Journal of Bone and Joint Diseases最新文献

{"title":"A rare case of comminuted fracture shaft humerus with intercondylar extension with monteggia dislocation and its management: A case report","authors":"A. Nallakumarasamy, Birju Manjhi, S. Sinha, R. Arya, L. Singh","doi":"10.4103/jbjd.jbjd_9_22","DOIUrl":"https://doi.org/10.4103/jbjd.jbjd_9_22","url":null,"abstract":"Background: Monteggia fracture-dislocation is a rare entity in adults with an incidence of less than 1%. However, a combination of fracture shaft humerus with distal intraarticular extension along with monteggia fracture-dislocation in an ipsilateral upper limb is very hard to find and manage, owing to its rare presentation. Materials and Methods: In this report, we detailed the surgical management of comminuted fracture(splinter) of shaft humerus with intercondylar extension AO C2 with typeII monteggia fracture-dislocation with the usage of proper implants in a 25year old male with a 3 year follow-up. Result: It shows that the fracture united well at the appropriate period and the elbow range of movements was satisfactorily ranging from 20° to 130° with no limitation in supination and pronation. Conclusion: Such complex elbow injuries are difficult to find in the literature. This study addresses the proper surgical management in terms of approach and usage of appropriate implants to improve the long-term functional outcome when dealing with such injuries.","PeriodicalId":232675,"journal":{"name":"Journal of Bone and Joint Diseases","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133586823","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":"Doping in sports","authors":"R. Arya","doi":"10.4103/jbjd.jbjd_20_22","DOIUrl":"https://doi.org/10.4103/jbjd.jbjd_20_22","url":null,"abstract":"In undergoing this life, many people always try to do and get the best. New knowledge, experience, lesson, and everything that can improve the life will be done. However, many people sometimes feel confused to get those things. Feeling the limited of experience and sources to be better is one of the lacks to own. However, there is a very simple thing that can be done. This is what your teacher always manoeuvres you to do this one. Yeah, reading is the answer. Reading a book as this doping in sports and other references can enrich your life quality. How can it be?","PeriodicalId":232675,"journal":{"name":"Journal of Bone and Joint Diseases","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123790443","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":"Conservative management of a lesser trochanter avulsion fracture: A case report","authors":"Amit Saraf, S. Bishnoi, Hamzat Habib, S. Aggarwal","doi":"10.4103/jbjd.jbjd_13_22","DOIUrl":"https://doi.org/10.4103/jbjd.jbjd_13_22","url":null,"abstract":"A 12-year-old male patient came to our outpatient department with a complaint of pain in the left hip region after he slipped and fell on a wet floor while playing at school. The symptoms were pain left the hip region with functional impairment, difficulty in walking, tenderness on inguinal region palpation, and restricted hip movements. The X-ray and computed tomography scan showed an avulsion fracture of the left lesser trochanter. The treatment included rest, immobilization, analgesia, and non-weight bearing. After a 9-month follow-up, the patient had a completely normal range of motion and was fully able to do all his daily activities","PeriodicalId":232675,"journal":{"name":"Journal of Bone and Joint Diseases","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115270206","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":"Can PFLP be the implant of choice for unstable trochanteric fractures? Outcomes and complications","authors":"C. Singh, J. Deshpande, A. Shah, Prabhanjan Agarwal","doi":"10.4103/jbjd.jbjd_18_22","DOIUrl":"https://doi.org/10.4103/jbjd.jbjd_18_22","url":null,"abstract":"Background: Intertrochanteric fracture is a common orthopedic injury sustained in the elderly population because of osteoporosis and trivial fall. Life-threatening systemic complications occur mainly due to immobility. Materials and Methods: We included 62 patients (40 males and 22 females) of unstable intertrochanteric fracture (AO 31 A2 and A3) attending Department of Orthopedics. They were all subjected to surgical treatment with proximal femoral locking plate (PFLP). Patients were followed up at 3rd, 6th, and 12th month for outcome variables, i.e., functional (Harris hip score, Palmer and Parker mobility score) and radiological outcomes (neck shaft angle, loss of reduction, union, and implant-related complications). Statistical analysis was done using Friedman’s test after calculating the data in terms of mean and median using SPSS 20 software. Results: Mean age of our patients was 64 years; 40 were