The most common presentation of tuberculosis (TB) of the spine is paradiscal lesion secondarily involving adjacent disc and vertebral bodies. If not diagnosed early, it can lead to extensive destruction and atypical features. We report a patient who presented late with posterolateral migration of the vertebral body and multifocal spinal involvement. A 30-year-old female presented with back pain, progressive spinal deformity, and paraparesis. Plain X-rays, computed tomography scans, and magnetic resonance imaging revealed multifocal extensive TB of the spine with posterolateral migration of the first lumbar vertebra. The vertebral body showed erosions. Posterior elements involvements with pars interarticularis defects of 12th dorsal to 2nd lumbar vertebra were observed. The patient was planned for stabilization of the spine along with excision of the migrated vertebra along with antituberculous treatment, but she refused surgery. The authors discuss the pathogenesis of such a rare event and stress the early detection of this complication.
{"title":"Posterolateral migration of complete vertebral body in neglected tuberculosis of the spine","authors":"Svareen Kaur, Roop Singh, Hemant More, M. Khanna","doi":"10.4103/jotr.jotr_79_21","DOIUrl":"https://doi.org/10.4103/jotr.jotr_79_21","url":null,"abstract":"The most common presentation of tuberculosis (TB) of the spine is paradiscal lesion secondarily involving adjacent disc and vertebral bodies. If not diagnosed early, it can lead to extensive destruction and atypical features. We report a patient who presented late with posterolateral migration of the vertebral body and multifocal spinal involvement. A 30-year-old female presented with back pain, progressive spinal deformity, and paraparesis. Plain X-rays, computed tomography scans, and magnetic resonance imaging revealed multifocal extensive TB of the spine with posterolateral migration of the first lumbar vertebra. The vertebral body showed erosions. Posterior elements involvements with pars interarticularis defects of 12th dorsal to 2nd lumbar vertebra were observed. The patient was planned for stabilization of the spine along with excision of the migrated vertebra along with antituberculous treatment, but she refused surgery. The authors discuss the pathogenesis of such a rare event and stress the early detection of this complication.","PeriodicalId":34195,"journal":{"name":"Journal of Orthopedics Traumatology and Rehabilitation","volume":"1 1","pages":"94 - 97"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80538491","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: The pronator quadratus is one of the deep muscles of the front of the forearm. The neurovascular supply of the muscle is derived from the anterior interosseous nerve and vessels. This muscle is approached in various surgical procedures involving the distal radius. Its nerve can be utilised as a graft in case of peripheral nerve lesions and the anterior interosseous artery perforator flap is used for wrist and hand surgeries. Hence, the anatomy of the muscle and its neurovascular pedicle is needed in orthopedic surgeries. Materials and Methods: In this study, 84 upper limbs from 24 male and 18 female cadavers, age ranging from 55 to 78 years, were dissected to study the pronator quadratus muscle and its neurovascular supply in the Department of Anatomy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. Various levels of measurements regarding the length and width of the muscle were considered. The number of branches of its neurovascular structures and their levels of entry into the muscle from various landmarks was measured. The Student t-test was applied to identify the P-value regarding the difference between the subjects. Results: No significant differences were observed regarding the measurements of the muscle and its neurovascular structures between male and female cadavers. Conclusion: This study can be useful for the surgeries involving the lower part of front of forearm. Since no significant difference was found between the genders regarding the variables, the morphometry of the muscle and its supply can be generalised for both sexes.
