{"title":"Epidemiology Of Gunshot Injuries In Abeokuta, Southwest Nigeria","authors":"N. Aigoro, Ganiyu O. Abass","doi":"10.5580/2cdd","DOIUrl":"https://doi.org/10.5580/2cdd","url":null,"abstract":"Background: Civilian gunshot injuries are a common encounter in medical practice in our environment with varied aetiological factors in different geopolitical regions. This report examines the pattern of gunshot injuries in a secondary Health facility over a 24-month period. Patients and Methods: All cases of GSI seen at the Accident and Emergency department of the State Hospital, Abeokuta from January 2010 to December 2011 retrospectively analyzed. Results: There were 46 cases with males constituting 44(95.1%) of cases, whilst female accounted for 2 (4.4%) cases thus giving a M:F ratio of 22:1. GSI commonly occurs in the age group 21 – 40 years (65.1%), whilst the lower limb was the most common anatomic region affected (39.1%). The other body regions affected were upper limb (30.4%), Head & Neck (15.2%), Abdomen (6.5%), Chest (2.2%), Trunk(back) (2.2%). 4.4% of patients had multiple sites of GSI.13(28.3%) cases were recorded in 2010 as against the 33(71.7%) cases seen in 2011an election year.35(76.1%) patients were treated and eventually discharged, while 5(10.9%) patients were referred to a Neurosurgical service. 5 patients died from their injuriesgiving a mortality rate of 10.9%. 1 patient discharged himself against medical advice. Conclusion: GSI is a cause of traumatic death, and enormous morbidity in our environment, striking at the most productive age group of the economy. There is need for a concerted effort to stem the tide.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121151044","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":"Effect of Human Versus Computerized Voice Recognition Transcription on Billing Level in an Orthopaedic Surgery Practice","authors":"B. Dezfuli, Margaret Chilvers","doi":"10.5580/2cdc","DOIUrl":"https://doi.org/10.5580/2cdc","url":null,"abstract":"Computer based speech recognition transcription software (CBT) use has increased in prevalence in the last decade. However, its effects on level of billing in an orthopaedic practice have not been published. During a one-year period, patients were seen by the author at one of two Orthopaedic Surgery Clinics at the University of Arizona. One clinic utilized human transcriptionists (HT) and another CBT. A total of 1,758 notes were generated, 900 completed by HT and 858 by CBT. Of all HT notes, 70 (8%) were billed as level 4, whereas only 27 (3%) notes generated by CBT billed as level 4 (p< 0.01). When analyzing only new patient reports, 29 (9%) HT reports billed as level 4, whereas only 11 (3%) notes generated by CBT billed as level 4. CBT does not result in a higher level of billing. Caution must be used with implementation of this new technology on the basis of cost savings.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130981297","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}
M. Fiogbe, S. Gbenou, R. Sossou, O. Biaou, A. Koura, V. Boco
{"title":"Long Term Sequels Of Intramedullary Nailing In Childhood Femoral Shaft Fractures.","authors":"M. Fiogbe, S. Gbenou, R. Sossou, O. Biaou, A. Koura, V. Boco","doi":"10.5580/2cf3","DOIUrl":"https://doi.org/10.5580/2cf3","url":null,"abstract":"Objective. To evaluate the impact on bone growth of intramedullary nailing of femur using Kuntscher technique in childhood. ¦ Methods: 18 patients who had undergone Kuntscher technique intramedullary nailing were analyzed as they have grown to adulthood. Growth of each lower limb was compared using predefined clinical and radiological parameters.Results: Patient ages at the time of evaluation, ranged from 21 to 30 years and the follow up length 12 to 16 years. Clinical examination noted 10 normal patients and 8 patients with anomalies, among them 6 were less than 12 years old at the time of intervention. Six¶ patients had lengthening of the operated limb; 4 patients had atrophy¦¦ of the thigh of the operated limb and¦¦¶ 7 patients had coxa valga of operated limb. All patients with coxa valga had undergone the intervention before the age of 12 years.Conclusion: intramedullary nailing using Kuntschter technique to treat femoral fractures in children ¦of feoo may have some long terms sequels. Therefore it is advisable not to use this technique in children less than 12 years old.