{"title":"Effect of Covid-19 on Orthopedic Medical Education in Tamil Nadu","authors":"S. V. Chezian","doi":"10.5005/jojs-3-1-v","DOIUrl":"https://doi.org/10.5005/jojs-3-1-v","url":null,"abstract":"","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"33 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":"125070248","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-10079-1039
W. Chau, Victor Illescas, B. Ng
Introduction: Lenke classification organizes curve patterns into six major “curve types”. Health-related quality of life (HRQOL) in AIS patients is gaining attention particularly on whose undergone surgery and findings are sometimes not expected. Comparisons of HRQOL in severe patients between Lenke 1 (main thoracic) and Lenke 2 (double thoracic) and patients with Lenke 5 (thoracolumbar/lumbar) and Lenke 6 (thoracolumbar/ lumbar-main thoracic) curve types have yet to be carried out. Materials and methods: Forty-six severe AIS patients classified Lenke type 1, 2, 4, and 5 undergone surgery from 2016 to 2019 were recruited. Demographic variables and surgical details were collected. Patients filled out the SRS-22 questionnaire at (1) Before surgery (preoperative), (2) Before hospital discharge (post-op1), (3) 1 year postoperative (post-op2), and (4) 2 years post-op (post-op3). Statistical comparisons of HRQOL domain scores were carried out between Lenke 1 + 2 group and Lenke 5 + 6 group longitudinally and between groups. Results: The mean age at surgery is 18.14 years. Longitudinal comparisons showed “Function” and “Pain” scores dropped before hospital discharge and recovered at post-op follow-ups. “Function” and “Pain” in Lenke 1 + 2 group at between-group comparisons were significantly higher than Lenke 5 + 6. Self-image, satisfaction, and mean scores were also higher in Lenke 1 + 2 without statistical significance. Conclusion: All domains showed improvements 2 years after surgery in both Lenke type groups, of which significant improvements were statistically found in “Function”, “Pain”, and “Mental health” in Lenke 1 + 2 patients. + thoracolumbar/ lumbar-main thoracic) group improved after spinal surgery. • “Function”, “Pain”, and “Mental health” in patients of Lenke 1 + 2 group significantly were improved statistically than patients in Lenke 5 + 6 group. • “Self-image” and “Satisfaction” were also improved without statistical significance. Journal of
{"title":"Comparing Health-related Quality of Life of Lenke 1–2, and Lenke 5–6 Severe AIS Adolescent Idiopathic Scoliosis Patients 2 Years after Surgery Using SRS-22 Questionnaire","authors":"W. Chau, Victor Illescas, B. Ng","doi":"10.5005/jp-journals-10079-1039","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1039","url":null,"abstract":"Introduction: Lenke classification organizes curve patterns into six major “curve types”. Health-related quality of life (HRQOL) in AIS patients is gaining attention particularly on whose undergone surgery and findings are sometimes not expected. Comparisons of HRQOL in severe patients between Lenke 1 (main thoracic) and Lenke 2 (double thoracic) and patients with Lenke 5 (thoracolumbar/lumbar) and Lenke 6 (thoracolumbar/ lumbar-main thoracic) curve types have yet to be carried out. Materials and methods: Forty-six severe AIS patients classified Lenke type 1, 2, 4, and 5 undergone surgery from 2016 to 2019 were recruited. Demographic variables and surgical details were collected. Patients filled out the SRS-22 questionnaire at (1) Before surgery (preoperative), (2) Before hospital discharge (post-op1), (3) 1 year postoperative (post-op2), and (4) 2 years post-op (post-op3). Statistical comparisons of HRQOL domain scores were carried out between Lenke 1 + 2 group and Lenke 5 + 6 group longitudinally and between groups. Results: The mean age at surgery is 18.14 years. Longitudinal comparisons showed “Function” and “Pain” scores dropped before hospital discharge and recovered at post-op follow-ups. “Function” and “Pain” in Lenke 1 + 2 group at between-group comparisons were significantly higher than Lenke 5 + 6. Self-image, satisfaction, and mean scores were also higher in Lenke 1 + 2 without statistical significance. Conclusion: All domains showed improvements 2 years after surgery in both Lenke type groups, of which significant improvements were statistically found in “Function”, “Pain”, and “Mental health” in Lenke 1 + 2 patients. + thoracolumbar/ lumbar-main thoracic) group improved after spinal surgery. • “Function”, “Pain”, and “Mental health” in patients of Lenke 1 + 2 group significantly were improved statistically than patients in Lenke 5 + 6 group. • “Self-image” and “Satisfaction” were also improved without statistical significance. Journal of","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"303 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":"125760149","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-10079-1033
M. Ramachandraiah, T. Kishen
