Journal of Clinical Orthopaedics最新文献

{"title":"The magic of moulding – Applying upper limb cast in a child","authors":"Chintan Doshi","doi":"10.13107/jcorth.2022.v07i02.515","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i02.515","url":null,"abstract":"Upper limb fractures are common in pediatric population. Most of these injuries need application of cast as a routine procedure. The purpose of this review is to discuss the art of applying a well moulded upper limb cast in children in order to get excellent outcome. Material to be selected for cast application depends on the fracture configuration, requirement for moulding, and other physical properties of the cast required for particular patient. A well –moulded cast should be applied in order to prevent further fracture displacement. It is important to understand and maintain certain radiographic indices in order to ensure a good outcome from casting technique. Preventing cast related complications like wet cast, skin complication, compartment syndrome, thermal injuries, and cast syndrome are important consideration when taking care of the cast. Patient education is one of the most important factor in ensuring proper cast maintenance.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85248075","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":"Thoracolumbar kyphosis in siblings of Mucopolysaccharidosis: A case report","authors":"S. Sheth, A. Jhala","doi":"10.13107/jcorth.2022.v07i01.491","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i01.491","url":null,"abstract":"Mucopolysaccharidosis (MPS) is a group of inherited metabolic disorders caused due to abnormal storage of mucopolysaccharides in different tissues of the body. They are autosomal recessive disorders, except MPS II which has an X-linked recessive pattern. Musculoskeletal manifestations occur due to disturbance in bone remodeling and improper development of ossification centers. Thoracolumbar kyphosis is the most common spinal pathology resulting from abnormal vertebral end plate ossification and growth arrest as well as hypotonia and spinal musculature imbalance. The increased life span as a result of medical treatment and lack of osseous penetration of enzyme replacement has raised the issue of thoracolumbar dysplasia and resultant deformity. Here, we discuss a case report of progressive thoracolumbar spinal deformity in two siblings suffering from MPS who underwent spine deformity correction surgeries, and literature review for the same.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84963190","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":"Vertebral fragility fractures in osteoporosis – A comprehensive review on its management","authors":"V. Viswanathan, R. Kanna, A. Shetty","doi":"10.13107/jcorth.2022.v07i01.477","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i01.477","url":null,"abstract":"Introduction: Approximately 20% of individuals older than 50 years of age have been reported to present with vertebral fragility fractures (VFF) – a prevalence which is anticipated to steadily increase in future. VFF is associated with disabling pain, significant impairment of quality of life, reduced ambulatory capacity, impaired social interactions, and poor quality of sleep. Early detection, appropriate management, evaluation of osteoporosis, and prevention of future fragility fractures would form the crux of treatment. Nevertheless, there is no consensus on what constitutes the ideal management protocol for symptomatic VFF. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to prepare this review. A detailed review of the literature was performed using PubMed, EMBASE, MEDLINE, and Cochrane Database of Systematic Reviews, which were searched for eligible studies with terms “treatment of VEF,” “osteoporotic vertebral fracture (OVF),” “management of osteoporotic compression fracture,” “imaging in OVF,” “percutaneous vertebral augmentation,” and “conservative treatment of OVF” from inception to November 2021. Duplicate studies, case reports, and letters to the editor were excluded from the study. Results: A total of 286 studies were identified using our search criteria. Of these, 142 were duplicates and 107 did not meet inclusion criteria. After removal of these articles through various stages of screening, a total of 37 studies were finally included in the review. Plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) are helpful in the diagnosis, evaluation, and management of these fractures. Radiologically, unstable VFFs need to be identified based on the following criteria (>50% vertebral height loss, kyphosis ≥25–35°, substantial retropulsion of bony fragments, significant bony, or ligamentous posterior column injuries). Conservative treatment (which includes analgesics, orthoses, and early mobilization) has remained the traditional way of treating these fractures. More recent systematic reviews have demonstrated a significant improvement in early pain control, vertebral height restoration, and ambulation with percutaneous augmentation (PKP or PVP) procedures. These studies have recommended cement augmentation in patients with intractable pain, not responding to medications. Surgical stabilization is recommended in elderly patients with pseudoarthrosis, substantial intervertebral instability, intractable pain with vertebral collapse, neurological deficit, and kyphosis. The need for long-term medical therapy to improve the bone density cannot be understated. Conclusion: A high index of suspicion is necessary to diagnose VFFs in elderly patients with back pain. Conservative treatment has remained the traditional way of treating these fractures. Recent evidence shows early pain control and better vertebral height restoration with cement augmentation procedures (PKP or PVP)","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"150 