{"title":"The dimensions of pronator quadratus and its neurovascular structures – A cadaveric study with its clinical implications in distal forearm surgeries","authors":"S. Ramalingam, Deepa Somanath","doi":"10.4103/jotr.jotr_67_21","DOIUrl":"https://doi.org/10.4103/jotr.jotr_67_21","url":null,"abstract":"Introduction: The pronator quadratus is one of the deep muscles of the front of the forearm. The neurovascular supply of the muscle is derived from the anterior interosseous nerve and vessels. This muscle is approached in various surgical procedures involving the distal radius. Its nerve can be utilised as a graft in case of peripheral nerve lesions and the anterior interosseous artery perforator flap is used for wrist and hand surgeries. Hence, the anatomy of the muscle and its neurovascular pedicle is needed in orthopedic surgeries. Materials and Methods: In this study, 84 upper limbs from 24 male and 18 female cadavers, age ranging from 55 to 78 years, were dissected to study the pronator quadratus muscle and its neurovascular supply in the Department of Anatomy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. Various levels of measurements regarding the length and width of the muscle were considered. The number of branches of its neurovascular structures and their levels of entry into the muscle from various landmarks was measured. The Student t-test was applied to identify the P-value regarding the difference between the subjects. Results: No significant differences were observed regarding the measurements of the muscle and its neurovascular structures between male and female cadavers. Conclusion: This study can be useful for the surgeries involving the lower part of front of forearm. Since no significant difference was found between the genders regarding the variables, the morphometry of the muscle and its supply can be generalised for both sexes.","PeriodicalId":34195,"journal":{"name":"Journal of Orthopedics Traumatology and Rehabilitation","volume":"135 1","pages":"46 - 49"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75067795","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: Plantar fasciitis is an aseptic inflammation of the plantar fascia and also the most common cause of plantar heel pain.Approximately more than 10% of the population is affected by it over their lifetime. Aims and Objectives: The aim of this study is to evaluate the role of platelet-rich plasma (PRP) versus corticosteroid (triamcinolone) therapy in plantar fasciitis and to study the complications associated with both the procedures and their management. Materials and Methods: The study included 36 patients of plantar fasciitis (fulfilling the inclusion criteria) who presented to the OPD/Casualty of Department of Orthopaedics and Traumatology, M.G.M. Medical College and M.Y. Hospital, Indore, between September 2018 and August 2020. The study was a prospective and interventional type. Results: The mean Roles and Maudsley Subjective Pain score (RMSPS) score at pretreatment was 3.72 ± 0.46 for PRP and 3.72 ± 0.46 for steroids; at 1 month, it was 1.61 ± 0.78 for PRP and 1.44 ± 0.70 for steroids; and at 6 months, it was 1.22 ± 0.55 for PRP and 1.94 ± 0.73 for steroids. The mean Visual Analog Scale (VAS) score at pretreatment was 7.72 ± 0.96 for PRP and 7.78 ± 1.0 for steroids; at 1 month, it was 2.89 ± 1.68 for PRP and 2.50 ± 1.47 for steroids; and at 6 months, it was 1.28 ± 1.49 for PRP and 2.61 ± 1.69 for steroids. PRP injections have shown effectiveness in providing pain relief, improving function in plantar fasciitis patients. As a result, VAS and RMSPS score was significantly reduced (P = 0.015) at 6 months as compared to preprocedure and thus proved the effectiveness of the PRP therapy. It also shows that PRP is a better method in reducing pain in plantar fasciitis compared to steroid injection. Conclusion: Our study demonstrates PRP injection to be an effective and well-tolerated alternative to corticosteroid injection in the management of chronic plantar fasciitis with an added advantage of almost no side effects due to its biological nature and better patient compliance.
{"title":"To evaluate the role of intralesional injection of platelet-rich plasma versus corticosteroid (triamcinolone) in plantar fasciitis","authors":"Mahendra Solanki, R. Kelkar, Pawan Baghel","doi":"10.4103/jotr.jotr_9_21","DOIUrl":"https://doi.org/10.4103/jotr.jotr_9_21","url":null,"abstract":"Introduction: Plantar fasciitis is an aseptic inflammation of the plantar fascia and also the most common cause of plantar heel pain.Approximately more than 10% of the population is affected by it over their lifetime. Aims and Objectives: The aim of this study is to evaluate the role of platelet-rich plasma (PRP) versus corticosteroid (triamcinolone) therapy in plantar fasciitis and to study the complications associated with both the procedures and their management. Materials and Methods: The study included 36 patients of plantar fasciitis (fulfilling the inclusion criteria) who presented to the OPD/Casualty of Department of Orthopaedics and Traumatology, M.G.M. Medical College and M.Y. Hospital, Indore, between September 2018 and August 2020. The study was a prospective and interventional type. Results: The mean Roles and Maudsley Subjective Pain score (RMSPS) score at pretreatment was 3.72 ± 0.46 for PRP and 3.72 ± 0.46 for steroids; at 1 month, it was 1.61 ± 0.78 for PRP and 1.44 ± 0.70 for steroids; and at 6 months, it was 1.22 ± 0.55 for PRP and 1.94 ± 0.73 for steroids. The mean Visual Analog Scale (VAS) score at pretreatment was 7.72 ± 0.96 for PRP