The Internet Journal of Orthopedic Surgery最新文献

{"title":"Cost Benefit Analysis Of Suture-Button Versus Screw Fixation Of The Distal Tibiofibular Syndesmosis.","authors":"C. Carmody, U. Dhanjee, Amin Masaumi","doi":"10.5580/2B6B","DOIUrl":"https://doi.org/10.5580/2B6B","url":null,"abstract":"The aim of the paper is to discuss and evaluate the cost effective use of the suture-button device as an alternative to screw fixation for the use of distal tibiofibular syndesmosis for the purpose of anatomical reduction of posttraumatic disruption in association with ankle fractures. While the medical consumables remain more expensive per unit cost, the relative cost savings to the organisation through a combination of length of stay, procedural cost, and the risk of operative and post operative complications, provides strong evidence that the suture-button technique, if adopted, may result in significant savings to the health care providers while at the same time not increasing the risk profile to the patient- that is, provided that the organisation’s practice is to remove the Diastasis Screw fixation prior to mobilisation. -","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"55 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":"125851362","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":"Necrotizing Fasciitis Of Lower Limb In 4 Patients","authors":"M. Lawson, E. Lawson, A. H. Akué, F. Atadokpede","doi":"10.5580/2a96","DOIUrl":"https://doi.org/10.5580/2a96","url":null,"abstract":"The necrotizing fasciitis of limbs is a toxic severe infection who can compromise functional and vital prognosis. We report 4 cases of the lower limb. It was about 2 men and 2 women with an average age of 65,25 years. We have found a skin injury for all the patients but the germs were isolated for only two of them. The medical treatment consisted in antibiotics and analgesics administration. The surgical one consisted in the wide ablation of necrotic tissues for three patients and an amputation in the thigh for the fourth. Two patients have got a good evolution and received a skin graft. For the last patient, the extension of necrosis have obliged to amputate in the thigh. The necrotizing fasciitis of the lower limb is uncommon and necessitates an emergency medical and surgical treatment.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"220 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":"115590187","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":"Infected Primary Total Knee Arthroplasty Due To Aeromonas Hydrophilia. Case Report And Literature Review.","authors":"Jason Chow, R. Freihaut","doi":"10.5580/2b30","DOIUrl":"https://doi.org/10.5580/2b30","url":null,"abstract":"Purpose: Aeromonas hydrophilia is bacteria found in the water of warmer climate areas and is resistant to empirical antibiotics. Furthermore, it can live in aerobic and anaerobic environments and when it causes a skin or soft tissue infection it can mimic a staphylococcal or streptococcal infection but is much more pathogenic and destructive. In this report a 60 year old male three weeks post elective primary total knee replacement presented to hospital with an infected prosthesis. He had his staples removed two weeks post operatively by the community nurses and a small proximal wound discharge was noted, however at the three week mark post operatively the knee became a swollen, red and painful. He had systemic symptoms and was taken for a washout and poly liner exchange for which Aeromonas hydrophilia was isolated from fluid and soft tissue cultures.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"29 3 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":"123262087","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":"Our experience with epidural steroid injections in the management of low back pain and sciatica","authors":"A. Wani, Masood Habib, M. D. Tantray, Gulzar Ahmad Kuchey, Dara Singh","doi":"10.5580/2a98","DOIUrl":"https://doi.org/10.5580/2a98","url":null,"abstract":"Background: Low back pain (LBP) and sciatica is a common clinical condition worldwide.The initial treatment of Low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a reliable mode of conservative management in many orthopaedic centres of the world. This is a preliminary report of on-going study of the use of epidural steroid injection the management of low back pain cases coming to the orthopaedic department of Government Medical College Jammu. Methods: 150 Patients reporting with low back pain and sciatica not responding to other modes of conservative treatment were prospectively followed over a two year period. The caudal epidural steroid injections were performed, as many as three injections two week apart .The patients were assessed before and after the procedure clinically and the Level of pain, improvement in physical signs and ability to do activities