Journal of Clinical Orthopaedics最新文献

{"title":"Clinical Profile of Congenital Clasped thumb: A case series","authors":"B. Kumar, A. Acharya, H. Prasad, S. Venugopal","doi":"10.13107/jcorth.2022.v07i02.529","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i02.529","url":null,"abstract":"Purpose: :Congenital clasped thumb is a rare deformity and not much has been described in literature about it. The aim of this study was to evaluate clinical profile of congenital clasped thumb, examine peroperative pathoanatomy, and evaluate the results of the treatment of such cases. Methods: A prospective study on 57 patients [106 hands] was done and their data recorded from the medical case records. A thorough clinical and radiological assessment was performed. Patients were classified using the Tsuyuguchi classification. Splinting program was initially started and patients not responding to it and those older than 10 years underwent contracture release, joint stabilization, and local flap cover with or without tendon transfers. All patients were assessed by Gilbert’s grading after 1 year. Results: There were 43 males and 14 females. The average age was 33 months [range 0–21 years]. At presentation, 51% [54/106] of hands were classified as severe with syndromic pattern [Type III]. About 61% [35/57] of the patients presented at the age <5 years and 21% after 10 years including three adults. About 41% of these patients [23/57] had a history of consanguinity and 27% [15/57] had a family history of a similar or associated congenital deformity. Splinting program showed excellent results in type I. An a-la-Carté release of soft tissues, joint stabilization with K-wire, and ligament reconstruction with local flap cover gave good to excellent results in 73% of our patients. Nine patients had features of web creep at first web space. Conclusion: Congenital clasp thumb showed a strong genetic predisposition. There was no difference between type II and type III variants with respect to the pathoanatomy, treatment protocol, operative procedures, and results. Splinting program in mild deformity and surgical correction with reconstruction in more severe cases gave satisfactory results.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87250513","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}

{"title":"Children are not young adults","authors":"S. Keny","doi":"10.13107/jcorth.2022.v07i02.509","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i02.509","url":null,"abstract":"","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88535608","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}

{"title":"Comparison Of Clinical and Ultrasound Examination in Neonatal Hip Screening for Detection of Developmental Dysplasia of Hip-Hospital-Based Cross-Sectional Study","authors":"Viveksheel Kashyap, Rajeev Reddy Kikkuri, Dr. Anmol RS Mittal, Karri Sandeep Reddy, R. Singhal","doi":"10.13107/jcorth.2022.v07i02.533","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i02.533","url":null,"abstract":"Background: During infancy, among developmental abnormalities of the hip joint, a broad-spectrum anomaly is developmental dysplasia of the hip (DDH). To examine this abnormality, no standardized screening protocol is available. Clinical examination is most frequently followed, and in doubtful cases, ultrasound (US) examination is used to confirm the diagnosis. Aims: The present study aims to compare the sensitivity and specificity of clinical to US examination in neonatal hip screening to detect DDH. Materials and Methods: This is a 1-year hospital-based cross-sectional study. Newborns who were referred to the Department of Orthopaedics with suspected DDH and examined by both clinical examination and US examination were included in the study. The Chi-square test and Fisher’s t-test were used for statistical analysis. Results: Out of the 75 babies, referred two-thirds were girls. The mean age of the babies was 6.25 ± 3.50 days. The breech presentation was the common risk factor (85.33%) for DDH, and LSCS was the standard mode of delivery. Clinical diagnosis of DDH was positive among babies, more on the left side than the right side. Eight babies (10.67%) were diagnosed to have DDH based on Graf’s test using USG. Among them, 4 (50%) babies had a clinical diagnosis of DDH. The sensitivity of the clinical trial with USG as reference standard was 50% Conclusion: Due to the lower sensitivity of clinical examination, USG screening should be done to detect DDH.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"157 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73112319","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}

{"title":"The AB&C of what to see in the hip X-ray of children","authors":"S. Keny, Nihar Modi","doi":"10.13107/jcorth.2022.v07i02.525","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i02.525","url":null,"abstract":"","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84249870","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}

{"title":"Wooden board technique for Hip Spica application in children","authors":"S. Patwardhan, Vivek Sodhai, C. Gundawar, Vishwajit Patil","doi":"10.13107/jcorth.2022.v07i02.523","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i02.523","url":null,"abstract":"","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"375 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86239891","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}

