Hong Kong Journal of Orthopaedic Research最新文献

{"title":"Tibial Diaphysis Fracture in Paediatric Age Group: Outcome with Elastic Nailing Fixation in Tertiary Care Center in Lumbini Province of Nepal","authors":"S. Panthi, R. Shrestha, S. K. Gaihre, Angelica Karki, Suyachha Chettri, Ishory Bhusal","doi":"10.37515/ortho.8231.4103","DOIUrl":"https://doi.org/10.37515/ortho.8231.4103","url":null,"abstract":"Introduction- Tibial diaphysis fracture in paediatric age group accounts for 10 to 15% of all fractures. Fixation of tibial diaphysis fracture in paediatric age group by elastic nailing system provides relative stability. The purpose of this study is to evaluate the functional outcome of tibial diaphysis fracture in paediatric age group treated elastic nailing system. Methods- A prospective interventional study was conducted at Rapti Academy of Health Sciences, Ghorahi, Dang from November 2018 to November 2020. Ethical clearance was obtained from Institutional review board. All the children who were operated for tibial diaphysis fracture were followed up for six months. Final outcome was analyzed at final follow up. Results- Out of thirty children, there were sixteen male and fourteen female. Mean time of fracture union was 10.03 weeks. Two children develop limb lengthening of 1.5 cm and 1.2 cm respectively. One child had 1 cm shortening and three children develop bursitis on entry site. At final follow up 83.33% of child had an excellent outcome according to Flynn grading. Conclusion- Tibial diaphysis fracture can be treated with elastic nailing system with excellent to good functional outcomes.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130040501","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":"Congenital Insensitivity to Pain and Anhidrosis: A painful experience by a painless child","authors":"Sia Ung, Z. Osman, Nur Syahida Termizi, Mohd Firdaus Hafni Bin Ahmad","doi":"10.37515/ortho.8231.4102","DOIUrl":"https://doi.org/10.37515/ortho.8231.4102","url":null,"abstract":"A three-year-old boy with congenital insensitivity to pain and anhidrosis (CIPA) was first presented with transphyseal separation of distal left humerus. Surgical treatment with closed reduction and k-wiring of transphyseal separation of distal humerus resulted in devastating surgical site infection and osteomyelitis. Multiple surgical debridement and application of external fixator to eliminate infection were futile. At the age of four years, he refused to bear weight as a result of left hip dislocation. Closed reduction and spica cast was unsuccessful, resulting in recurrent left hip dislocation. He has since not been able to walk. At the age of five years, the right hip was dislocated followed by ipsilateral subtrochanteric femur fracture. Appropriate treatments such as hip spica and titanium elastic nail were not possible due to extensive bruising and skin ulceration over the right thigh. This child ended up with a functionless left upper limb, bilateral hip dislocation and malunited right femur fracture. Conservative treatment and watchful neglect might be the ideal treatment for patients with CIPA.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124330256","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":"Outcome of Intertrochanteric Fractures Treated with Proximal Femoral Nail Antirotation (PFNA)","authors":"Mohanrao Garabadi, Amit Grover","doi":"10.37515/ortho.8231.3304","DOIUrl":"https://doi.org/10.37515/ortho.8231.3304","url":null,"abstract":"Background: The superiority of PFN (Proximal Femoral Nail) in treatment of intertrochanteric fractures of the hip are well documented but there is no well documented evidence regarding the superiority of PFNA (Proximal Femoral Nail Antirotation). The design of PFNA reduces bone loss and subsequently improves fracture fixation & union. Aims & Objectives: i) To evaluate the outcome of intertrochanteric fractures treated with PFNA. ii) To study the complications associated with the procedure and implant. iii) To compare with well-established studies in literature. Study Design: Prospective Observational Study. Setting: Department of Orthopaedics, Rajawadi Municipal Hospital, Mumbai. Materials & Methods: Total 70 cases of Intertrochanteric fracture satisfying inclusion and exclusion criteria were treated with PFNA from August 2017 to August 2018. The minimum follow up period was 1 year and maximum follow up was for 2 years. Patients were assessed for functional capacity and radiological fracture healing at each follow up. Harris Hip score was used to evaluate functional outcome. Statistics: 22 patients were males and 48 were females. The patient’s age ranged from 40 to 94 years with a mean of 75 years. 32 fractures involved the right side and 38 involved the left side. Of the 70 fractures 14 were AO 31A1, 50 were AO 31A2, 6 was AO 31A3. The length of the nail was 170mm in all of the cases. Most commonly used blade was 95mm. The operative time ranged from 30 min to 100 min with an average of 44 min. Average blood loss was 82 ml. Results: Of 70 patients, 66 Patients (94%) showed radiological union by 3months. Average time for union was 3 months. 2 patients had non-union at the end of 1 year of follow up. No patients had infection or cut out of the blade. 8 patients had migration of the blade. 2 patients had varus collapse. No fractures below the tip of the nail were seen during the follow-up period. Outcome was assessed using Harris Hip Score. Conclusions: Based on our observations we hereby conclude that in intertrochanteric fractures treated with PFNA, we found excellent outcomes with high union rates & very few complications. A randomized trial comparing the PFNA with other devices in elderly patients will probably be required for definitive assessment.