and 7.78 ± 1.0 for steroids; at 1 month, it was 2.89 ± 1.68 for PRP and 2.50 ± 1.47 for steroids; and at 6 months, it was 1.28 ± 1.49 for PRP and 2.61 ± 1.69 for steroids. PRP injections have shown effectiveness in providing pain relief, improving function in plantar fasciitis patients. As a result, VAS and RMSPS score was significantly reduced (P = 0.015) at 6 months as compared to preprocedure and thus proved the effectiveness of the PRP therapy. It also shows that PRP is a better method in reducing pain in plantar fasciitis compared to steroid injection. Conclusion: Our study demonstrates PRP injection to be an effective and well-tolerated alternative to corticosteroid injection in the management of chronic plantar fasciitis with an added advantage of almost no side effects due to its biological nature and better patient compliance.","PeriodicalId":34195,"journal":{"name":"Journal of Orthopedics Traumatology and Rehabilitation","volume":"94 1","pages":"70 - 74"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86016022","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: Tailor's bunion or Bunionette deformities were described by Davies et al. as abnormal, painful bony prominence on the lateral aspect of the fifth metatarsal head. This prominence, though present in many individuals, seldom causes symptoms. Most deformities can be managed conservatively, and surgical interventions will be needed only for refractory cases presenting with chronic pain. Various surgical interventions (percutaneous, mini-open, open), including osteotomies at different level, has been described in the literature. Case: A thirty-three-year-old female house-maker presented with swelling over the bilateral fifth metatarsal lateral aspect and pain while walking for the last six months. The patient is a known case of Rheumatoid arthritis controlled on medication. The patient underwent Lateral exostectomy resection for bilateral swelling, At one year follow up, the patient had good functional outcome with no recurrence. Conclusion: Tailor's bunion deformity, although morphologically common, is rarely symptomatic. Its management involves identifying the cause, thorough clinical and radiographic evaluation of the deformity, and deciding the best surgical procedure to obtain optimal results.
{"title":"Bilateral bunionette in rheumatoid arthritis","authors":"A. Agrawal, A. Garg, Deepak Garg, R. Ranjan","doi":"10.4103/jotr.jotr_48_22","DOIUrl":"https://doi.org/10.4103/jotr.jotr_48_22","url":null,"abstract":"Introduction: Tailor's bunion or Bunionette deformities were described by Davies et al. as abnormal, painful bony prominence on the lateral aspect of the fifth metatarsal head. This prominence, though present in many individuals, seldom causes symptoms. Most deformities can be managed conservatively, and surgical interventions will be needed only for refractory cases presenting with chronic pain. Various surgical interventions (percutaneous, mini-open, open), including osteotomies at different level, has been described in the literature. Case: A thirty-three-year-old female house-maker presented with swelling over the bilateral fifth metatarsal lateral aspect and pain while walking for the last six months. The patient is a known case of Rheumatoid arthritis controlled on medication. The patient underwent Lateral exostectomy resection for bilateral swelling, At one year follow up, the patient had good functional outcome with no recurrence. Conclusion: Tailor's bunion deformity, although morphologically common, is rarely symptomatic. Its management involves identifying the cause, thorough clinical and radiographic evaluation of the deformity, and deciding the best surgical procedure to obtain optimal results.","PeriodicalId":34195,"journal":{"name":"Journal of Orthopedics Traumatology and Rehabilitation","volume":"11 4 1","pages":"90 - 93"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78409355","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: Capitellar fractures are rare injuries and difficult to manage, especially so if the patient presents late. Treatment is almost always operative. The purpose of this study is to evaluate the functional outcome of capitellar fractures in adults treated by open reduction and internal fixation (ORIF) with cannulated compression headless screws (Herbert screw) with an inadvertent delay of 2 weeks or more. Materials and Methods: Twelve patients (4 males and 8 females) of capitellum fracture who were reported after an inadvertent delay of at least 2 weeks, with near-normal elbow range of motion, operated by ORIF with Herbert screw, were studied retrospectively from April 2013 to March 2019. All cases were operated between 2 to 3 weeks of injury. All patients had a follow-up for a mean period of 34 months, and the final functional outcome was assessed using Mayo Elbow Performance Index (MEPI) and by radiology. Results: The mean MEPI score was 92.9 points, and as per this evaluation of the functional rating, all but one patient had excellent results. The mean range of elbow flexion/extension was 125 (90–140), while the range of movement in supination/pronation was 170 (130–180). Conclusion: ORIF of capitellum fractures with Herbert screw was found to be superior and gives excellent result, even with a delay of around 2 weeks. Preoperative computed tomography is helpful not only to know clear picture of fracture configuration but also to choose right surgical approach and right implant. Apart from stable internal fixation, early mobilization and rehabilitation are the keys for optimum functional outcome.