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82898740","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":"Arthroscopic Latarjet – Retrospective Study of 74 Patients – Technique, Indications, and Results","authors":"Sameer Shaikh, Farzana Shaikh, S. Takale, Amol Gowaikar, M. Kachare, Vijaykumar Rukde, Mahadev Mali","doi":"10.13107/jcorth.2022.v07i01.483","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i01.483","url":null,"abstract":"Objective: The all arthroscopic latarjet procedure was performed to manage anterior recurrent shoulder instability with bone loss. The aim of present study was to briefly describe the technique and to evaluate the results and complications following procedure. Materials and Methods: Retrospective study of 74 patients with anterior shoulder instability since 2010–2019 conducted in a single center. Out of 74 patients, 32 patients were sportsperson who were involved in at least district level games, 14 were manual laborers and remaining were non-sportsmen. Fifty-five patients were males and 19 were females. Arthrolatarjet was done using DePuy Synthes double barrel cannula system and fixation of coracoid with 4.00 mm titanium cannulated cancellous screws with Top Hat. No capsular repair done in our cases.. Results: Out of 74 cases, two-screw fixation was possible in 98% of patients. No neurological complications seen in our series. Two patients had graft resorption and non-union. Osteolysis of the graft around upper screw is seen in eight patients post-operative computed tomography scans but clinically no complaints. Technically challenging in first 25 cases. Conclusion: Arthrolatarjet is a safe and reproducible procedure which gives good results, better visualization of anatomy, more precise graft positioning, concomitant abnormalities that can be treated. Cadaveric workshops needed. Technically demanding.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73303639","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":"A Clinical Overview of Management of First time Anterior Shoulder Dislocation","authors":"A. Narvekar, Nikhil Iyer, Nagraj S. Shetty, Shreya Joshi","doi":"10.13107/jcorth.2022.v07i01.467","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i01.467","url":null,"abstract":"Background: Instability following a traumatic shoulder dislocation is known to cause significant morbidity especially as ost-traumatic dislocations occur in young active patients. The management of this injury is still controversial. There is always a debate between those that recommend surgical stabilization following a 1st time dislocation (FTD) and those that prefer treating them conservatively. The aim of treatment following a dislocation is to manage the episode such that there is no threat of recurrence, there is a full functional recovery with no apprehension, and an ability to get back to the same level of sporting activity. Purpose: The purpose of the study is to review the current literature and provide recommendations regarding management following FTD. Design: Clinical overview, Perspective. Methods: Review of literature using PUBMED, MEDLINE. Results: The present thought process is towards Arthroscopic primary stabilization following 1st time post-traumatic dislocation in young active individuals with projected significant overhead activities. Conclusion: Management of a patient following a FTD/subluxation has been the subject of debate for a long time. A number of factors have been studied and published such as age, sports participation, sex, pathological findings after the dislocation to enable the surgeon to decide on the management of this condition. Recurrence comes at a cost of increasing the instability with every episode of dislocation. More the instability before the surgical stabilization, more are the chances of either failure or the requirement of a salvage procedure like a Latarjet with its inherent high complication rate. But not every patient with FTD should warrant a surgical stabilization. A personalized approach is recommended and not a one size fits all approach.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"113 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79736312","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":"Prevention and Management of Sudden Cardiac Death in Athletes","authors":"Alwar Thiagarajan, A. Prakash, G. Janani, Vikram Rao, S. Arumugam","doi":"10.13107/jcorth.2022.v07i02.535","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i02.535","url":null,"abstract":"Sudden cardiac death (SCD) is the biggest challenge of all sports emergencies, as it is the leading cause of preventable deaths in both professional and recreational athletes. There is also an ongoing concern about COVID-19-associated cardiac pathology among athletes because myocarditis is an important cause of SCD during exercise. Hypertrophic cardiomyopathy represents 24% of SCD and Sudden Unexplained Death (normal heart at autopsy) represents 34% of SCD. To make sports participation safer, it is important to synergistically combine primary prevention of SCD by pre-participation identification of athletes affected by at-risk cardiomyopathies and secondary prevention with backup defibrillation of unpredictable sudden cardiac arrest on the field. The prompt application of an automated external defibrillator itself is associated with a greater likelihood of survival. With the advancement in the field of sports cardiology, the implantation of implantable cardioverter defibrillator has been promising in getting the athlete back on the field including in contact sports. Hence, knowledge of primary and secondary prevention is of great importance in reducing the incidence of SCD as well as improvising existing strategies.