Ab s t r Ac t Background: Intraspinal facet cyst or juxta-facet cyst is a term that includes synovial and ganglion cysts in the spine. Facetal synovial cysts are fluid-containing synovial outpouchings arising from degenerated facet joints resulting from chronic hypermobility of the joints. These cysts can cause low back pain, radicular leg pain, and in rare cases cauda equina syndrome. Case description: In this report, we would like to present the occurrence of incomplete cauda equine syndrome resulting from a facet synovial cyst in a 65-year-old woman who presented with weakness in both lower limbs, difficulty in walking, and saddle anesthesia. The symptoms resolved following a posterior decompression, cyst excision, and instrumented fusion surgery. Conclusion: This report highlights the occurrence of acute cauda equina syndrome in a 65-year-old woman resulting from an L4–L5 facet synovial cyst. Prompt diagnosis and immediate surgical intervention in the form of decompression and fusion surgery lead to a favorable outcome. Clinical message: Acute cauda equina syndrome in a patient with a lumbar facet cyst is a relatively uncommon presentation. It requires early diagnosis and immediate surgical intervention in the form of decompression to prevent neurological deterioration and to have a favorable outcome.
{"title":"Lumbar Facet Cyst Causing Incomplete Cauda Equina Syndrome: A Case Report and Review of Literature","authors":"M. Ramachandraiah, T. Kishen","doi":"10.5005/jp-journals-10079-1033","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1033","url":null,"abstract":"Ab s t r Ac t Background: Intraspinal facet cyst or juxta-facet cyst is a term that includes synovial and ganglion cysts in the spine. Facetal synovial cysts are fluid-containing synovial outpouchings arising from degenerated facet joints resulting from chronic hypermobility of the joints. These cysts can cause low back pain, radicular leg pain, and in rare cases cauda equina syndrome. Case description: In this report, we would like to present the occurrence of incomplete cauda equine syndrome resulting from a facet synovial cyst in a 65-year-old woman who presented with weakness in both lower limbs, difficulty in walking, and saddle anesthesia. The symptoms resolved following a posterior decompression, cyst excision, and instrumented fusion surgery. Conclusion: This report highlights the occurrence of acute cauda equina syndrome in a 65-year-old woman resulting from an L4–L5 facet synovial cyst. Prompt diagnosis and immediate surgical intervention in the form of decompression and fusion surgery lead to a favorable outcome. Clinical message: Acute cauda equina syndrome in a patient with a lumbar facet cyst is a relatively uncommon presentation. It requires early diagnosis and immediate surgical intervention in the form of decompression to prevent neurological deterioration and to have a favorable outcome.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"51 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":"122874145","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-10079-1030
S. Raju, Venkatappa Somashekar, Anandsrinivas A. Sowlee, P. Singhi, Venkatasamy Pandiarajan Raghava Kumar
Ab s t r Ac t Introduction: Osteoarthritis patients usually come very late in the natural course often having bilateral involvement of degenerative changes. Patients are counseled and advised for staged procedures, however, after the first knee surgery, due to postoperative pain, the majority of them are reluctant to undergo total knee arthroplasty (TKA) in the other knee. We did a prospective randomized double-blind control study comparing the amount of analgesic required in the immediate postoperative period in those patients who received a periarticular cocktail injection and those who did not, following TKA. Materials and methods: This was a single-center prospective randomized controlled, double-blind, clinical analysis comparing 126 patients receiving intraoperative analgesia cocktail and control group during TKA. Group I (n 72) received local infiltration of analgesic (LIA), group II (n 54) did not receive any injection. Patients were assessed for pain in terms of visual analog scale (VAS) score, postoperative analgesia requirement, and knee range of motion. Results: The mean postoperative Oxford knee score at 2 months of group I was 30.47 (SD 4.45) compared with group II was 30.30 (SD 5.44). There was a significantly lower mean VAS score (3.16) in group I than group II (7.45) and was statistically significant with a p value of 0.0005. At the end of 2 months, both the groups had similar degrees of range of motion. Conclusion: Local infiltration of analgesia during TKA with our combination of drugs effectively reduces postoperative pain and decreased analgesic consumption, without adding much to the cost of the surgery and also significantly improves patient compliance and rehabilitation.
