The Internet Journal of Orthopedic Surgery最新文献

{"title":"Pediatric Femoral Shaft Fracture Management By Titanium Elastic Nailing; A Prospective Study Of 112 Patients","authors":"P. Singh, Rupesh Kumar","doi":"10.5580/2c5a","DOIUrl":"https://doi.org/10.5580/2c5a","url":null,"abstract":"Objective – To assess the usefulness of TENS in treatment of pediatric femoral shaft fractures, which is one of most common pediatric major injuries encountered to orthopedic surgeon.Material and method – The study was conducted on 112 patients admitted at Govt. Medical College, Haldwani in the Department of Orthopedics from January 2007 to Januray 2012. We included patients of age group of 5 -15 years with fracture shafts of femurs excluding grade 3 compound fractures and pathological fractures. Patients were followed more than a year. Greater emphasis was given on complication analysis, major complications like limb length discrepancy, infection, angulations, and loss of knee movement were noted. Functional outcomes were analyzed according to Flynn criteria. In our prospective study by using Flynn criteria, 86 had excellent results, 24 had satisfactory results, and 2 had poor results.Discussion and conclusionTreatment of long bone fracture in pediatric age group by titanium elastic nail is broadly under acceptance. Technical ease, good functional outcome, preservation of epiphysis, low complications are very favorable point for TENS use for femoral shaft fracture. Encouraging reports and low complication from our study also supports exclusive use of TENS in pediatric femoral shaft fracture in age group 5-15 years.","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":"128761322","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":"Relieving Tenderness Over Anatomical Snuff Box Through Penetration Enhancing Vehicles","authors":"T. Hasan, K. Abdulaziz, A. Sabbour, H. Emara","doi":"10.5580/2c58","DOIUrl":"https://doi.org/10.5580/2c58","url":null,"abstract":"Introduction-De Quervain's tenosynovitis is caused by inflammation of the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB) tendons, which pass through the first dorsal compartment at the radial styloid. Patients who have this stenosing tenosynovitis usually describe tenderness in the anatomical snuff box and swelling proximal to the radial styloid process as well as pain in the wrist and on the lateral side of the hand .Retention of fluid has been suspected as an initiator of this problem, which appears to be significantly more common in women. Interestingly, many women suffer from de Quervain tenosynovitis during pregnancy or the postpartum period. This study was carried out to investigate the efficacy of ketoprofen phonophoresis (ultrasound mediated topical drug penetration enhancer) in the treatment of de Quervain's tenosynovitis during pregnancy.Methods -This study was carried out on thirty volunteer pregnant women in the 3 rd trimester complaining of dequervain's tenosynovitis of the dominant hand. The patients were divided into 2 groups equal in numbers. Group (A) received ultrasound therapy using Fastum gel (ketoprofen 2.5%) as a coupling medium. Group (B) served as a control group and received placebo (KY inert gel) with ultrasound therapy. Each patient was treated for 4 weeks .Assessment of pain intensity for each subject was done before and after the four weeks of treatment through Present pain intensity (PPi) scale.Results-The intervention group showed remarkable recovery in the form of reduction in pain. (p<0.005)Conclusion-From the statistical point of view it can be concluded that ketoprofen phonophoresis has an excellent effect on relieving pain of de Quervain's tenosynovitis during pregnancy that physiotherapists should confidently be able to use it in treating such cases.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"10 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":"131937699","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":"Unusual Presentation Of An Aneurismal Bone Cyst In The Patella With Fracture – A Case Report","authors":"M. Todkar","doi":"10.5580/2c52","DOIUrl":"https://doi.org/10.5580/2c52","url":null,"abstract":"We report about a 25-year old man having an aneurysmal bone cyst in the patella presenting with fracture after falling from a height of 3 feet. He was asymptomatic before the fall. He was treated with curettage, bone grafting and internal fixation using tension band wire technique. Bone cysts are very unusual in the patella. Around 1% of primary bone tumours are aneurysmal bone cysts.(1) They are common in metaphyses of long bones of the lower extremity. Less than 1% of aneurysmal bone cysts occur in the patella.","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":"128676275","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 Comparative Study Of Efficacy Of Pre And Post Debridement Cultures In Open Fractures","authors":"Sachin Gupta, N. Saini, Rakesh Sharma, Jasimran Kehal, Y. Saini","doi":"10.5580/2c53","DOIUrl":"https://doi.org/10.5580/2c53","url":null,"abstract":"Objective: To compare the efficacy of pre and post debridement cultures in open fractures Methods: In 100 patients with open fractures a pre and a post debridement culture were taken. Results of pre and post-debridement cultures with respect to respective organism and the percentage of wound ultimately infected with respect to the culture report were compiled. Results: Post debridement cultures showed a sensitivity of 70% and a Specificity of 55% as compared to pre debridement cultures which showed a sensitivity of 64% and a specificity of 24% ultimately led to infection. Conclusion: The use of postdebridement culture reports have better prognostic value than perioperative cultures in predicting the incidence of infection as well as the infecting organisms in open fractures .","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"342 