Background: Thoracic vertebral osteomyelitis/spondylodiscitis and spinal epidural abscess are rare but life-threatening conditions, commonly seen in immunocompromised persons. It requires early detection and prompt management, to avoid late sequelae and complications. The cause for this abscess can be pyogenic, tuberculosis, fungal, or parasitic. Candida and Aspergillus species are the most common fungal causes which mainly present as discitis or osteomyelitis in the immunocompromised patient, after hematogenous dissemination. Case discussion: We report about Fusarium , an opportunistic human pathogen which is a normal commensal of human skin flora, in a 60-year- old healthy gentleman with no immunocompromised stage, the rare cause of thoracic vertebral osteomyelitis with epidural abscess D9 to D11 with compressive myelopathy and neurological deficit in this article. Conclusion: Along with aerobic, anaerobic bacterial and tuberculous, microbiological and histopathological investigations should also include fungal workup. Proper fungal isolation from the tissue is a must for prompt treatment and a better outcome for the patient.
{"title":"Thoracic Fungal Osteomyelitis with Compressive Myelopathy in an Immunocompetent Individual by a Rare Fusarium Species: A Case Report","authors":"S. Raju, Chidambaram Muthu, Sudeep Reddy, Vinoth Thangamani, Bharat Kumar Ramalingam Jeyashankaran, Arunraj Sambandam","doi":"10.5005/jp-journals-10079-1051","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1051","url":null,"abstract":"Background: Thoracic vertebral osteomyelitis/spondylodiscitis and spinal epidural abscess are rare but life-threatening conditions, commonly seen in immunocompromised persons. It requires early detection and prompt management, to avoid late sequelae and complications. The cause for this abscess can be pyogenic, tuberculosis, fungal, or parasitic. Candida and Aspergillus species are the most common fungal causes which mainly present as discitis or osteomyelitis in the immunocompromised patient, after hematogenous dissemination. Case discussion: We report about Fusarium , an opportunistic human pathogen which is a normal commensal of human skin flora, in a 60-year- old healthy gentleman with no immunocompromised stage, the rare cause of thoracic vertebral osteomyelitis with epidural abscess D9 to D11 with compressive myelopathy and neurological deficit in this article. Conclusion: Along with aerobic, anaerobic bacterial and tuberculous, microbiological and histopathological investigations should also include fungal workup. Proper fungal isolation from the tissue is a must for prompt treatment and a better outcome for the patient.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122731080","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 bstrAct Alkaptonuria is caused by the defective metabolism of homogentisic acid, which causes arthritis and connective tissue pigmentation. The knee is a commonly affected joint. Total knee arthroplasty (TKA) has been suggested as an effective treatment for end-stage ochronosis arthropathy. A case of a 62-year-old man presented with pain in both knee joints and X-rays revealed advanced degenerative arthritis. During knee replacement, the subcutaneous tissues revealed blackish nodules. It was difficult to retract the patella as the patella tendon was stiff and hard with blackish discoloration. On dislocating patella, the patella tendon was avulsed on the right knee; later, it was fixed with a suture anchor and stapler. To avoid patella tendon avulsion, we did a tibial tuberosity flip osteotomy on the left knee. Ochronosis arthropathy should be considered as a diagnosis when faced with black connective tissue intraoperatively. Surgeons should anticipate patella tendon avulsion and difficulties in soft tissue balancing in the onchronitic knee and ready to tackle the complications.