{"title":"A Randomized Clinical Trial Assessing the Efficacy of Periarticular Injection (LIA) during Total Knee Joint Replacement in the Asian Population","authors":"S. Raju, Venkatappa Somashekar, Anandsrinivas A. Sowlee, P. Singhi, Venkatasamy Pandiarajan Raghava Kumar","doi":"10.5005/jp-journals-10079-1030","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1030","url":null,"abstract":"Ab s t r Ac t Introduction: Osteoarthritis patients usually come very late in the natural course often having bilateral involvement of degenerative changes. Patients are counseled and advised for staged procedures, however, after the first knee surgery, due to postoperative pain, the majority of them are reluctant to undergo total knee arthroplasty (TKA) in the other knee. We did a prospective randomized double-blind control study comparing the amount of analgesic required in the immediate postoperative period in those patients who received a periarticular cocktail injection and those who did not, following TKA. Materials and methods: This was a single-center prospective randomized controlled, double-blind, clinical analysis comparing 126 patients receiving intraoperative analgesia cocktail and control group during TKA. Group I (n 72) received local infiltration of analgesic (LIA), group II (n 54) did not receive any injection. Patients were assessed for pain in terms of visual analog scale (VAS) score, postoperative analgesia requirement, and knee range of motion. Results: The mean postoperative Oxford knee score at 2 months of group I was 30.47 (SD 4.45) compared with group II was 30.30 (SD 5.44). There was a significantly lower mean VAS score (3.16) in group I than group II (7.45) and was statistically significant with a p value of 0.0005. At the end of 2 months, both the groups had similar degrees of range of motion. Conclusion: Local infiltration of analgesia during TKA with our combination of drugs effectively reduces postoperative pain and decreased analgesic consumption, without adding much to the cost of the surgery and also significantly improves patient compliance and rehabilitation.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"4 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":"129125963","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-10079-1038
Saikrishna Gadde, Sudhir Ganesan, Vignesh Jeyabalan, K. Kannan, Venkatesh Kumar
Ab s t r Ac t Background: Facet tropism (FT) is the presence of asymmetry in the sagittal angulations of the bilateral facet joints, which is proposed to be a contributing factor for certain spinal disorders. Few studies are present in literature discussing the prevalence of FT in the lumbar spine among the South Indian population and our study shall focus on this by identifying it on MR imaging. Materials and methods: It is a cross-sectional study, where 400 lumbar MRI scans of patients with low back pain without trauma, deformities, and surgical history were studied between 2016 and 2019. Facet angles are measured and the presence of FT and its severity is assessed on axial sections in all the patients. Data is subjected to statistical analysis. Results: One hundred and eighty-two (45.5%) females and 218 (54.5%) males are included in this study. The age range is 26–86 years and the mean ages of the female and male samples are 52.89 ± 14.06 and 52.31 ± 13.62 years. Facet tropism is seen in 178 (44.6%) individuals and is noticed at all levels from L1 to S1. The presence of FT is 2% at L1-L2, 12.9% at L2-L3, 13.9% at L3-L4, 28.7% at L4-L5, and 21.8% at L5-S1. The degree of tropism was severe at the L4-L5 intervertebral level in 5.9% of the study population. Age and gender do not have a significant correlation with the presence of tropism. All the above results have attained statistical significance. Conclusion: The presence of FT is not uncommon, although its incidence varies at each level of the lumbar spine. The prevalence of FT in our study population is 44.6%. The highest prevalence of FT and a severe degree of FT were noticed in the L4-L5 level.