{"title":"Functional outcome of delayed surgical fixation of capitellar fractures treated by open reduction and internal fixation with herbert screw","authors":"S. Keshkar, Riddhideb Barman, Mohammad Akhtar","doi":"10.4103/jotr.jotr_46_22","DOIUrl":"https://doi.org/10.4103/jotr.jotr_46_22","url":null,"abstract":"Introduction: Capitellar fractures are rare injuries and difficult to manage, especially so if the patient presents late. Treatment is almost always operative. The purpose of this study is to evaluate the functional outcome of capitellar fractures in adults treated by open reduction and internal fixation (ORIF) with cannulated compression headless screws (Herbert screw) with an inadvertent delay of 2 weeks or more. Materials and Methods: Twelve patients (4 males and 8 females) of capitellum fracture who were reported after an inadvertent delay of at least 2 weeks, with near-normal elbow range of motion, operated by ORIF with Herbert screw, were studied retrospectively from April 2013 to March 2019. All cases were operated between 2 to 3 weeks of injury. All patients had a follow-up for a mean period of 34 months, and the final functional outcome was assessed using Mayo Elbow Performance Index (MEPI) and by radiology. Results: The mean MEPI score was 92.9 points, and as per this evaluation of the functional rating, all but one patient had excellent results. The mean range of elbow flexion/extension was 125 (90–140), while the range of movement in supination/pronation was 170 (130–180). Conclusion: ORIF of capitellum fractures with Herbert screw was found to be superior and gives excellent result, even with a delay of around 2 weeks. Preoperative computed tomography is helpful not only to know clear picture of fracture configuration but also to choose right surgical approach and right implant. Apart from stable internal fixation, early mobilization and rehabilitation are the keys for optimum functional outcome.","PeriodicalId":34195,"journal":{"name":"Journal of Orthopedics Traumatology and Rehabilitation","volume":"66 1","pages":"9 - 12"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90761385","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 : 2022-01-01DOI: 10.4103/jotr.jotr_113_21
Mahendra Solanki, D. Sharma, R. Prasad, Mitul K. Jain
Introduction: Distal end radius fractures are the most common fractures of the upper extremity. The most common mode of injury is a fall on outstretched hand. Closed reduction and percutaneous pinning with “the five-pin technique” improve the reliability of fixation. The current study aimed to assess the clinical and functional outcome of fixation of distal radius fractures using the five-pin technique. Materials and Methods: Thirty patients with fracture of distal end radius Frykman type 1 and 2 were subjected to close reduction and K-wire fixation by five-pin technique. Results: Functional outcome-using Obrien scoring system for functional outcome, there was 90%–100% score in 11 patients, 80%–89% in 18 patients, and <80 in one patient. Radiological outcome-using Sarmiento modification Lindstrom criteria for radiological outcome, 11 patients had excellent results, and 18 had good results, and one had fair results. Conclusion: “The five-pin technique” is a versatile tool which provides optimum functional and radiological outcomes.