males and 22 females. Fifty patients sustained fracture due to trivial fall and 12 due to road traffic accidents. Thirty-five out of 62 patients had medical comorbidities. Twenty-six patients needed open reduction of fracture and 36 were close reduced. Twenty-two patients had severe comminution (AO A3 III type). Mean degree of loss of reduction was 5° in 6th month and 4° in 12th month. Union was achieved in 48 out of 50 patients at 12th month. Most of the patients achieved fair-to-good functional outcome scores at 12th month of follow-up. We noticed difficulties in fracture reduction as well as complications related to implant. Conclusion: PFLP is an effective implant in comminuted intertrochanteric fractures with broken lateral wall. Complications can be minimized by following the principles of locking plate meticulously.","PeriodicalId":232675,"journal":{"name":"Journal of Bone and Joint Diseases","volume":"198 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116370433","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":"Assessment of outcome of uncemented total hip arthroplasty","authors":"R. Shakunt, B. Sharma, S. Sharma, C. Pal, A. Sadana, Jeetesh V. Patel","doi":"10.4103/jbjd.jbjd_11_22","DOIUrl":"https://doi.org/10.4103/jbjd.jbjd_11_22","url":null,"abstract":"Introduction: Uncemented total hip arthroplasty is a time-tested remarkable surgical procedure that provides mobility, stability, and better quality of life for thousands of patients, especially young patients throughout the world. Thus, uncemented total hip arthroplasty today has become the main mode of hip replacement, especially in young patients. However, uncemented total hip arthroplasty has its own drawbacks such as inadequate initial fixation, excessive wear, and periprosthetic bone loss due to particle-induced lysis. Materials and Methods: This prospective study was conducted between September 2018 and August 2020. A total of 30 patients were selected from patients attending emergency department and outpatient department of orthopedics. For all prospective cases, a detailed history regarding mode and mechanism of injury (in case of trauma) was taken followed by clinical examination, and the patient was documented. Follow-up visits were made at 3 months, 6 months, 1 year, and periodically thereafter. Results: In our study, functional outcomes after uncemented total hip replacement were excellent in 30% of cases, good in 53.33% of cases, fair in 13.33% of cases, and poor in 3.33% of cases by using Harris Hip Score. No patients showed any radiographic signs of loosening. No patients showed any complications during follow-up. Conclusion: In our study, the results are fair to poor in noncompliant young patients with high functional demands. The results are fair to poor in patients with bilateral affections such as chronic arthritis and avascular necrosis in which the patient undergoes only unilateral total hip arthroplasty.","PeriodicalId":232675,"journal":{"name":"Journal of Bone and Joint Diseases","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131535068","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 between outcomes of small head and large head prosthesis use in total hip arthroplasty","authors":"V. Mittal, C. Pal, Hemant Chahar, A. Sadana, Ashutosh Verma, Jeetesh V. Patel","doi":"10.4103/jbjd.jbjd_15_22","DOIUrl":"https://doi.org/10.4103/jbjd.jbjd_15_22","url":null,"abstract":"Introduction: Total hip replacement (THR) currently uses a various size of head and bearing. These days the most common head diameter used in the THR is 32 mm. The purpose of our study is to compare the functional and radiographic evaluation of outcomes of two groups of patients undergoing the THR, received either small diameter (≤28 mm) or large diameter (≥32 mm) femoral head prosthesis. Materials and Methods: This was an interventional prospective study done between September 2018 and August 2020. The diameter of femoral head sizes 32 mm and 28 mm was used in this study. At definite intervals, patients were regularly followed and specifically assessed for functional and radiographic evaluation. Results: During follow-up of patients with 32-mm femoral head diameter excellent functional results were achieved as graded by Harris hip score (P < 0.0001). No patients showed any complications in the large diameter femoral head group. Conclusions: Large femoral head diameter prosthesis may lead to more stability, range of motion, wear rate, and reducing the complications of revision surgery, but with small diameter femoral head, there is an increased chance of dislocation, impingement, and more complications.","PeriodicalId":232675,"journal":{"name":"Journal of Bone and Joint Diseases","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131297097","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":"Study