{"title":"Prevalence of Facet Tropism in Lumbar Spine among South Indian Population: An MRI-based Radiological Study in 400 Patients","authors":"Saikrishna Gadde, Sudhir Ganesan, Vignesh Jeyabalan, K. Kannan, Venkatesh Kumar","doi":"10.5005/jp-journals-10079-1038","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1038","url":null,"abstract":"Ab s t r Ac t Background: Facet tropism (FT) is the presence of asymmetry in the sagittal angulations of the bilateral facet joints, which is proposed to be a contributing factor for certain spinal disorders. Few studies are present in literature discussing the prevalence of FT in the lumbar spine among the South Indian population and our study shall focus on this by identifying it on MR imaging. Materials and methods: It is a cross-sectional study, where 400 lumbar MRI scans of patients with low back pain without trauma, deformities, and surgical history were studied between 2016 and 2019. Facet angles are measured and the presence of FT and its severity is assessed on axial sections in all the patients. Data is subjected to statistical analysis. Results: One hundred and eighty-two (45.5%) females and 218 (54.5%) males are included in this study. The age range is 26–86 years and the mean ages of the female and male samples are 52.89 ± 14.06 and 52.31 ± 13.62 years. Facet tropism is seen in 178 (44.6%) individuals and is noticed at all levels from L1 to S1. The presence of FT is 2% at L1-L2, 12.9% at L2-L3, 13.9% at L3-L4, 28.7% at L4-L5, and 21.8% at L5-S1. The degree of tropism was severe at the L4-L5 intervertebral level in 5.9% of the study population. Age and gender do not have a significant correlation with the presence of tropism. All the above results have attained statistical significance. Conclusion: The presence of FT is not uncommon, although its incidence varies at each level of the lumbar spine. The prevalence of FT in our study population is 44.6%. The highest prevalence of FT and a severe degree of FT were noticed in the L4-L5 level.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"2001 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":"121687609","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-10079-1031
S. Rajasekaran, Ramesh Perumal, S. K. Patra, Sivakumar S Palanivelayutham, Dheenadhayalan Jayamaraju
Introduction: Despite successful union after intramedullary nailing of open femur fractures with bone loss or significant comminution, the discrepancy in leg length can lead to a significant impairment for the patient. Lengthening over a femoral nail is a described technique in such clinical scenarios. Corticotomy around an existing intramedullary nail (IMN) was introduced to address lengthening of the limbs without changing or removing any previously implanted IMN. Osteotomy around an existing IMN is a challenging technique that requires careful handling to avoid inadvertent damage to the IMN. Case description: Two patients with open type IIIA shaft of femur fractures who presented with bone loss following trauma underwent debridement and IMN fixation. After nailing, the patient was placed on a fluoroscopic table to enable an anteroposterior and lateral radiograph of the femur. Under image guidance, a rail frame was applied and we used a novel technique of osteotomy for lengthening of the femur using a Gigli saw. In both cases, the bony union was achieved by the end of 1 year. Conclusion: Lengthening over the IMN using a lengthening device helps in correcting limb length discrepancy as well as aids in achieving optimal bony union at the same time. The use of our novel corticotomy technique helps to minimize the damage to the intramedullary device. The existence of the nail minimizes the time required for the external frame since during the consolidation phase the nail supports the regenerate bone.
{"title":"Transport of Bone in Femur over an Intramedullary Nail: A Novel Corticotomy Technique","authors":"S. Rajasekaran, Ramesh Perumal, S. K. Patra, Sivakumar S Palanivelayutham, Dheenadhayalan Jayamaraju","doi":"10.5005/jp-journals-10079-1031","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1031","url":null,"abstract":"Introduction: Despite successful union after intramedullary nailing of open femur fractures with bone loss or significant comminution, the discrepancy in leg length can lead to a significant impairment for the patient. Lengthening over a femoral nail is a described technique in such clinical scenarios. Corticotomy around an existing intramedullary nail (IMN) was introduced to address lengthening of the limbs without changing or removing any previously implanted IMN. Osteotomy around an existing IMN is a challenging technique that requires careful handling to avoid inadvertent damage to the IMN. Case description: Two patients with open type IIIA shaft of femur fractures who presented with bone loss following trauma underwent debridement and IMN fixation. After nailing, the patient was placed on a fluoroscopic table to enable an anteroposterior and lateral radiograph of the femur. Under image guidance, a rail frame was applied and we used a novel technique of osteotomy for lengthening of the femur using a Gigli saw. In both cases, the bony union was achieved by the end of 1 year. Conclusion: Lengthening over the IMN using a lengthening device helps in correcting limb length discrepancy as well as aids in achieving optimal bony union at the same time. The use of our novel corticotomy technique helps to minimize the damage to the intramedullary device. The existence of the nail minimizes the time required for the external frame since during the consolidation phase the nail supports the regenerate bone.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"36 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":"116450122","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 : 2021-01-19DOI: 10.5005/JP-JOURNALS-10079-1026
V. Subbiah
The surgical treatment is being advocated for all types of displaced clavicle fractures currently. At the same time, the neurovascular and other serious operative complications are in rise. This article updates the applied anatomical knowledge and operative skills required for the orthopedic surgeon who intends to surgically fix the clavicle fracture safely. How to cite this article: Babu SV. Safe Clavicle Fracture Surgery. J Orth Joint Surg 2020;2(2):62–65.