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128457385","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 Limping Child: On A First Look It Is Hip Or Knee In Origin! No! It’s A Talus Osteomyelitis","authors":"P. Ganaisan, Avthar Singh, C. Kumar, R. Manikam","doi":"10.5580/2cde","DOIUrl":"https://doi.org/10.5580/2cde","url":null,"abstract":"Isolated osteomyelitis of the talus in a child is very rare incidence [1,2]. Children presenting with pain and limp to emergency department are predominantly investigated for pathologies of hip or knee, hence a condition originating from talus is frequently missed. A delay in its diagnosis are precursors to gait and bony deformity in future where the cost of disability is a huge burden to the patient. We present a case of osteomyelitis of talus where initially it was a missed diagnosis but due to awareness and alertness of the treating physician it was identified and treated early.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"26 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133867299","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":"TIP APEX DISTANCE – IS IT ENOUGH TO PREDICT IMPLANT FAILURE?","authors":"N. Agni, E. Sellers, Riem Johnson, A. Gray","doi":"10.5580/2c50","DOIUrl":"https://doi.org/10.5580/2c50","url":null,"abstract":"The aim of this study was to establish any association between implant cut-out and a Tip Apex Distance (TAD), ≥25mm, in proximal femoral fractures, following closed reduction and stabilisation, with either a Dynamic Hip Screw (DHS) or Intramedullary Hip Screw (IMHS) device. Furthermore, we investigated whether any difference in cut-out rate was related to fracture configuration or implant type. WE conducted a retrospective review of the full clinical records and radiographs of 65 consecutive patients, who underwent either DHS or IMHS fixation of proximal femoral fractures. The TAD was measured in the standard fashion using the combined measured AP and lateral radiograph distances. Fractures were classified according to the Muller AO classification. 35 patients underwent DHS fixation and 30 patients had IMHS fixation. 5 in each group had a TAD≥25mm. There were no cut-outs in the DHS group and 3 in the IMHS group. 2 of the cut-outs had a TAD≥25mm. The 3 cut-outs in the IMHS group had a fracture classification of 31-A2, 31-A3 and 32-A3.1 respectively. In addition, the fractures were inadequately reduced and fixed into a varus position. A TAD","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121838395","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 Proximal Humerus Locking Plate As A Fixation Modality In Proximal Humeral Fractures: Preliminary Results","authors":"B. Sachde, K. Sayani, N. Maru","doi":"10.5580/2ba8","DOIUrl":"https://doi.org/10.5580/2ba8","url":null,"abstract":"Proximal humeral fractures are the third most common fractures after hip and distal radius in elderly population. The majority of proximal humeral fractures are minimally displaced and can be successfully treated non-operatively with early rehabilitation. Early studies reported less satisfactory results for 3and 4-part fractures treated by closed reduction, with only 10% of patients achieving satisfactory function. Closed reductions of comminuted fractures are difficult to maintain. Threeand 4-part fractures in healthy, active patients are typically treated with surgery to optimize shoulder function.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115093569","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 Intercondylar Notch Width Index and Reverse Notch Width Index in Cases With and Without Anterior Cruciate Ligament Tears","authors":"Sachin Gupta, Rakesh Sharma, N. Saini, Y. Saini","doi":"10.5580/2c4f","DOIUrl":"https://doi.org/10.5580/2c4f","url":null,"abstract":"Objective: To compare intercondylar notch width index and reverse notch width index in cases with and without anterior cruciate ligament tears. Patients and methods: 33 patients with a positive lachman’s test and pivot shift and a complete ACL tear on MRI were taken as cases. 33 patients with knee pain but a negative Lachman’s test and pivot shift and no ACL tear on MRI were taken as controls. To obtain the radiographic images of femoral intercondylar notch, the Holmblad (1937) method was used. The Notch width index and the Reverse notch width index was calculated for all the cases and controls from radiographic measurements and the results were compared statistically using Pearson chi square test. Results: The maximum number of cases and controls were in the age group 21-30 years with mean age of 28.61 yrs for cases and 28.91 yrs for controls. Maximum number of cases (69.7%) and controls (75.8%) had NWI greater than 0.25. Maximum number of cases (45.5%) and controls (54.5%) had RNWI less than 4.7 indicating wide notch. Conclusion: No significant relation could be established between Notch width Index and Reverse notch width index with anterior cruciate ligament injury.