of early infection in open fractures of long bones","authors":"R. Maheshwari, Digvijay Agarwal, Rohan Ratra","doi":"10.4103/jbjd.jbjd_17_21","DOIUrl":"https://doi.org/10.4103/jbjd.jbjd_17_21","url":null,"abstract":"Introduction: The complications associated with open fracture make the task of a surgeon difficult and also increase the financial burden. Underlying bone is exposed to contaminating agents due to breakdown of the tissue barrier between the fracture zone and the environment. It leads to an increased risk of complications such as wound infections and nonunion. Materials and Methods: We performed a prospective observational study on 82 patients presenting with open fractures of long bones treated in the year 2019 in the Department of Orthopedics, Himalayan Institute of Medical Sciences. Patients presenting with long bone open fractures within 72 h from injury to the Emergency were included in the study. All patients were clinically and radiologically followed for a period of 6 weeks. Results: Of the 82 cases, 26 developed an infection (31.70%). Fracture classified as Type IIIa had the highest infection rate (50%), whereas Type 1 had the lowest infection rate (14.3%). Infection rate in patients presenting 24 h after injury was higher than those presenting within 24 h from injury but a significant association could not be established between infection rate and late presentation from injury. Enterococcus species were the most commonly identified organism in both intraop and postop swabs (31.57%). Discussion: Trauma patients can present with chest, abdomen, or head injury, which may require emergency intervention precludes early debridement for open fracture. In our study, no significant decrease in infection rate was observed in patients undergoing debridement within 6 h from injury. However, it was also observed that open fractures presenting 24 h after injury had a higher infection rate than those presenting before it, which is in accordance with previous literature. Organisms finally causing established infection in bone were isolated mostly from postop swabs and were gram negative, which further strengthens the fact that most infections are nosocomial in origin. Conclusion: This paper furnishes the literature by validating facts, theories, and guidelines given in the past to manage open fractures. The study has limitation that the numbers of patients presenting with open fractures were less, and especially patients having common risk factors such as diabetes and anemia due to which correlation with infection rate could not be assessed effectively.","PeriodicalId":232675,"journal":{"name":"Journal of Bone and Joint Diseases","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129178612","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":"Mid-term comparative analysis of orthogonal versus parallel plating in bicondylar tibial plateau fracture","authors":"Rahul Patel, S. Sinha, R. Arya, Devanshu Mohaniya, Birju Manjhi, A. Rastogi","doi":"10.4103/jbjd.jbjd_11_21","DOIUrl":"https://doi.org/10.4103/jbjd.jbjd_11_21","url":null,"abstract":"Background: Proximal tibial plateau involvement is one of the most common intra-articular fractures. Bicondylar fractures have both tibial plateaus fractures, usually with depressed fracture of lateral tibial plateaus, meniscal tears and anterior cruciate ligament avulsions. Internal fixation in bicondylar proximal tibia fractures using plating devices are usually done using lateral plate along with supplementary postero-medial plate (orthogonal plating) and lateral plate along with medial plate (parallel plating). Objectives: The comparison of functional and radiological outcomes. Materials and Methods: 60 cases of bicondylar tibia plateau fracture were included. Group A (orthogonal plating) were cases treated with orthogonal plating and Group B (parallel plating) were cases those treated with parallel plating. A clinic-radiological comparison of results of these two groups were done. Clinical evaluation for at least 6 months and radiographically for at least 1 year. Results: Our clinico-radiological result showed that knee range of motion (mean) (P = 0.002) and Hip-Knee-Ankle angle (HKA) were significantly better in group B while non-significant difference in Varus/valgus angulation, fracture union status, post-operative loss of reduction and residual articular surface depression, implant position and other surgery or implant related complications. Conclusions: Our mid-term results showed that treating above fractures with parallel plate resulted in better functional and radiological outcomes with an acceptable complication rate as compared to orthogonal plate","PeriodicalId":232675,"journal":{"name":"Journal of Bone and Joint