsened until she eventually deceased, 1 month after admission.
{"title":"Atypical necrotizing fasciitis following surgical treatment for closed ankle fracture dislocation","authors":"A. Grenho, L. Vieira, Joana Arcângelo, A. Pereira","doi":"10.4103/JOAS.JOAS_40_17","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_40_17","url":null,"abstract":"We report the case of a 66-year-old female who sustained a closed ankle fracture dislocation of her right ankle (Weber B; AO 44-B3.2). She underwent an open reduction with internal fixation, complicated with a small, superficial wound dehiscence during the initial follow-up. One month after surgery, she developed inflammatory signs on her right ankle, but disregarded them. One week later, she was admitted into the emergency department with infection of her ankle's osteosynthesis, and a necrotizing fasciitis of her left upper limb, neck, and thorax. The patient underwent multiple surgical interventions for the removal of osteosynthesis hardware, fasciotomies, consecutive debridements, and finally a below-the-knee amputation. Streptococcus pyogenes was identified in several cultures as the responsible agent, and directed antibiotic treatment was performed. However, despite all treatments, the patient's clinical status progressively worsened until she eventually deceased, 1 month after admission.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45279743","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}
Endoscopic spine surgeons bridge the major gap between fusion-oriented spinal surgeons and pain management physicians. Current surgical philosophy by traditionally trained spinal surgeons focuses on decompression with or without fusion as the “ultimate cure” for a painful spinal segment, while pain management uses spinal injections and techniques such as peripheral nerve and spinal cord neuro-modulation to relieve pain. Endoscopic surgery is the least invasive of current minimally invasive surgical options-focuses on treating the patho-anatomy of the pain generator. This represents a path between traditional open decompression with or without fusion and the more temporary techniques of pain management.
{"title":"The role of endoscopic surgery in the treatment of painful conditions of an aging spine: State of the art","authors":"A. Yeung","doi":"10.4103/JOAS.JOAS_1_18","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_1_18","url":null,"abstract":"Endoscopic spine surgeons bridge the major gap between fusion-oriented spinal surgeons and pain management physicians. Current surgical philosophy by traditionally trained spinal surgeons focuses on decompression with or without fusion as the “ultimate cure” for a painful spinal segment, while pain management uses spinal injections and techniques such as peripheral nerve and spinal cord neuro-modulation to relieve pain. Endoscopic surgery is the least invasive of current minimally invasive surgical options-focuses on treating the patho-anatomy of the pain generator. This represents a path between traditional open decompression with or without fusion and the more temporary techniques of pain management.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46542188","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}
AIMS: The current orthopedic treatment of geriatric hip fracture is inadequate as per the British Orthopaedic Association guidelines and hence to know whether there is a need of orthogeriatric unit in the tertiary hospital setups in India for the management of hip fracture. METHODOLOGY: This is a retrospective cross-sectional study, held in tertiary care teaching hospital. The data of patients with age >60 years admitted with hip fracture of 2016–2017 were recorded from medical record section. Age, sex, type of fracture, total duration of admission, delay in surgery, and associated comorbidities were recorded. Patients who had undergone hip surgery electively for other hip or acetabular fracture were excluded from the study. OBSERVATION: There were a total of 81 cases of hip fracture, of which there were 39 males and 42 females. Seventy-one percent of patients were from the age group of 60–70 years. Maximum number of (54.3%), 44 Patients were having intertrochanteric fracture, followed by fracture of the neck of the femur (35 patients) and subtrochanteric fracture (7 patients). These patients were treated with bipolar hemiarthroplasty, total hip replacement, or with proximal femoral nail fixation or with dynamic hip screw fixation. Hypertension, diabetes mellitus, asthma, and hemiparesis were associated diseases. The maximum stay was 65 days, the minimum stay was 8 days, and the average stay was 13 days.The average delay between admission to surgery was 7 days, maximum of 24 days. We could not analyze the exact cause for delay due to lack of proper data in most of the cases. CONCLUSION (IMPACT OF STUDY): Hip fractures in the elderly in India are increasing and not getting the quality of care required. There is an urgent need to the implementation of orthogeriatric unit, and team approach is required to curtail the delay in treatment. This may lead to decrease in the cost of treatment, reduced postfracture morbidity, and mortality. Formation of hip fracture registry would also help us to analyze the present status of care for hip fractures in the elderly.