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126003474","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":"Malrotation Due to a Design Element of a New Antegrade Femoral Nail","authors":"Mayuran Suthersan, I. Harris, Arnold Suzuki","doi":"10.5580/2bc7","DOIUrl":"https://doi.org/10.5580/2bc7","url":null,"abstract":"","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124191385","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":"Biomechanical Comparison Of A Novel Suture Configuration As An Alternative Single-Row Repair Technique For Rotator Cuff Repair","authors":"David Lieu, S. Tan, D. Bell, B. Walsh, Amir Rubin","doi":"10.5580/2ba6","DOIUrl":"https://doi.org/10.5580/2ba6","url":null,"abstract":"Background Arthroscopic techniques of rotator cuff repair are constantly evolving. Although biomechanically stronger, doublerow repair techniques have not been proven to be clinically superior. There are also situations where double-row techniques are not suitable and/or indicated. In these circumstances typical single-row sutures used are the simple suture or the modified Mason-Allen suture. We describe an alternative single-row suture technique – the ‘Down Under Suture Technique’ (DUST). We hypothesise that this suture has an improved tendon-to-bone contact area and pull-out strength than the established alternatives. Methods In a controlled laboratory study, 1cm tears of the infraspinatus tendon were created in 42 fresh frozen porcine shoulders. The tears were repaired using either a simple suture, a modified Mason-Allen suture or a DUST suture. The tendon-to-bone contact area was measured and compared in 15 shoulders, and suture pull-out strength was measured in the remaining 27 specimens. Results The DUST suture achieved a tendon-to-bone contact area of 122 mm, significantly higher than that achieved by the MasonAllen (48 mm, p=0.008) and simple suture (51 mm, p=0.01). Suture pull-out strength was 191N, significantly higher than the simple suture (97N, p=0.028), but not significantly higher than the Mason-Allen suture (127N, p=0.22). Conclusions We conclude that the DUST has favourable biomechanical properties when compared to other single-row suture techniques. It is a useful arthroscopic alternative where a single row cuff repair is needed.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125785696","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}
F. O’Neill, T. McGloughlin, B. Lenehan, F. Condon, J. Coffey, M. Walsh
{"title":"Biomechanical Study. The Role of Osteoporotic or Osteoarthritic Bone in Determining the Fixation Achieved Within the Femoral Head by the Lag Screw Elements of the Dynamic Hip Screw (DHS) and DHS Blade","authors":"F. O’Neill, T. McGloughlin, B. Lenehan, F. Condon, J. Coffey, M. Walsh","doi":"10.5580/2c51","DOIUrl":"https://doi.org/10.5580/2c51","url":null,"abstract":"Objective This study was conducted to investigate the fixation that the lag screw elements of two different implants used in the treatment of intertrochanteric fractures achieve within osteoporotic and osteoarthritic femoral heads, as a practical means of comparing the mechanical properties of osteoporotic bone against those of osteoarthritic bone. Methods The lag screw elements of the Dynamic Hip Screw (DHS) and DHS Blade were the two lag screws that were chosen to conduct this study with. “Pushout” tests were performed as the means to investigate the fixation that each lag screw achieved within the femoral heads, as the most common mode of failure with these devices is ‘cut-out’ Results The results demonstrate that the difference in mechanical properties between osteoporotic and osteoarthritic bone in cadaveric femoral heads mean that the devices used in the fixation of intertrochanteric fractures achieve a much greater fixation within osteoarthritic bone. The results also demonstrate that the overall failure patterns were similar for each device within both the osteoporotic and osteoarthritic bone apart from the large difference in forces achieved. Conclusion The results demonstrate, that as expected when the density of the bone increases, in general the implants achieve better fixation within it. However this study also demonstrates that it is the implant that dictates the pattern of failure and not the bone.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133610236","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}