{"title":"Safe Clavicle Fracture Surgery","authors":"V. Subbiah","doi":"10.5005/JP-JOURNALS-10079-1026","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10079-1026","url":null,"abstract":"\u0000The surgical treatment is being advocated for all types of displaced clavicle fractures currently. At the same time, the neurovascular and other serious operative complications are in rise. This article updates the applied anatomical knowledge and operative skills required for the orthopedic surgeon who intends to surgically fix the clavicle fracture safely.\u0000How to cite this article: Babu SV. Safe Clavicle Fracture Surgery. J Orth Joint Surg 2020;2(2):62–65.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123239328","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 : 2019-12-01DOI: 10.5005/jp-journals-10079-1001
Viksheth Basani, M. R. Kumar, D. Dhanalakshmi, T. Ramesh
To study clinicoradiological outcome of subtrochanteric femur fractures following intramedullary nailing. This was a prospective study of 22 cases of subtrochanteric fractures admitted and operated by intramedullary nailing at Southern Railway HQ Hospital, Chennai, between June 1, 2017, and May 31, 2018. The mean age distribution was 65.09 ± 17.84 years with 12 females and 10 males. According to Seinsheimer classification, there were six cases of type II, seven cases of type III, three cases of type IV, and six cases of type V. Intraoperative reduction techniques included closed reduction in 25% of subjects, limited open reduction in 50% and open reduction, augmentation with cerclage wiring in remaining 25%. Radiographic examination using radiological union score of hip (RUSH) was done to evaluate fracture union at monthly follow-up. Our mean time for union was 13.86 ± 3.8 weeks. Functional recovery was evaluated by the Harris hip scoring (HHS) system at 1, 3, 6, and 12 months postoperatively. The mean HHS at 6 months and 12 months were 81.57 ± 12.39 and 87.33 ± 8.2, respectively. Excellent to good functional outcome was seen in 76% of cases. There were two patients with superficial infections, one case of foot drop, and another case of lag screw cut-out. The mean shortening noted at final follow-up was 1.548 ± 0.57 cm. An intramedullary nail is an efficient device for the treatment of subtrochanteric fractures with high rate of bony union provided optimal reduction of the fracture and good positioning of the nail and screws is achieved. Basani V, Kumar MR, Dhanalakshmi D, et al. Intramedullary Nailing of Subtrochanteric Fractures: Our Experience. J Orth Joint Surg 2019;1(1):15–21.
{"title":"Intramedullary Nailing of Subtrochanteric Fractures: Our Experience","authors":"Viksheth Basani, M. R. Kumar, D. Dhanalakshmi, T. Ramesh","doi":"10.5005/jp-journals-10079-1001","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1001","url":null,"abstract":"\u0000\u0000\u0000To study clinicoradiological outcome of subtrochanteric femur fractures following intramedullary nailing.\u0000\u0000\u0000\u0000This was a prospective study of 22 cases of subtrochanteric fractures admitted and operated by intramedullary nailing at Southern Railway HQ Hospital, Chennai, between June 1, 2017, and May 31, 2018.\u0000\u0000\u0000\u0000The mean age distribution was 65.09 ± 17.84 years with 12 females and 10 males. According to Seinsheimer classification, there were six cases of type II, seven cases of type III, three cases of type IV, and six cases of type V. Intraoperative reduction techniques included closed reduction in 25% of subjects, limited open reduction in 50% and open reduction, augmentation with cerclage wiring in remaining 25%. Radiographic examination using radiological union score of hip (RUSH) was done to evaluate fracture union at monthly follow-up. Our mean time for union was 13.86 ± 3.8 weeks. Functional recovery was evaluated by the Harris hip scoring (HHS) system at 1, 3, 6, and 12 months postoperatively. The mean HHS at 6 months and 12 months were 81.57 ± 12.39 and 87.33 ± 8.2, respectively. Excellent to good functional outcome was seen in 76% of cases. There were two patients with superficial infections, one case of foot drop, and another case of lag screw cut-out. The mean shortening noted at final follow-up was 1.548 ± 0.57 cm.\u0000\u0000\u0000\u0000An intramedullary nail is an efficient device for the treatment of subtrochanteric fractures with high rate of bony union provided optimal reduction of the fracture and good positioning of the nail and screws is achieved.\u0000\u0000Basani V, Kumar MR, Dhanalakshmi D, et al. Intramedullary Nailing of Subtrochanteric Fractures: Our Experience. J Orth Joint Surg 2019;1(1):15–21.\u0000","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114575573","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 : 2019-12-01DOI: 10.5005/jp-journals-10079-1003