Diseases","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116611371","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":"Ensuring safety from COVID-19 in arthroscopic surgery","authors":"J. Kumar, RK Arya, Chhewang Topgia, D. Joshi, A. Goyal, H. Lal, S. Sinha","doi":"10.4103/jbjd.jbjd_10_21","DOIUrl":"https://doi.org/10.4103/jbjd.jbjd_10_21","url":null,"abstract":"In the current time of coronavirus disease-2019 (COVID-19) pandemic, orthopedic procedures have been shelved and guidelines to establish the safety of medical professionals and patients are still evolving. Although sports injuries are not life threatening, a spectrum of these injuries requires urgent intervention. To ensure the safety of medical professionals and patients of sports injuries in COVID times, the following guidelines are suggested. Such surgery needs to be performed only in COVID-free facility (green zone). Patients from red zone and containment zone should be avoided. Young, fit individuals without medical comorbidities should be considered. Wherever possible, regional anesthesia should be used. As COVID virus is present in all body fluids, aerosol generation (coughing, sneezing, intubation, use of power instruments, and cautery) should be minimized. Operation theater (OT) should be fumigated on the prior night and ideally between the cases. The number of cases per OT should be kept under three to get adequate time in-between for sterilization. The ventilation setup of OT should be negative pressure in addition to positive pressure. If there are hindrances in setting up negative pressure, a simple exhaust can be added to the existing setup. The ventilation system should ideally provide more than 20 air changes per hour. During surgery, movement of doors of OT and OT personnel should be minimal so as to minimize the air turbulence and eddy current. This will reduce the risk of infection. Surgical team should wear personal protective equipment (PPE) and helmet hood to reduce the chances of respiratory droplet infection. The doffing of helmet and PPE should be done with utmost care and should be discarded in a chloro-derivate solution. The motorized drill used for surgical procedure should be used at low revolution per minute (RPM). Usage of sterile transparent polythene hood while irrigating during drilling and sequential drilling will help in minimizing aerosol generation. Spillage of arthroscopic fluid should be avoided at all times. These basic norms will minimize the chance of accidental spread of COVID.","PeriodicalId":232675,"journal":{"name":"Journal of Bone and Joint Diseases","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133987967","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":"Evaluation of radiological and clinical outcome of minimally invasive plate osteosynthesis (MIPO) for metaphyseal fracture of distal femur and proximal tibia","authors":"A. Verma, S. Agarwal, A. Garg, S. Prakash, Raghvendra Choubisa","doi":"10.4103/jbjd.jbjd_15_21","DOIUrl":"https://doi.org/10.4103/jbjd.jbjd_15_21","url":null,"abstract":"Background: Metaphyseal fracture of distal femur and proximal tibia results from high-velocity road traffic accidents. Using minimally invasive plate osteosynthesis (MIPO), the complex fracture zone is left untouched and length, alignment, and rotation are restored. As the fracture site is not explored, the osteogenic tissues surrounding the fracture are well protected and their blood supply is well preserved. This accelerates fracture healing. Materials and Methods: Thirty-five patients within the span of 3 years underwent internal fixation of distal end femur and proximal tibia by locking compression plate (LCP) using MIPPO technique. All the patients were assessed using Johner–Wruhs’ criteria and lower extremity functional scale (LEFS). Results: The mean time of partial weight bearing in fractures of distal femur was 10.14 weeks and proximal tibia was 9.71 weeks, respectively. The mean time of full weight bearing in fractures of distal femur was 16 weeks and in proximal tibia was 15.28 weeks. The mean time of bone union in fractures of distal femur was 18.14 weeks and in proximal tibia it was 18.57 weeks. The overall average LEFS score comes out to be 67 out of 80 points. According to Johner Wruhs’ criteria, results were excellent in 14 (40%), good in 16 (45.7%), fair in 4 (11.4%), and poor in 1 patient. Conclusion: MIPO techniques represent a fascinating new armamentarium in fracture fixation, which is made easier with the LCP technology and the different available minimally invasive surgical instruments, which were developed to cause less additional damage to the soft tissue and the bone.","PeriodicalId":232675,"journal":{"name":"Journal of Bone and Joint Diseases","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116488389","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}