{"title":"Is there a need for orthogeriatric unit in the Indian hospital setup for managing hip fractures?","authors":"A. Kedar, S. Dwidmuthe, Devashis Barick","doi":"10.4103/JOAS.JOAS_9_18","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_9_18","url":null,"abstract":"AIMS: The current orthopedic treatment of geriatric hip fracture is inadequate as per the British Orthopaedic Association guidelines and hence to know whether there is a need of orthogeriatric unit in the tertiary hospital setups in India for the management of hip fracture. METHODOLOGY: This is a retrospective cross-sectional study, held in tertiary care teaching hospital. The data of patients with age >60 years admitted with hip fracture of 2016–2017 were recorded from medical record section. Age, sex, type of fracture, total duration of admission, delay in surgery, and associated comorbidities were recorded. Patients who had undergone hip surgery electively for other hip or acetabular fracture were excluded from the study. OBSERVATION: There were a total of 81 cases of hip fracture, of which there were 39 males and 42 females. Seventy-one percent of patients were from the age group of 60–70 years. Maximum number of (54.3%), 44 Patients were having intertrochanteric fracture, followed by fracture of the neck of the femur (35 patients) and subtrochanteric fracture (7 patients). These patients were treated with bipolar hemiarthroplasty, total hip replacement, or with proximal femoral nail fixation or with dynamic hip screw fixation. Hypertension, diabetes mellitus, asthma, and hemiparesis were associated diseases. The maximum stay was 65 days, the minimum stay was 8 days, and the average stay was 13 days.The average delay between admission to surgery was 7 days, maximum of 24 days. We could not analyze the exact cause for delay due to lack of proper data in most of the cases. CONCLUSION (IMPACT OF STUDY): Hip fractures in the elderly in India are increasing and not getting the quality of care required. There is an urgent need to the implementation of orthogeriatric unit, and team approach is required to curtail the delay in treatment. This may lead to decrease in the cost of treatment, reduced postfracture morbidity, and mortality. Formation of hip fracture registry would also help us to analyze the present status of care for hip fractures in the elderly.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43856252","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}
C. Pal, K. Dinkar, R. Shakunt, Amit Singh, Asif Hussain, Y. Sharma
AIMS: The aim of this prospective study was to evaluate the effectiveness of intramedullary nailing and fixation by locking plates in displaced midclavicular fracture and to compare the functional outcome of intramedullary nailing versus plating. MATERIALS AND METHODS: This prospective comparative study was conducted at the tertiary center between October 2013 and September 2015 after being approved by the local Ethical Committee. A total of 66 patients ranging between 18 and 60 years of age were included in this study. They were randomized into two groups to be treated either by an intramedullary nail or by locking plate. Clinical and radiological assessments were performed at the 3rd week and 6th week and 3rd, 6th, and 12th month postoperatively. Outcomes and complications were compared to the 1-year follow-up in both groups. RESULTS: There was no significant difference found between two groups with regard to functional outcome after fracture union. Although lesser operative time, lower blood loss, less duration of hospital stay, easier implant removal, and better cosmetic appearance were noted in the nailing group. Constant shoulder scores were significantly higher in plating groups when compared to nailing group for the 1st 12 weeks of follow-up. However, this difference becomes insignificant between the two groups after 6 months of follow-up. Infection and revision surgery rates were more in plating group, but this difference is not significant. CONCLUSIONS: Functional outcome and complications remain same in intramedullary nailing and plating group. However, intramedullary nailing is advantageous concerning faster healing, secure implant removal, and better cosmetically appeared scars.
{"title":"Comparison of the functional outcome of intramedullary nailing versus plating in displaced midclavicular fractures","authors":"C. Pal, K. Dinkar, R. Shakunt, Amit Singh, Asif Hussain, Y. Sharma","doi":"10.4103/JOAS.JOAS_28_17","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_28_17","url":null,"abstract":"AIMS: The aim of this prospective study was to evaluate the effectiveness of intramedullary nailing and fixation by locking plates in displaced midclavicular fracture and to compare the functional outcome of intramedullary nailing versus plating. MATERIALS AND METHODS: This prospective comparative study was conducted at the tertiary center between October 2013 and September 2015 after being approved by the local Ethical Committee. A total of 66 patients ranging between 18 and 60 years of age were included in this study. They were randomized into two groups to be treated either by an intramedullary nail or by locking plate. Clinical and radiological assessments were performed at the 3rd week and 6th week and 3rd, 6th, and 12th month postoperatively. Outcomes and complications were compared to the 1-year follow-up in both groups. RESULTS: There was no significant difference found between two groups with regard to functional outcome after fracture union. Although lesser operative time, lower blood loss, less duration of hospital stay, easier implant removal, and better cosmetic appearance were noted in the nailing group. Constant shoulder scores were significantly higher in plating groups when compared to nailing group for the 1st 12 weeks of follow-up. However, this difference becomes insignificant between the two groups after 6 months of follow-up. Infection and revision surgery rates were more in plating group, but this difference is not significant. CONCLUSIONS: Functional outcome and complications remain same in intramedullary nailing and plating group. However, intramedullary nailing is advantageous concerning faster healing, secure implant removal, and better cosmetically appeared scars.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41454934","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}
Diabetic muscle infarction is an underdiagnosed and underreported complication of long-standing diabetes mellitus occurring in a middle-aged person with symptoms simulating infective or inflammatory condition most commonly involving the thigh muscles, legs, and arms, in decreasing order of frequency. Magnetic resonance imaging is the diagnostic modality of choice showing diffuse hyperintense signal involving the muscles and deep fascia on T2 images. It is a self-limiting condition which resolves simply by rest and analgesic; therefore, being aware of this condition is necessary to avoid unnecessary interventions.