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"377 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126722719","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":"Predictors of Outcome in Hallux Valgus Surgery","authors":"W. W. Ang, M. Charalambides, A. Overton, Chalaralambos Charalambides","doi":"10.37515/ortho.8231.3305","DOIUrl":"https://doi.org/10.37515/ortho.8231.3305","url":null,"abstract":"Introduction: Hallux valgus (HV) is the most common forefoot deformity, and is known to be a debilitating disease, causing pain and reduced social function. There are various established surgical treatments for HV, with patient satisfaction up to 85% after surgery. In this paper, we aim to identify the pre-operative factors that may serve as predictors to patient outcome after surgery, to help surgeons select suitable candidates for surgery in the clinic. Methods: A prospective study was done on patients who underwent scarf and akin osteotomy for symptomatic HV between October 2015 and March 2018. Five patient factors were collected pre-operatively, including osteoarthritis grade of first metatarsophalangeal joint, severity of HV, presence of osteoarthritic or sesamoid pain, and presence of flat foot. Patient’s self-reported outcomes was assessed pre- and post-surgery, using the Manchester-Oxford Foot Questionnaire (MOXFQ) and Visual Analogue Score (VAS). Pre- and post-surgery outcome scores were compared, and changes in scores analysed with numerous patient factors to identify any significant association. Results: 41 feet of 36 patients were included after implementation of exclusion criteria. Both MOXFQ and VAS showed a significant reduction in scores (improvement in outcomes) after surgery. None of the pre-operative patient factors examined was found to be significantly associated with the reduction in MOXFQ score. However, the results suggested that high pre-surgery MOXFQ score was associated with a greater MOXFQ score reduction post-surgery, with p-value of <0.001. Conclusion: Our study found that none of the factors looked at significantly correlated with reductions in MOXFQ and VAS scores post-surgery, other than high presurgery MOXFQ scores. This suggests that surgeons should counsel as such in clinic. Nonetheless, as this study had a small study size, further studies should be done to support the findings of this research.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128485857","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 Review literature about Chondroblastoma with a case on Talus bone","authors":"S. Jami, Siam Al Mobarak, M. Tanvir, Syma Nosin","doi":"10.37515/ortho.8231.3306","DOIUrl":"https://doi.org/10.37515/ortho.8231.3306","url":null,"abstract":"Background: Chondroblastomas are rare bone tumors, which are the cartilaginous origin and account for nearly 1% of all primary bone tumors. It can affect people of all ages. Chondroblastomas arising in the talus are very rare and are known to have less aggressive behavior. Methods: 11 authors, a total of 572 patient data with our talus case, were analyzed for this review literature. Here is the mentioning of epidemiological and clinical information, radiological details, surgery type, adjuvants types, genders, follow-up years, recurrence, affected areas, death rates, successful outcome, MSTS functionality scores, and survival rates by analyzing all data. Result: Chondroblastoma was treated by curettage and bone grafting during surgical procedures. This procedure is curative in 90% of cases. There was no recurrence in this study case of the talus. Also, the MSTS functionality score for CB averages 90% more in most of the author’s literature, and 0% death rate was reported. Conclusion: We believe that chondroblastoma of the talus bone should be considered among the differential diagnosis whenever a neoplastic cause is being considered as the underlying pathologic entity. We present a review of the literature detailing their occurrence, radiological findings, and treatments and to report functional outcomes after treatments, which have been rarely documented in a large series.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130808171","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":"Absence of SARS-CoV-2 in Synovial Fluid of COVID-19 Positive Patient: A Case Report","authors":"D. Mao","doi":"10.37515/ortho.8231.3301","DOIUrl":"https://doi.org/10.37515/ortho.8231.3301","url":null,"abstract":"Emergence of the SARS-CoV-2 virus has led to the COVID-19 pandemic. The extent of spread of the virus throughout body fluids is an exposure hazard to healthcare workers. The presence of virus particles has been well established in the lung, nasopharyngeal and oropharyngeal tissue. Its presence in more immunologically privileged areas such as synovial joints is not well established. We investigated a COVID-19 positive patient with knee pain and effusion. Knee synovial joint fluid PCR revealed absence of SARS-CoV-2 virus particles. We encourage further synovial fluid analysis in patients with COVID19 to give a better understanding of the virus’s tropism.