{"title":"The Surprising Tale of Dark Replacement","authors":"Selvaraj Velusamy, Sathyanarayana Venkat Ramaiah, Amar Murugananthan","doi":"10.5005/jp-journals-10079-1036","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1036","url":null,"abstract":"A bstrAct Alkaptonuria is caused by the defective metabolism of homogentisic acid, which causes arthritis and connective tissue pigmentation. The knee is a commonly affected joint. Total knee arthroplasty (TKA) has been suggested as an effective treatment for end-stage ochronosis arthropathy. A case of a 62-year-old man presented with pain in both knee joints and X-rays revealed advanced degenerative arthritis. During knee replacement, the subcutaneous tissues revealed blackish nodules. It was difficult to retract the patella as the patella tendon was stiff and hard with blackish discoloration. On dislocating patella, the patella tendon was avulsed on the right knee; later, it was fixed with a suture anchor and stapler. To avoid patella tendon avulsion, we did a tibial tuberosity flip osteotomy on the left knee. Ochronosis arthropathy should be considered as a diagnosis when faced with black connective tissue intraoperatively. Surgeons should anticipate patella tendon avulsion and difficulties in soft tissue balancing in the onchronitic knee and ready to tackle the complications.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"os-55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127717924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-07DOI: 10.5005/jp-journals-10079-1045
R. Vipin, N. Rengarajan, M. Manoharan, K. Kesavan
Background: Distal radius fractures are an extensively debated topic throughout decades. The treatment options include POP casting, plating, external fixation with or without ligamentotaxis, and K -wiring. This study was conducted to assess the functional outcome of a novel percutaneous 5-pin technique in distal radius fractures. Materials and methods: This is a prospective observational study over 16 months from January 2019 to May 2020. Novel percutaneous 5-pin technique in a sequential configuration following a closed reduction was performed, followed by physiotherapy, and functional outcome was assessed at 6, 12, and 28 weeks following K -wire removal using Cooney’s modification of Green and Obrien scoring and evaluated for functional status, pin loosening, tendon impalement, and nerve injury. Results: All 20 patients were assessed. The mean age of patients was 47.15 years, 10 being females, with road traffic accidents being the major mode of injury. All patients were followed up for 6 months post- K -wire removal and 90% of patients had good to the excellent outcome and 10% of patients had fair to bad outcome with a functional range of supination and pronation movements. All fracture unions were satisfactory and four patients (20%) developed minor complications. None of them developed tendon impalement or nerve injuries. Conclusion: The novel percutaneous 5-pin technique includes two additional ulnoradial wires which provide superior rotational stability and avoid the chance of late collapse and maintain radial height, unlike conventional K -wire techniques. Thus, avoiding the need for more invasive techniques and allows early mobilization of wrist and fingers preventing stiffness, resulting in an excellent outcome.
{"title":"A Novel 5-pin Fixation for Distal Radius Fractures and Its Functional Assessment","authors":"R. Vipin, N. Rengarajan, M. Manoharan, K. Kesavan","doi":"10.5005/jp-journals-10079-1045","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1045","url":null,"abstract":"Background: Distal radius fractures are an extensively debated topic throughout decades. The treatment options include POP casting, plating, external fixation with or without ligamentotaxis, and K -wiring. This study was conducted to assess the functional outcome of a novel percutaneous 5-pin technique in distal radius fractures. Materials and methods: This is a prospective observational study over 16 months from January 2019 to May 2020. Novel percutaneous 5-pin technique in a sequential configuration following a closed reduction was performed, followed by physiotherapy, and functional outcome was assessed at 6, 12, and 28 weeks following K -wire removal using Cooney’s modification of Green and Obrien scoring and evaluated for functional status, pin loosening, tendon impalement, and nerve injury. Results: All 20 patients were assessed. The mean age of patients was 47.15 years, 10 being females, with road traffic accidents being the major mode of injury. All patients were followed up for 6 months post- K -wire removal and 90% of patients had good to the excellent outcome and 10% of patients had fair to bad outcome with a functional range of supination and pronation movements. All fracture unions were satisfactory and four patients (20%) developed minor complications. None of them developed tendon impalement or nerve injuries. Conclusion: The novel percutaneous 5-pin technique includes two additional ulnoradial wires which provide superior rotational stability and avoid the chance of late collapse and maintain radial height, unlike conventional K -wire techniques. Thus, avoiding the need for more invasive techniques and allows early mobilization of wrist and fingers preventing stiffness, resulting in an excellent outcome.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121033436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-07DOI: 10.5005/jp-journals-10079-1032
R. Raju, Srikanth Ravuru, Raju C Nagaraju, P. Soraganvi
{"title":"Management of Intracalcaneal Lipoma: A Case Report","authors":"R. Raju, Srikanth Ravuru, Raju C Nagaraju, P. Soraganvi","doi":"10.5005/jp-journals-10079-1032","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1032","url":null,"abstract":"","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127982107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-07DOI: 10.5005/jp-journals-10079-1035
Ramesh Perumal, S. K. Patra, Sivakumar S Palanivelayutham, Avinash Mahender, D. Jayaramaraju, S. Rajasekaran
Introduction: Screw placement at the posterior margin of the acetabulum while operating for wall fractures requires additional care to avoid articular penetration which can lead to poor functional outcomes. The main objective of this study is to describe a simple four-step surgical guide to avoid intra-articular screw penetration during fixation. Materials and methods: We prospectively analyzed 23 patients (21 males and 2 females) with posterior wall acetabular fractures treated with the described technique in our institution from 2017 to 2019. Of these 23 patients, 8 patients had isolated posterior wall fractures, 9 patients had transverse with posterior wall fracture, and 6 patients had posterior wall and column fractures. Radiograph Judet views and computerized tomography (CT) scan were done in all the patients to check for intra-articular screws on the second postoperative day. Results: By radiograph and CT scan in all the patients, there was no intra-articular screw penetration noticed following acetabular fracture fixation. All the 23 patients in our study had a good functional outcome with Merle D’aubigne score of ≥ 18 in 12 patients and ≥ 10 in 11 patients. Conclusion: Good knowledge of the osseous anatomy of the pelvis is essential to prevent intra-articular screw placement during fixation of acetabular fractures. Our four-step surgical tip to insert periacetabular screws under direct vision helps prevent intra-articular screw placement during acetabular fracture fixation by posterior approach. Besides, this technique is easily reproducible and helps to minimize intraoperative radiation time.