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86372537","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":"Uncemented Total Knee Replacement- Rediscovering the Past","authors":"N. Rao, A. Patil, Kunal Bansal","doi":"10.13107/jcorth.2022.v07i01.495","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i01.495","url":null,"abstract":"Total knee replacements (TKR) both cemented and uncemented were developed almost simultaneously in the 1980’s. Cemented TKR found favor among the surgeons due to its technical ease and early failure of uncemented TKR due to poor design. In the past two decades; however, interest has been generated in uncemented TKR both because of design improvements which, in turn, has led to better results, especially in young active, obese, and geriatric but active patients where cemented TKR’s have been found to have increased failure rates. Active research is ongoing to refine the designs of uncemented TKR and future holds promise for this re-emerging technique and implant. This review helps to summarize the reasons for increasing interest in uncemented TKR, the newer designs and their results and the future developments expected.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84382198","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":"WIROC GLOBAL: A Mega-Event","authors":"Sangeet K. Gawhale, Vishal Kundnani, Ashok Shyam","doi":"10.13107/jcorth.2022.v07i02.507","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i02.507","url":null,"abstract":"","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"339 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76600612","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":"Effective and sustainable syndesmotic injury repair using endobuttons and fibre-wire, in bimalleolar fractures","authors":"Vaibhav J. Koli, P. Samant, Rohit M Sane, Maitreya Patil, Pankaj Singh","doi":"10.13107/jcorth.2022.v07i01.497","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i01.497","url":null,"abstract":"Ankle fractures are the most frequent fractures accounting for 10% of all fractures, having an incidence of about 184/100,000 per year. Moreover, after external rotation or dorsiflexion injuries, syndesmotic disruption typically occurs at the ankle. The physiologic normality of the joint gets affected after a transverse syndesmotic screw fixation, which decreases the magnitude of motion at the lower extremes of the tibia and fibula, reducing contact forces between bones, and increasing stress on the crural interosseous membrane (which may lead to screw breakage). With this concern, we thus suggested to achieving a semi-rigid dynamic stabilization of the syndesmosis, using an endobutton and transosseous suture. We present a case of a 22-year-old active male who had a Lauge-Hansen pronation-abduction type injury. He was managed with an eight holes anatomical plate for lateral malleolus, two 65 mm CC screws with a washer for medial malleolus, and two endobuttons (one on the tibial and other on the fibular side) with transosseous sutures to provide stabilization of the syndesmosis. With this concern, we thus suggested achieving a semi-rigid dynamic stabilization of the syndesmosis, using an endobutton and transosseous suture; which can help in early mobilization, is cost effective, and prevent a second surgery for the removal of the syndesmotic screw.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75794280","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":"Navigate and Succeed: MI-Transforminal Lumbar Interbody Fusion with Three-Dimensional Navigation","authors":"Arvind A. Kulkarni, Pradhyumn Rathi, Pritem A. Rajamani","doi":"10.13107/jcorth.2022.v07i01.463","DOIUrl":"https://doi.org/10.13107/jcorth.2022.v07i01.463","url":null,"abstract":"Introduction: Lumbar Interbody Fusion (TLIF) has become a popular technique for achieving segmental interbody fusion and minimal access approach has its advantages. We have described the various Components in Spine Navigation Systems and how they have evolved in time and also describing our technique in detail. We have discussed on the advantages and disadvantages of the minimal access and use of Navigation. Method: The authors ventured to assess the impact of 3D navigation in 117 patients that were treated with single level 3D navigated MI-TLIF in evaluating, Navigation setting time , Radiation exposure, Disc space preparation, Cage placement, Accuracy of pedicle screw placement, Cranial facet violation and Evaluation of canal decompression. Result: Total time taken for setting up of navigation was 46.65±9.45 min. Average Radiation exposure was 5.69 mSv. In our study, the amount of disc removed was 75% in the ipsilateral anterior, 81% in ipsilateral posterior, 63% in contralateral anterior and 43% in contralateral posterior quadrants. The cage position was central in 87 patients, contralateral antero-central in six patients and ipsilateral postero-central in eight patients. The mean intraoperative blood loss was 89.65 ± 23.67 ml. Regarding accuracy 95.6% showed grade 0 and 4.4% had Grade 1 pedicle breach. Only 25 out of 408 pedicle screws (6.1%) violated the cranial facet joint. The navigation array probe was utilized to verify the adequacy of decompression and to confirm the anatomical landmarks. In our study, no surgical site infection was seen. Conclusion: We find MIS to be associated with less post-operative infection rates as compared to open techniques. With 3D navigation, MIS becomes safer and highly accurate. MIS-TLIF with 3D navigation have satisfactory clinical outcomes and fusion rates with the additional benefits of less initial postoperative pain, less blood loss, earlier rehabilitation, and shorter hospitalization. MIS–TLIF with 3D navigation is a more cost-effective treatment than MIS-TLIF with fluoroscopy.","PeriodicalId":15476,"journal":{"name":"Journal of Clinical Orthopaedics","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72909887","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}