{"title":"EOS – A new frontier in spine imaging","authors":"B. Garg, Pulak Vatsya","doi":"10.13107/jcorth.2022.v07i01.457","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i01.457","url":null,"abstract":"EOS is a new tool in the armamemtarium of orthopedicians. Its ability to give a standing 3 dimesnionla image of the spine, has made it an indespenisble tool, specially for spine surgeons. Scoliosis is a 3 dimesnional deformity with multiple compensatory mechanisms being applied at the level of the pelvis and lower limbs as well as in spine. Operating on such patients needs thorough understanding of the 3D anatomy. EOS, provides this along with its low radiation dose, quick scan time and ability to repeat test multiple times if needed. The uses of this modality is on the rise, and as awareness and accessibility to EOS increases, so will the diversity of uses of this tool. Spine surgeons need to understand and use EOS for planning of their surgeries more compared to orther specializations of orthopaedics. EOS is truly a game-changer for spine imaging.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85559920","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}

{"title":"MIS-TLIF: Technical note, Learning goals behind case selection during early part of learning curve and clinical outcomes in first 150 cases","authors":"Umesh Srikantha, Parichay J. Perikal, Akshay Hari, Yadhu K. Lokanath, Deepak Somasundaram, Nirmala Subramaniam, R. Varma","doi":"10.13107/jcorth.2022.v07i01.481","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i01.481","url":null,"abstract":"Introduction: Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF) has been shown to offer several advantages over conventional (open) TLIF and is being increasingly employed by young surgeons early in their careers. It is important to know the appropriate technique and the correct cases to be selected in the early phase to achieve good outcomes during the learning curve. A detailed and illustrative technical note along with a guide for case selection at different phases of experience has been presented in this article. Methods: The first consecutive single surgeon series of 150 MIS-TLIF cases done over 4 years between 2012 and 2015 were considered for analysis. Demographic and peri-operative data and previously documented follow-up were collected from case records. Telephonic questionnaire and consultation were done to collect latest status, any procedures/surgeries done elsewhere for issues related to index procedure. Results were stratified as Group 1 – first 25 cases; Group 2 – 26–75 cases; Group 3 – 76–150 cases. Results: The major indication for surgery in group 1 was either Grade 1 spondylolisthesis or lumbar canal stenosis with concomitant axial symptoms. The incidence of relatively complex cases (Grade 2 or 3 listhesis; Revision cases; Multilevel cases) increased with each successive group. As expected, the operative time (calculated for only single-level cases) improved with time. The overall rate of peri-operative complications was higher in group 2 as compared to groups 1 and 3, predominantly due to an increased incidence of intra-operative dural tears in group 2. Symptomatic screw malposition was detected in five screws, all were managed conservatively. The median duration of follow-up for the entire group was 39 months (Range – 1–119 months). Eighty-two (55%) patients had follow-up of more than 1 year while 31 (20.6%) patients had follow-up of more than 7 years. Around 80–85% of patients at each point of follow-up assessment had a successful outcome (McNab 4 and 5). The re-operation rate for index level problems or adjacent segment was 2.6%, only one of which was done at the author’s center. Conclusions: Minimally invasive TLIF is a safe and effective procedure with favorable long-term results and acceptable complication rates. Though technically challenging in initial phases, a good understanding of the technique and principles of minimally invasive spine surgery along with fulfilling helpful pre-requisites and appropriate case selection as mentioned in this article, will help to smoothen the learning curve and avoid unfavorable outcomes in early stages.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81439091","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}

{"title":"Toe Walking in Children","authors":"A. Bhaskar","doi":"10.13107/jcorth.2022.v07i02.511","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i02.511","url":null,"abstract":"","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72734512","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}

{"title":"Massive Tophaceous Gout at Right Elbow Region in 55 Years Old Male","authors":"Ida Bagus Anom Krishna Caitanya, M. Maharjana","doi":"10.13107/jcorth.2022.v07i01.493","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i01.493","url":null,"abstract":"Gouty arthritis is one of the most common inflammatory joint diseases, characterized by monosodium urate crystals in or around the joints that comes from purine metabolism. Risk factors of gout are age, excessive intake of purine, alcohol, obesity, lack of physical activity, hypertension and heart disease, certain drugs, and impaired kidney function. This case presented a 55-year-old male patient with lumps and pain in the right elbow. Uric acid laboratory test results with a level of 9.20 mg/dL. Surgical excision could be the only solution to solve minimally decreased range of motion and aesthetic problems. Metabolic problems should be considered a priority with the patients who have unilateral joints problems.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85614312","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}

{"title":"In Toeing & Out Toeing in children","authors":"Prajakta Bhide, S. Vaidya","doi":"10.13107/jcorth.2022.v07i02.519","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i02.519","url":null,"abstract":"Intoed and out-toed gait in children can occur due to foot deformities or torsional alignment of the femur and/or tibia. In most cases, these deformities are physiological and resolve with age. Physical examination consists of assessment of rotational profile of the lower limb which includes foot progression angle, torsional alignment of the femur and tibia, and foot shape. Few cases may be due to underlying pathological conditions which need to be identified and treated.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88360079","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}