导言:在髋臼后缘放置螺钉治疗髋臼壁骨折需要额外的注意，以避免关节穿透，从而导致不良的功能结果。本研究的主要目的是描述一种简单的四步手术指南，以避免在固定过程中关节内螺钉插入。材料与方法:前瞻性分析我院2017 - 2019年采用上述方法治疗髋臼后壁骨折患者23例(男21例，女2例)。23例患者中，8例为孤立性后壁骨折，9例为横向合并后壁骨折，6例为后壁及柱骨折。所有患者术后第二天均行x线片及CT扫描检查关节内螺钉。结果:所有患者髋臼骨折内固定后，经x线片及CT检查，均未见关节内螺钉穿透。我们研究的23例患者均具有良好的功能预后，其中12例患者的Merle D 'aubigne评分≥18,11例患者的Merle D 'aubigne评分≥10。结论:在髋臼骨折固定过程中，掌握骨盆骨性解剖知识是防止置入关节内螺钉的关键。我们的四步手术技巧是在直视下插入髋臼周围螺钉，这有助于防止后路固定髋臼骨折时在关节内放置螺钉。此外，该技术易于复制，并有助于减少术中放射时间。
{"title":"Technical Trick to Avoid Intra-articular Screw Placement in Posterior Wall Fractures of the Acetabulum","authors":"Ramesh Perumal, S. K. Patra, Sivakumar S Palanivelayutham, Avinash Mahender, D. Jayaramaraju, S. Rajasekaran","doi":"10.5005/jp-journals-10079-1035","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1035","url":null,"abstract":"Introduction: Screw placement at the posterior margin of the acetabulum while operating for wall fractures requires additional care to avoid articular penetration which can lead to poor functional outcomes. The main objective of this study is to describe a simple four-step surgical guide to avoid intra-articular screw penetration during fixation. Materials and methods: We prospectively analyzed 23 patients (21 males and 2 females) with posterior wall acetabular fractures treated with the described technique in our institution from 2017 to 2019. Of these 23 patients, 8 patients had isolated posterior wall fractures, 9 patients had transverse with posterior wall fracture, and 6 patients had posterior wall and column fractures. Radiograph Judet views and computerized tomography (CT) scan were done in all the patients to check for intra-articular screws on the second postoperative day. Results: By radiograph and CT scan in all the patients, there was no intra-articular screw penetration noticed following acetabular fracture fixation. All the 23 patients in our study had a good functional outcome with Merle D’aubigne score of ≥ 18 in 12 patients and ≥ 10 in 11 patients. Conclusion: Good knowledge of the osseous anatomy of the pelvis is essential to prevent intra-articular screw placement during fixation of acetabular fractures. Our four-step surgical tip to insert periacetabular screws under direct vision helps prevent intra-articular screw placement during acetabular fracture fixation by posterior approach. Besides, this technique is easily reproducible and helps to minimize intraoperative radiation time.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132874032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-07DOI: 10.5005/jp-journals-10079-1044
V. Sengodan, M. Sengodan, Ramachandran Perumal
Ab s t r Ac t Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coronavirus disease-2019 (COVID-19) outbreak became a pandemic across the world after the outbreak in China in December 2019. This study aimed to determine the impact on the emergency orthopedic fixation during the COVID-19 pandemic in the Institute of Orthopaedics and Traumatology, Coimbatore. Materials and methods: This is a retrospective study done on patients of trauma admitted in the emergency orthopaedic unit, under Tamilnadu Accident and Emergency Care Initiative (TAEI), Coimbatore Medical College Hospital from April 2020 to December 2020. All the patients admitted were evaluated as per the routine protocols followed in this COVID-19 pandemic in our institution and the patients were taken up for emergency orthopedic fixation based on the COVID-19 status. Results: The total number of emergency orthopedic surgical fixation procedures done during the pandemic period from April 2020 to December 2020 was 245. Orthopedic surgical fixation done in elective theatres during this pandemic in 2020 is 245 cases. As per the results, during the COVID-19 pandemic, emergency orthopedic surgical fixation was not stopped and treated as per the COVID-19 protocol followed in our hospital. Conclusion: The SARS-CoV-2 (COVID-19) pandemic has a major impact on orthopedic surgical fixation. All the patients admitted should be evaluated for the COVID-19 infection and use of adequate personal protective equipment while treating the patients to deliver safe and effective surgical services during this COVID-19 pandemic.