{"title":"Evaluation of functional and radiological outcome of five-pin technique in management of distal end radius fractures","authors":"Mahendra Solanki, D. Sharma, R. Prasad, Mitul K. Jain","doi":"10.4103/jotr.jotr_113_21","DOIUrl":"https://doi.org/10.4103/jotr.jotr_113_21","url":null,"abstract":"Introduction: Distal end radius fractures are the most common fractures of the upper extremity. The most common mode of injury is a fall on outstretched hand. Closed reduction and percutaneous pinning with “the five-pin technique” improve the reliability of fixation. The current study aimed to assess the clinical and functional outcome of fixation of distal radius fractures using the five-pin technique. Materials and Methods: Thirty patients with fracture of distal end radius Frykman type 1 and 2 were subjected to close reduction and K-wire fixation by five-pin technique. Results: Functional outcome-using Obrien scoring system for functional outcome, there was 90%–100% score in 11 patients, 80%–89% in 18 patients, and <80 in one patient. Radiological outcome-using Sarmiento modification Lindstrom criteria for radiological outcome, 11 patients had excellent results, and 18 had good results, and one had fair results. Conclusion: “The five-pin technique” is a versatile tool which provides optimum functional and radiological outcomes.","PeriodicalId":34195,"journal":{"name":"Journal of Orthopedics Traumatology and Rehabilitation","volume":"44 1","pages":"5 - 8"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89797604","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 : 2022-01-01DOI: 10.4103/jotr.jotr_103_21
A. Sharma, D. Varma, Umesh Vyas, A. Bohra, ShivBhagwan Sharma
Background: Junctional distal femur fractures are considered difficult to unite and often can led to a degree of disability. The incidence of malunion, nonunion, and infection is relatively high in many reported series. In elderly patients, low-energy distal femur fractures can cause devastating injuries, carrying high rates of morbidity and mortality. Operative fixation can be more challenging in comminuted fractures of osteoporotic bones. The management of junctional fractures of the distal femur by using the nail plate combination (NPC) technique can provide stable, well-balanced fixation, allowing for immediate weight-bearing and early mobilization and improve quality of life. Materials and Methods: A prospective randomized study including 16 patients with distal femur extraarticular and junctional fractures, was conducted in the department of orthopedic surgery Jhalawar medical college and SRG hospital Jhalawar, from May 2019 to June 2021. There were 9 male and 7 female patients, age range from 43 years to 70 years, with a mean age being 53 years. The average length of follow-up was 18.5 months (12 months to 24 months). Results: Patients followed up at 1 month, 3 months, 6 months, annually thereafter. Regular fracture healing was observed in 15 cases. Delayed union seen in 1 case who had infection postoperatively, which was treated with debridement and antibiotics as culture and sensitivity. mild rotational misalignment (~5°) seen in one case and there was no axial misalignment (Varus/valgus angulations) was found in any case. There were no implant failures. Conclusion: In our study, functional results trended toward better outcomes in nails plates combinations in terms of knee flexion, early weight-bearing, less union time, and better alignment. NPC system could take the challenges such as poor bone stock, severe comminution both metaphyseal and diaphyseal region.
{"title":"Management of extra articular distal femoral fractures with nail plate combination","authors":"A. Sharma, D. Varma, Umesh Vyas, A. Bohra, ShivBhagwan Sharma","doi":"10.4103/jotr.jotr_103_21","DOIUrl":"https://doi.org/10.4103/jotr.jotr_103_21","url":null,"abstract":"Background: Junctional distal femur fractures are considered difficult to unite and often can led to a degree of disability. The incidence of malunion, nonunion, and infection is relatively high in many reported series. In elderly patients, low-energy distal femur fractures can cause devastating injuries, carrying high rates of morbidity and mortality. Operative fixation can be more challenging in comminuted fractures of osteoporotic bones. The management of junctional fractures of the distal femur by using the nail plate combination (NPC) technique can provide stable, well-balanced fixation, allowing for immediate weight-bearing and early mobilization and improve quality of life. Materials and Methods: A prospective randomized study including 16 patients with distal femur extraarticular and junctional fractures, was conducted in the department of orthopedic surgery Jhalawar medical college and SRG hospital Jhalawar, from May 2019 to June 2021. There were 9 male and 7 female patients, age range from 43 years to 70 years, with a mean age being 53 years. The average length of follow-up was 18.5 months (12 months to 24 months). Results: Patients followed up at 1 month, 3 months, 6 months, annually thereafter. Regular fracture healing was observed in 15 cases. Delayed union seen in 1 case who had infection postoperatively, which was treated with debridement and antibiotics as culture and sensitivity. mild rotational misalignment (~5°) seen in one case and there was no axial misalignment (Varus/valgus angulations) was found in any case. There were no implant failures. Conclusion: In our study, functional results trended toward better outcomes in nails plates combinations in terms of knee flexion, early weight-bearing, less union time, and better alignment. NPC system could take the challenges such as poor bone stock, severe comminution both metaphyseal and diaphyseal region.","PeriodicalId":34195,"journal":{"name":"Journal of Orthopedics Traumatology and Rehabilitation","volume":"38 2 1","pages":"50 - 54"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79290435","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: Numerous techniques for the treatment of posterior cruciate ligament (PCL) avulsion fractures have been described in literature from closed reduction to definitive fixation, both open and arthroscopically assisted fixation. Aim: In this study, we evaluated the clinical and functional outcome after open reduction and internal fixation of tibial avulsion injuries of the PCL using number 5 polyester sutures (Ethicon-Ethibond excel) with Titanium AL (Tit) endobutton (Nebula Surgicals Private Limited, India) through burks and Schaffer posteromedial approach. Materials and Methods: It was a prospective study of 22 patients of PCL tibial avulsion fractures; fixed using number 5 polyester sutures with Tit endobutton through burks and Schaffer approach with the patient in the prone position. We included only those patients who had isolated PCL avulsion injuries and came within 12 weeks of injury. The final functional outcome was compared using the Lysholm knee scoring system. Student's t-tests were used for intergroup comparison of Lysholm knee scores before and after surgery. Results: The mean follow-up was of 11.9 months, with the loss of two patients in follow-up. Bony union was achieved in all patients within 8–15 weeks (mean-11.6 weeks). The average flexion of 122.8° with full extension achieved in all patients. Slight instability (1+) was noted in four patients. The Lysholm functional score was excellent in 16 patients and good in four patients with an average score of 94.6 ± 4.6. Conclusion: Using sutures and endobuttons for PCL tibial avulsion fixation provides secure fixation leading to satisfactory functional and clinical outcomes as well as omits placement of any hardware in joint, thus obviating risk of joint damage and burden of second surgery for removing the implant.