G. Kumar, R. Amarnath, S. Kumar, B. Thanigaiarasu
The treatment of intertrochanteric fractures continues to be a challenge in orthopedic trauma, especially in geriatric population. Among the various generations of cephalomedullary nails, proximal femoral nail antirotation II (PFN A-II) is specifically designed for Asian population, with helical blade, modified proximal diameter, and modified mediolateral angle. The aim of this study was to analyze the functional outcome of patients treated with PFN A-II using Harris hip score, at our institution. The study included 20 patients (11 males and 9 females). Among the 20 patients included in the study, outcome was excellent in 5, good in 11, fair in 4, and this is based on Harris hip score with the minimum follow-up period being 6 months. The average union time was 13 weeks, average Harris hip score was 82.3. An abductor lurch was reported in one patient, postoperative thigh pain in two patients, infection in three patients, and bedsore in three patients. Kumar GV, Amarnath R, Kumar SS, et al. Functional Outcome Analysis of Trochanteric Fractures Treated with Proximal Femoral Nail Antirotation II. J Orth Joint Surg 2019;1(1):22–26.
{"title":"Functional Outcome Analysis of Trochanteric Fractures Treated with Proximal Femoral Nail Antirotation II","authors":"G. Kumar, R. Amarnath, S. Kumar, B. Thanigaiarasu","doi":"10.5005/jp-journals-10079-1003","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1003","url":null,"abstract":"\u0000\u0000\u0000The treatment of intertrochanteric fractures continues to be a challenge in orthopedic trauma, especially in geriatric population. Among the various generations of cephalomedullary nails, proximal femoral nail antirotation II (PFN A-II) is specifically designed for Asian population, with helical blade, modified proximal diameter, and modified mediolateral angle.\u0000\u0000\u0000\u0000The aim of this study was to analyze the functional outcome of patients treated with PFN A-II using Harris hip score, at our institution. The study included 20 patients (11 males and 9 females).\u0000\u0000\u0000\u0000Among the 20 patients included in the study, outcome was excellent in 5, good in 11, fair in 4, and this is based on Harris hip score with the minimum follow-up period being 6 months. The average union time was 13 weeks, average Harris hip score was 82.3. An abductor lurch was reported in one patient, postoperative thigh pain in two patients, infection in three patients, and bedsore in three patients.\u0000\u0000Kumar GV, Amarnath R, Kumar SS, et al. Functional Outcome Analysis of Trochanteric Fractures Treated with Proximal Femoral Nail Antirotation II. J Orth Joint Surg 2019;1(1):22–26.\u0000","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127384165","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 : 2019-12-01DOI: 10.5005/jp-journals-10079-1002
V. Singaravadivelu, Ganesan Kartheesan, V. Sampathkumar
This study is to evaluate the clinical and radiological outcome of unstable fracture neck of the femur in young adults treated with three cannulated cancellous screws augmented with medial buttress plate. Fifteen patients of less than 60 years were operated from January 2017 to March 2018. Reduction was achieved by closed or open means to Garden's alignment index grade I. Internal fixation was done with three cannulated cancellous screws through mini lateral incision, and medial buttress plating was done through modified Smith–Peterson approach. All patients were mobilized from the immediate postoperative period and allowed toe-touch weight-bearing as tolerated. All patients were followed at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months postoperatively. Fracture united in 14 of 15 patients. Reduction loss and backing out of cancellous screws occurred in one patient. No cases of avascular necrosis was identified at a mean follow-up of 13.7 months. No significant femoral neck shortening was observed in all united fractures. Anatomical reduction by closed or open method; stable fixation with three cannulated cancellous screws augmented with medial buttress plate, increases fracture union rate compared to the historical series using closed reduction and cancellous screw fixation alone. Open reduction and medial antiglide plate fixation do not appear to increase morbidity. Singaravadivelu V, Kartheesan G, Vignesh S. Unstable Fracture Neck of Femur in Young Adults: Management with Cannulated Cancellous Screws Augmented with Medial Buttress Plate. J Orth Joint Surg 2019;1(1):1–4.
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