{"title":"Coimbatore Orthopedic Surgical Fixation Protocol in COVID-19 Pandemic—Our Experience","authors":"V. Sengodan, M. Sengodan, Ramachandran Perumal","doi":"10.5005/jp-journals-10079-1044","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1044","url":null,"abstract":"Ab s t r Ac t Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coronavirus disease-2019 (COVID-19) outbreak became a pandemic across the world after the outbreak in China in December 2019. This study aimed to determine the impact on the emergency orthopedic fixation during the COVID-19 pandemic in the Institute of Orthopaedics and Traumatology, Coimbatore. Materials and methods: This is a retrospective study done on patients of trauma admitted in the emergency orthopaedic unit, under Tamilnadu Accident and Emergency Care Initiative (TAEI), Coimbatore Medical College Hospital from April 2020 to December 2020. All the patients admitted were evaluated as per the routine protocols followed in this COVID-19 pandemic in our institution and the patients were taken up for emergency orthopedic fixation based on the COVID-19 status. Results: The total number of emergency orthopedic surgical fixation procedures done during the pandemic period from April 2020 to December 2020 was 245. Orthopedic surgical fixation done in elective theatres during this pandemic in 2020 is 245 cases. As per the results, during the COVID-19 pandemic, emergency orthopedic surgical fixation was not stopped and treated as per the COVID-19 protocol followed in our hospital. Conclusion: The SARS-CoV-2 (COVID-19) pandemic has a major impact on orthopedic surgical fixation. All the patients admitted should be evaluated for the COVID-19 infection and use of adequate personal protective equipment while treating the patients to deliver safe and effective surgical services during this COVID-19 pandemic.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133893912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-07DOI: 10.5005/jp-journals-10079-1040
W. Chau, B. Ng
Background: Both Scoliosis Research Society-22 questionnaire (SRS-22) and Spinal Appearance Questionnaire (SAQ) are well-established disease-specific patient-reported outcome questionnaires on adolescent idiopathic scoliosis (AIS). Our severe AIS patients were administered both questionnaires before and after surgery. The use of SRS-22 on surgical cases was well documented, however, SAQ which focused on patients’ perceptions of spinal appearance, was merely reported. This study summarized the longitudinal changes of SAQ and SRS-22 domain scores in surgical AIS patients from preoperative to 2 years after surgery. Materials and methods: All surgical AIS patients operated on in the year 2014 to 2016 were recruited. They completed both questionnaires at (1) before surgery (“Pre-op”), (2) immediately before hospital discharge (“Post-op”), (3) 1 year after surgery (“Post-op 1 year”), and (4) 2 years after surgery (“Post-op 2 years”). Results: There were 135 severe AIS patients recruited in this study, of which 74.1% were females, and the mean age at operation was 15.97. All SAQ domains were increasing (improving) until 2 years after surgery. Curve and prominence scored the highest among the nine domains across four time points. Significant increases were observed in “Trunk shift”, “Shoulders”, “Prominence”, “Curve”, and “General”. Conclusion: Improvements in appearance after surgery responded differently from function, pain, and other factors immediately after surgery. Patients’ appearance perception was continuously improving after surgery despite function, pain, and mental were dropped then recovered in the next 2 years. Using SAQ in conjunction with SRS-22 in health-related quality of life (HRQOL)-related studies on AIS patients greatly improves and complements the interpretations on patients’ appearance which endeavors further research on cognitive behavior in AIS patients after years of surgery in long-term follow-up studies.