{"title":"A novel technique for posterior cruciate ligament tibial avulsion fixation through the burks and schaffer approach","authors":"Akshat Vijay, D. Bairwa, R. Goel, Amit Gupta","doi":"10.4103/jotr.jotr_6_21","DOIUrl":"https://doi.org/10.4103/jotr.jotr_6_21","url":null,"abstract":"Introduction: Numerous techniques for the treatment of posterior cruciate ligament (PCL) avulsion fractures have been described in literature from closed reduction to definitive fixation, both open and arthroscopically assisted fixation. Aim: In this study, we evaluated the clinical and functional outcome after open reduction and internal fixation of tibial avulsion injuries of the PCL using number 5 polyester sutures (Ethicon-Ethibond excel) with Titanium AL (Tit) endobutton (Nebula Surgicals Private Limited, India) through burks and Schaffer posteromedial approach. Materials and Methods: It was a prospective study of 22 patients of PCL tibial avulsion fractures; fixed using number 5 polyester sutures with Tit endobutton through burks and Schaffer approach with the patient in the prone position. We included only those patients who had isolated PCL avulsion injuries and came within 12 weeks of injury. The final functional outcome was compared using the Lysholm knee scoring system. Student's t-tests were used for intergroup comparison of Lysholm knee scores before and after surgery. Results: The mean follow-up was of 11.9 months, with the loss of two patients in follow-up. Bony union was achieved in all patients within 8–15 weeks (mean-11.6 weeks). The average flexion of 122.8° with full extension achieved in all patients. Slight instability (1+) was noted in four patients. The Lysholm functional score was excellent in 16 patients and good in four patients with an average score of 94.6 ± 4.6. Conclusion: Using sutures and endobuttons for PCL tibial avulsion fixation provides secure fixation leading to satisfactory functional and clinical outcomes as well as omits placement of any hardware in joint, thus obviating risk of joint damage and burden of second surgery for removing the implant.","PeriodicalId":34195,"journal":{"name":"Journal of Orthopedics Traumatology and Rehabilitation","volume":"24 1","pages":"81 - 85"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90317188","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}
Tanmoy Mohanty, Madhuchhanda Pattnaik, G. Sethy, R. Jee
Sometimes genu valgum in an adult poses a challenge to orthopedic surgeons because the deformity is very gross if it developed due to injury or infection in early childhood. If the femoral condyle is found to be hypoplastic, then the corrective osteotomy site is very close to the joint. It may be difficult to manage with a conventional fixator and a hybrid fixator may become a necessity. A limb reconstruction system (LRS) is less cumbersome than ring fixators when fixed to the thigh. A hybrid fixator fabricated using a twin-ring Ilizarov system attached to an LRS was found to be very useful during the management of corrective osteotomy of genu valgum in an adult. A special clamp was designed to fix the Ilizarov portion to the end of the rail system of LRS. Here, the use of such a hybrid fixator to correct the deformity of the right knee in a 27-year-old person has been described in detail.