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":"115889784","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 Migration Of CAD-CAM Hips Stems In Patients With Juvenile Rheumatoid Arthritis Over A Follow-Up Period Of Ten Years","authors":"S. Jabir","doi":"10.5580/2ba7","DOIUrl":"https://doi.org/10.5580/2ba7","url":null,"abstract":"Background and Aims: The clinical results obtained after total hip arthroplasty in patients with juvenile rheumatoid arthritis were not encouraging when cemented implants were used. Therefore custom designed femoral components (uncemented and hydroxyapatite-coated) using computer-assisted-design and computer-assisted-manufacture (CAD-CAM) were used for these patients who required total hip replacement (THR). The minimal follow-up for these patients is now 10 years. The clinical results obtained with these implants were excellent. The purpose of this study is threefold; firstly to correlate the degree of migration of the femoral component with the clinical results, secondly to determine if CAD-CAM femoral components can achieve implant stability over 10 years and thirdly to determine if there in a correlation between the extent of migration and the degree of pain experienced by the patient. Methods: the hips were assessed clinically according to the Hospital for Special Surgery (HSS) hip rating system preoperatively and then at 1 year, 3 years, 5 years and 10 years postoperatively. The pain component of the HSS system was recorded separately in addition to the total HSS score. Migration of hip stems was measured by a technique developed in the Biomedical Engineering Department (BME) of the Institute of Orthopaedics and Musculoskeletal science, University College London (UCL). It involved digitisation of 16 points on an anteroposterior (AP) view radiograph in a manner prompted by the computer. The head diameter of the femoral component was inserted into the computer before digitisation. A specially developed computer program then used this information together with that obtained by digitisation to measure the distance between the top of the greater trochanter and the lateral aspect of the hip stem. This information was then used to measure the migration. Results: there was no significant correlation between the degree of migration and the clinical results at the end of the 10 year follow-up (r = 0.032, P = 0.881). However the migration of the CAD-CAM components over the 10 year period was significant (p< 0.05). This means CAD-CAM components were unable to achieve implant stability over the 10 year period. There was also no correlation between the degree of migration and the extent of pain experienced by patients at 10 years follow-up (r = -0.213, P = 0.308). Summary and conclusions: we conclude that the clinical results and degree of pain experienced by JIA patients with a THR are not related to the amount of CAD-CAM hip stem migration. Our study also established that CAD-CAM components undergo significant progressive migration over 10 years. However this rate of migration was not high enough to lead to radiological failure in most cases. Certain limitations were present in the method used to measure migration, thus the results of this study should be interpreted with caution.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"9 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":"130586101","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":"Rural Experience With The Austofix F2 Femoral Nail For Peri-Trochanteric Femur Fractures.","authors":"L. Host","doi":"10.5580/2c55","DOIUrl":"https://doi.org/10.5580/2c55","url":null,"abstract":"Rural health care provision is repeatedly substandard in comparison to that offered in urban settings, with many factors involved. Budgetary constraints, geographical limitations and professional isolation render best practice health care problematic. Sustainable, cost-effective health service provision is always the aim, but must constantly be tempered against evidence-based best practice. Our review aimed to highlight local experience with the Austofix F2 femoral nail for treatment of peri-trochanteric femur fractures, and to assess this relative to evidence-based best practice. The development of Z-deformity in 29% of patients requiring revision of implants in 26% has led to a change of implant usage at our institution, and raises questions of the utility of dual sliding screw systems for proximal femoral fracture management.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"65 6 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":"121216476","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":"Epidemiology Of Elbow Fractures In Children In The African Context: About 465 Cases.","authors":"O. Ndour, N. Ndoye, D. Alumeti, M. Fall, A. Fall, C. Diouf, G. Ngom, M. Ndoye","doi":"10.5580/2c54","DOIUrl":"https://doi.org/10.5580/2c54","url":null,"abstract":"Purpose: The aim of our study was to analyse the epidemiology of elbow fractures in children. Patients and Methods We conducted a retrospective study over a period of 8 years where we collected 465 cases of children with elbow fractures and treated by the department of Paediatric Surgery and Surgical Emergency at CHU Aristide Le Dantec Hospital, Dakar. For each case the parameters studied were the frequency, age, sex, geographic origin, circumstances of occurrence, the mechanism, the suffered side, the anatomical lesion and associated lesions.Results The annual incidence was 58.12. Elbow fracture accounted for 30.79% of fractures of the child and came in second place after fractures of the femur (39.17%). The average age was 7 years with a peak incidence between 4 and 6 years. The majority observed are male with a sex ratio of 3.6: 1. Most of our patients (96.1%) came from the suburbs of the capital. The circumstances of occurrence were dominated by recreational accidents (59.5%) and the fall was the most frequently mechanism with 90.1% of cases. The left elbow sustained injury in 63.45% of cases. Supracondylar fractures accounted for 81.29% of cases. The associated lesions were found in 6.1% of cases.Conclusion Fractures of the elbow are common in our context. They occur more often in boys (male children) in the settings of a fall during games. The left side is the most affected. Supracondylar fractures are more frequent with rare associated injuries.