{"title":"Longitudinal Changes of Spinal Appearance Questionnaire and SRS-22 Questionnaire Domain Scores on Surgical Adolescent Idiopathic Scoliosis Patients before and after 2 Years of Operation","authors":"W. Chau, B. Ng","doi":"10.5005/jp-journals-10079-1040","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1040","url":null,"abstract":"Background: Both Scoliosis Research Society-22 questionnaire (SRS-22) and Spinal Appearance Questionnaire (SAQ) are well-established disease-specific patient-reported outcome questionnaires on adolescent idiopathic scoliosis (AIS). Our severe AIS patients were administered both questionnaires before and after surgery. The use of SRS-22 on surgical cases was well documented, however, SAQ which focused on patients’ perceptions of spinal appearance, was merely reported. This study summarized the longitudinal changes of SAQ and SRS-22 domain scores in surgical AIS patients from preoperative to 2 years after surgery. Materials and methods: All surgical AIS patients operated on in the year 2014 to 2016 were recruited. They completed both questionnaires at (1) before surgery (“Pre-op”), (2) immediately before hospital discharge (“Post-op”), (3) 1 year after surgery (“Post-op 1 year”), and (4) 2 years after surgery (“Post-op 2 years”). Results: There were 135 severe AIS patients recruited in this study, of which 74.1% were females, and the mean age at operation was 15.97. All SAQ domains were increasing (improving) until 2 years after surgery. Curve and prominence scored the highest among the nine domains across four time points. Significant increases were observed in “Trunk shift”, “Shoulders”, “Prominence”, “Curve”, and “General”. Conclusion: Improvements in appearance after surgery responded differently from function, pain, and other factors immediately after surgery. Patients’ appearance perception was continuously improving after surgery despite function, pain, and mental were dropped then recovered in the next 2 years. Using SAQ in conjunction with SRS-22 in health-related quality of life (HRQOL)-related studies on AIS patients greatly improves and complements the interpretations on patients’ appearance which endeavors further research on cognitive behavior in AIS patients after years of surgery in long-term follow-up studies.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"280 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131956732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-07DOI: 10.5005/jp-journals-10079-1029
V. Subbiah
{"title":"Principles of Antibiotic Therapy in Orthopedic Surgery","authors":"V. Subbiah","doi":"10.5005/jp-journals-10079-1029","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1029","url":null,"abstract":"","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134496917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-07DOI: 10.5005/jp-journals-10079-1043
A. Khurana, S. Gupta, Kuldeep Malik, V. Jain, Ishoo R Taneja
{"title":"Reconfiguration of Strategy for Hand Surgery during COVID-19 Pandemic: Our Experience","authors":"A. Khurana, S. Gupta, Kuldeep Malik, V. Jain, Ishoo R Taneja","doi":"10.5005/jp-journals-10079-1043","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1043","url":null,"abstract":"","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"34 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115707456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-07DOI: 10.5005/jp-journals-10079-1046
N. Rengarajan, M. Manoharan, F. Khan, Dhanasekaran Rajarajan
Ab s t r Ac t Introduction: Around 60% of all the elbow injuries in the first decade, supracondylar fractures of the humerus are the most widely recognized elbow injuries in youngsters. Accompanied with problems like compartment disorder, neurovascular harm, Volksman’s ischemic contracture, and malunion. The most widely recognized choice of pinning is either cross-pin fashion or two parallel pins. Closed reduction and percutaneous K-wire fixation are best with the least problems in contrast with different modalities. In our study, we want to assess the functional and radiological outcome of pediatric displaced supracondylar humerus fracture treated with closed reduction percutaneous K-wire fixation. Materials and methods: Sixteen patients were selected for the study based on the inclusion and exclusion criteria based on the consecutive sampling. For all patients, the standard technique of percutaneous k wire fixation was performed, and patients were evaluated on 6 weeks, 3 months, and 6 months with functional scoring by Flynn et al. Criteria and Mayo elbow scoring and radiological scoring with Baumann’s angle. Results: Ten children (62.5%) were affected in their first decade of life, with a clear male predilection than females. Mayo elbow scoring was 2.5, 6.0, and 3.75 at 6 weeks, 3 months, and 6 months. Pin-tract infection (4), two cases of malunion of our study population. In all 16 cases, the union was achieved with 14 cases satisfactorily excellent and satisfactorily good in 1 case and unsatisfactorily poor in 1 case. Conclusion: Closed reduction and percutaneous pinning are the treatment of choice for pediatric supracondylar humerus fractures with Modified Gartland’s type II and type III. Appropriate pinning technique ensures a successful outcome with cross configuration providing excellent outcome with good rotational stability. Closed reduction and percutaneous pinning is a safe, cost-effective, less morbid procedure.
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