{"title":"Hybrid external fixator for correction of genu valgum in an adult","authors":"Tanmoy Mohanty, Madhuchhanda Pattnaik, G. Sethy, R. Jee","doi":"10.4103/jotr.jotr_61_21","DOIUrl":"https://doi.org/10.4103/jotr.jotr_61_21","url":null,"abstract":"Sometimes genu valgum in an adult poses a challenge to orthopedic surgeons because the deformity is very gross if it developed due to injury or infection in early childhood. If the femoral condyle is found to be hypoplastic, then the corrective osteotomy site is very close to the joint. It may be difficult to manage with a conventional fixator and a hybrid fixator may become a necessity. A limb reconstruction system (LRS) is less cumbersome than ring fixators when fixed to the thigh. A hybrid fixator fabricated using a twin-ring Ilizarov system attached to an LRS was found to be very useful during the management of corrective osteotomy of genu valgum in an adult. A special clamp was designed to fix the Ilizarov portion to the end of the rail system of LRS. Here, the use of such a hybrid fixator to correct the deformity of the right knee in a 27-year-old person has been described in detail.","PeriodicalId":34195,"journal":{"name":"Journal of Orthopedics Traumatology and Rehabilitation","volume":"136 1","pages":"86 - 89"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77336452","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}
Narendra Kumar, V. Pandey, D. Sharma, M. Patralekh, H. Lal
Aims: The aim is to study the role of serum procalcitonin (PCT) levels in early diagnosis of acute osteomyelitis (OM) and septic arthritis (SA). Settings and Design: This is a prospective study in a tertiary hospital. Subjects and Methods: This study was done at a tertiary care hospital. Thirty-nine patients with SA or acute OM who attended the outpatient department or emergency were included in the study. 39 patients were taken as control group out of which one patient lost to follow-up, so 38 patients were left with control group. PCT level was evaluated by using immunoluminetric assay and a cutoff value of 0.5 ng/ml was taken as positive. After collection of data, sensitivity, specificity, positive predictive value, and negative predictive value are calculated for PCT. Statistical Analysis Used: Mann–Whitney U-test and Kruskal–Wallis test were used. Results: The sensitivity for PCT was 94.87 (95% confidence interval [CI] 82.68–99.37), specificity was 86.84 (95% CI 71.91–95.59), positive predictive value was 88.10%, and negative predictive value was 94.29%, when taking cutoff of 0.5 ng/ml. We have taken 0.5 ng/ml as a cutoff point for PCT; however, as per receiver operator characteristic of this study, the cutoff point was 1.1 ng/ml. Conclusions: This study clearly showed that PCT can be helpful in the early diagnosis of OM and SA, along with other indicators such as total leukocyte count, erythrocyte sedimentation rate, and C-reactive protein.
{"title":"Evaluation of serum procalcitonin levels in patients of acute osteomyelitis and septic arthritis","authors":"Narendra Kumar, V. Pandey, D. Sharma, M. Patralekh, H. Lal","doi":"10.4103/jotr.jotr_16_21","DOIUrl":"https://doi.org/10.4103/jotr.jotr_16_21","url":null,"abstract":"Aims: The aim is to study the role of serum procalcitonin (PCT) levels in early diagnosis of acute osteomyelitis (OM) and septic arthritis (SA). Settings and Design: This is a prospective study in a tertiary hospital. Subjects and Methods: This study was done at a tertiary care hospital. Thirty-nine patients with SA or acute OM who attended the outpatient department or emergency were included in the study. 39 patients were taken as control group out of which one patient lost to follow-up, so 38 patients were left with control group. PCT level was evaluated by using immunoluminetric assay and a cutoff value of 0.5 ng/ml was taken as positive. After collection of data, sensitivity, specificity, positive predictive value, and negative predictive value are calculated for PCT. Statistical Analysis Used: Mann–Whitney U-test and Kruskal–Wallis test were used. Results: The sensitivity for PCT was 94.87 (95% confidence interval [CI] 82.68–99.37), specificity was 86.84 (95% CI 71.91–95.59), positive predictive value was 88.10%, and negative predictive value was 94.29%, when taking cutoff of 0.5 ng/ml. We have taken 0.5 ng/ml as a cutoff point for PCT; however, as per receiver operator characteristic of this study, the cutoff point was 1.1 ng/ml. Conclusions: This study clearly showed that PCT can be helpful in the early diagnosis of OM and SA, along with other indicators such as total leukocyte count, erythrocyte sedimentation rate, and C-reactive protein.","PeriodicalId":34195,"journal":{"name":"Journal of Orthopedics Traumatology and Rehabilitation","volume":"45 1","pages":"66 - 69"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79903084","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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