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"2 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":"121263944","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 Examination, MRI And Arthroscopy In Knee Injuries.","authors":"Sachin Gupta, Rakesh Sharma, A. Sachar, Y. Saini, N. Saini","doi":"10.5580/2c56","DOIUrl":"https://doi.org/10.5580/2c56","url":null,"abstract":"Objective: To compare accuracy of clinical examination and MRI taking Arthroscopy as Standard in knee injuries. Patients and Methods: 60 patients with knee injury were subjected to clinical examination, MRI and then Arthroscopy. The results were compared and analysed using various statistical tests. Results: Diagnostic accuracy of MRI was 66.67% for medial meniscus and 90% for lateral meniscus GR 1 and 2 meniscal tears have low sensitivity 50% as compared to GR 3 and 4 with 88%. In the case of ACL tears, diagnostic accuracy for both clinical examination and MR examination came out to be 90% Conclusion: We can avoid diagnostic arthroscopy in patients with ACL and PCL injuries having equivocal clinical and MRI examination and go on for therapeutic modality. In case of meniscal injuries graded as 1 and 2 on MRI, are rarely seen on arthroscopy hence arthroscopy is not required for these meniscal injuries.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"198 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":"124445333","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":"Subacute Haematogenous Osteomyelitis of the Calcaneus in a Child: A Case Report and Review of the Literature","authors":"W. Talbot","doi":"10.5580/2c59","DOIUrl":"https://doi.org/10.5580/2c59","url":null,"abstract":"Osteomyelitis is an inflammation of bone caused by a pyogenic organism. Osteomyelitis of the calcaneus in children is an uncommon diagnosis, particularly when haematogenous in nature and not caused by direct inoculation. Historically haematogenous osteomyelitis has been characterized as acute, subacute or chronic with each type based on the time of disease onset. Subacute haematogenous osteomyelitis is characterized by mild localized bony pain and tenderness usually of more than two weeks duration, mild or no systemic manifestations, noncontributory lab data, negative blood cultures, and positive radiological findings. Prior reports and studies have found that children with calcaneal osteomyelitis can be a diagnostic challenge because of the unimpressive signs and symptoms and often marginal lab results. 6 This is made even more difficult when subacute in presentation and associated with a traumatic injury. Therefore we present a case of subacute haematogenous osteomyelitis of the calcaneus with an associated minor traumatic injury, and a review of the literature","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"82 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":"130785188","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":"Noninfected Atrophic Tibial Pseudoarthrosis Threated With Ilizarov External Fixation And With Autogenous Intramedullary Spongioplasty","authors":"Blagoj Nedelkov Primarius, Mihajlo Djolonga, Margarita Videvska","doi":"10.5580/2aee","DOIUrl":"https://doi.org/10.5580/2aee","url":null,"abstract":"We report a case report of a tibial aseptic, atrophic pseudoarthrosis. The patient was treated with immobilization of the lower extremity with a long-leg cast for a period of two and a half months. This treatment was interrupted because the patient developed thrombophlebitis of the affected leg. Possible reasons for the pseudoartrosis were: short period of immobilization, alcoholic malnutrition, and cigarette smoking. When the thrombophlebitis was cured, closed intramedullary fixation of the pseudoarthrosis was planned. The operation was converted later on to external fixation of the pseudoarthrosis according to Ilizarov, because it was not possible to introduce the intramedullary nail to the distal bone fragment with a closed technique, and because the surgical incision had to be made on the place where the pseudoarthrosis was. Second reason for the conversion to Ilizarov external fixation was the bad condition of the skin around the pseudoarthrosis. After the operation was finished, an idea for pseudoarthrosis spongioplasty with spongiosis from crista iliaca, together with fibular resection of one inch length, as a second surgical intervention came into mind. There was a pleasant surprise, because on the following x ray six weeks after the fixation, there was a calus where during the operation the guide wire for the intramedullary nail could not passed to the distal tibial fragment and was going outside. Maybe, during the unsuccessful attempts to pass the intramedullary nail`s guide wire, collateral autogenous intramedullary spongioplasty was made, i.e. spongiosis was brought (transplanted) with the guide wire from the proximal part of the tibia distally to the place of pseudoarthrosis. Three and a half months later the pseudoarthrosis of the tibia was cured and the Ilizarov external fixator was removed. The result of the operation was good. The patient was happy and he could walk normally without subjective difficulties. There was only discrete contracture of the left talocrural joint.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117123919","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}