{"title":"Diabetic muscle infarction","authors":"G. Rava, Nipanka Goswami, P. Mahanta","doi":"10.4103/JOAS.JOAS_56_17","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_56_17","url":null,"abstract":"Diabetic muscle infarction is an underdiagnosed and underreported complication of long-standing diabetes mellitus occurring in a middle-aged person with symptoms simulating infective or inflammatory condition most commonly involving the thigh muscles, legs, and arms, in decreasing order of frequency. Magnetic resonance imaging is the diagnostic modality of choice showing diffuse hyperintense signal involving the muscles and deep fascia on T2 images. It is a self-limiting condition which resolves simply by rest and analgesic; therefore, being aware of this condition is necessary to avoid unnecessary interventions.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45069858","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}
T. Pisal, Y. Hira, Swaroop Solunke, Shiva Basvaraj Sangam, Amol Patil, Shubanshu Gupta
INTRODUCTION: Managing and treating infected nonunion is one of the most challenging clinical scenarios despite numerous advances in the fixation methods, soft-tissue management, and antibiotic therapy. The infection of the fracture site causes internal fixation to become unstable and it slows down fracture healing. AIMS AND OBJECTIVES: To assess role of antibiotic-impregnated bone cement rod in control of bone infection and assessing its role in union in cases of infective nonunion of long bones. MATERIALS AND METHODS: This was a prospective study comprising of 30 cases of established infected nonunion of long bones carried out in a tertiary care center in Western Maharashtra. Patients of nonunion of long bone diaphysis with established clinical and laboratory evidence of infection were included in the study. RESULTS: Twenty-one cases showed complete union at 6 months or earlier. Two more cases showed significant callus formation. In three cases, there was no callus formation at fracture site till 6 months. DISCUSSION: Various authors in their studies confirmed that gentamicin and vancomycin are antibiotics which maintain activity even after being exposed to the high temperatures resulting from poly (methyl methacrylate) hardening. CONCLUSION: From our study, we confirm that the use of antibiotic-impregnated bone cement rod has a significant role in control of bone infection and also assists in union in cases of infective nonunion of long bones.
{"title":"Role of antibiotic-impregnated bone cement rod in control of bone infection and assessing its role in union in cases of infective nonunion of long bones","authors":"T. Pisal, Y. Hira, Swaroop Solunke, Shiva Basvaraj Sangam, Amol Patil, Shubanshu Gupta","doi":"10.4103/JOAS.JOAS_52_17","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_52_17","url":null,"abstract":"INTRODUCTION: Managing and treating infected nonunion is one of the most challenging clinical scenarios despite numerous advances in the fixation methods, soft-tissue management, and antibiotic therapy. The infection of the fracture site causes internal fixation to become unstable and it slows down fracture healing. AIMS AND OBJECTIVES: To assess role of antibiotic-impregnated bone cement rod in control of bone infection and assessing its role in union in cases of infective nonunion of long bones. MATERIALS AND METHODS: This was a prospective study comprising of 30 cases of established infected nonunion of long bones carried out in a tertiary care center in Western Maharashtra. Patients of nonunion of long bone diaphysis with established clinical and laboratory evidence of infection were included in the study. RESULTS: Twenty-one cases showed complete union at 6 months or earlier. Two more cases showed significant callus formation. In three cases, there was no callus formation at fracture site till 6 months. DISCUSSION: Various authors in their studies confirmed that gentamicin and vancomycin are antibiotics which maintain activity even after being exposed to the high temperatures resulting from poly (methyl methacrylate) hardening. CONCLUSION: From our study, we confirm that the use of antibiotic-impregnated bone cement rod has a significant role in control of bone infection and also assists in union in cases of infective nonunion of long bones.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44399700","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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