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134626097","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":"Effects of COVID-19 Quarantine on patients affect of hip osteoarthritis in list for joint replacement","authors":"M. Grassi, M. Larghi, E. Placenza, L. Faugno, C. Rampulla, A. Manzotti","doi":"10.37515/ortho.8231.3302","DOIUrl":"https://doi.org/10.37515/ortho.8231.3302","url":null,"abstract":"Background: The emergency caused by COVID-19 Pandemia has resulted in a complete suspension and consequent delay of common planned surgery such total hip replacement in patients affect by osteoarthritis. At the same time, the issue of the quarantine imposed changes to the normal lifestyle of these patients. The purpose of our study is to evaluate how the presence of these two factors affect the quality of live of patients living in the Italian red zone. Methods: From outpatient pre-operative assessment we collect data about: demographic data, WOMAC score, NRS (Numeric rating scale 0-10), PCS SF12 and MCS SF12 score. Selected patients were therefore contacted by telephone call and re-assess using the same score. In addition, patients were asked if they intended to undergo the planned surgery again despite the current emergency. Results: 14 patient have been recruited for the study. Male/female ration was 10/4, mean age was 70 years. Pre operative outpatient assessment mean WOMAC score was 44,86 (SD ± 8,52) , mean NRS was 8,07 (SD ± 1,33), PCS SF12 was 30,33 (SD ± 5,0) and MCS SF12 was 40,95 (SD ± 3,51). At re-evalutation the mean WOMAC score was 32,86 (SD ± 17,88) , mean NRS was 5,79 (SD ± 3,66), PCS SF12 was 39,9 (SD ± 3,70) and MCS SF12 was 50,14 (SD ± 6,86). Conclusion: The exceptionale pandemic from Covid-19 has profoundly changed our lifestyle, impacting normal daily activities but also on regular surgical activity in patients affected by osteoarthritis. Our study suggested that the lifestyle changes imposed by the situation led to an improvement of clinical score. This shows how an exceptional event can affect many aspects of daily life.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"159 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133851064","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":"Unilateral spinal motion segment rotational deformity causing foraminal stenosis","authors":"Fitz-Gerald Connor, H. Niels, Kieser David","doi":"10.37515/ortho.8231.3303","DOIUrl":"https://doi.org/10.37515/ortho.8231.3303","url":null,"abstract":"The objective of this article is to describe for the first time a case of unilateral spinal motion segment rotational deformity causing foraminal stenosis. In this report we present the case of a 43 year old male with multilevel lumbar degeneration who progressively developed an isolated L3/4 rotational deformity leading to symptomatic neural compression from foraminal stenosis. He first presented to our clinic in 2015 and was followed up over the course of four years. The patient failed non-operative treatment and developed increasing L3 radiculopathy and neurological dysfunction for which he had temporary improvement of symptoms after a foraminal epidural steroid injection. He therefore underwent a decompression with no resolution of symptoms and subsequently a lateral interbody fusion that restored foraminal height but not antero-posterior (AP) compression. Subsequent derotation with pedicle screws resulted in an increase in the antero-posterior size and resolution of his symptoms. Unilateral mono-segmental rotational deformity is a cause of foraminal stenosis that should be considered when patients present with radiculopathy. Surgical management should involve restoration of the antero-posterior dimension, which can be achieved with derotation.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125556985","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":"Recommendations management of preoperative nasopharyngeal swab screening before non-urgent/elective spine surgery during COVID-19 Situation","authors":"Wongthawat Liawrungrueang, uanrit Sornsa-ard, Anugoon Niramitsantiphong, S. Sribunditkul","doi":"10.37515/ortho.8231.3206","DOIUrl":"https://doi.org/10.37515/ortho.8231.3206","url":null,"abstract":"The coronavirus outbreak has been labeled as a pandemic by the World Health Organization (WHO) in March 2020. The patient who was taken non-urgent/elective spine surgery should receive the coronavirus disease 2019 (COVID-19) nasopharyngeal (NP) swab for RT-PCR test to prevent the nosocomial cross-infection before surgery. However, there are no standard protocols for preoperative nasopharyngeal swab management for non-urgent/elective spine surgery. This article aims to propose the recommendations of preoperative NP swab for RT-PCR test before non-urgent/elective spine surgery, type of personal protective equipment (PPE) and algorithm for management in COVID-19 situation.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125357351","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":"Anterior cervical osteophytic “giant beak-like lesion” causing dysphagia","authors":"Wongthawat Liawrungrueang, Rattanaporn Chamnan, Weera Chaiyamongkol, P. Bintachitt","doi":"10.37515/ortho.8231.3201","DOIUrl":"https://doi.org/10.37515/ortho.8231.3201","url":null,"abstract":"Large anterior cervical osteophytes can occur during degenerative cervical disease, a condition called Diffuse Idiopathic Skeletal Hyperostosis (DISH), which can cause mechanical compression of the pharyngoesophageal area causing dysphagia. Both conditions are very rare. Here we present the case of an 81-year-old male who presented with progressive dysphagia due to a giant beak-like osteophytic lesion anterior to the C3 and C4 vertebral spine causing compression of the pharyngoesophageal segment. The patient declined treatment by anterior cervical osteophytectomy and accepted the possible complications such as progressive dysphagia.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115165642","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}