of daily living were noted. Results:150 patients were observed for the duration of 2 years. Average duration of symptoms was for six months. After first epidural steroid injection 80% [120] of patients reported relief within first two weeks. Forty Four (44) patients required two injections and 12 patients required three injections. Twelve (12) patients reported no relief after first injection. The duration between two injections was two to three weeks. Average duration of pain relief was 17days. At the end of three months, good results were seen in 49%, fair in 32% and bad results in 18%. Overall 69% of patients were able to do activities of daily living. Most common complaint of patients after injection was pain at the injection site. No major complications were encountered. Conclusion: Epidural Steroid Injection is a simple, cost effective and minimally invasivemode of treatment of Low Back Pain and sciatica. It provides pain free period to enable the patient for physiotherapy which helps in early recovery.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"8 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":"128070413","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":"Paediatric Shaft Femur Fractures Treated By Early Spica Cast.","authors":"Khalid Muzafa, Tariq A Bhat, Sudesh Sharma, A. Bhat, I. Malik","doi":"10.5580/2a97","DOIUrl":"https://doi.org/10.5580/2a97","url":null,"abstract":"Objective: To find out the advantages of early spica cast as a treatment for isolated femoral shaft fracture in children.Study design: Descriptive studyPlace and duration of study: Department of orthopaedics. Government medical college Jammu.Patients and Methods: 31 patients with a mean age of 3.2 years range (2months -10 years) with closed isolated femoral shaft fractures were included in the study. Patients having compound fractures and those with associated injuries were excluded from the study .spica cast was applied under general anaesthesia after prelimnary skin traction, however immediate spica was given in children less than one year and those who had less than 2cm shortening on telescopy. Follow up was done in OPD after 1,4,6,10,12 weeks with check x-rays taken at every visit.Results: 31 children were included in the study, with a mean age of 3.2 years range (2months to 10 yrs.). Average duration of skin traction was 11.8 days range (0-21) days. Average duration of hospital stay was 13 days range (2-22) days. Average time for fracture union was 5.9 weeks range (4-12) weeks. At final followup 1 patient had LLD of 1.5 cm, 3 had LLD of 1 cm, 6 had LLD of 0.5cm, while 21 children had no LLD. None of the patients had short legged gait. None of the patients needed cast removal for any cast related complication.Conclusion: Traction followed by spica cast is a safe and effective method for closed fracture shaft of femur with very low risk of complication and should be recommended in children in less than 10 years of age.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"278 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":"116555996","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":"Anatomic Approach To The Removal Of A Bent Intramedullary Nail In A Refractured Tibia Minimising Soft Tissue And Bone Injury: A Rare Case Report.","authors":"A. Buunaaim, P. Sekimpi","doi":"10.5580/2b69","DOIUrl":"https://doi.org/10.5580/2b69","url":null,"abstract":"Interlocking intramedullary nailing of closed tibia fractures is the gold standard in current practice. Sometimes patients present with bent nails following another trauma after a fixation. This is somewhat a rare complication posing a difficult challenge of removal with minimal soft tissue and bone injury in developing countries.We report the removal of an angulated tibia nail following a refracture of the tibia and fibula in a 28 year old woman with minimum soft tissue and bone injury.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"64 4 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":"116447500","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":"An Exceptional Tendinous Fibroma Of The Foot","authors":"A. Bousso, E. S. Camara, J. Sané, Amadou Kasse, B. Thiam, M. Sy","doi":"10.5580/2aef","DOIUrl":"https://doi.org/10.5580/2aef","url":null,"abstract":"The authors report a case of exceptional tendinous fibroma of the foot. The tendinous sheath fibroma benign tumours and Recurrence is the most common complication after excision. The complete excision of the tumour permitted to our patient to find a functional foot. INTRODUCTION The fibroma of the sheath of the tendon are rare benign tumours [1], often repeating after excision. We report an exceptional pseudo-tumoral case localized in the foot. CASE REPORT A 29 years old patient was seen for consultation in April 2004 for a painless tumor of the right foot, evolving since more than 6 years. The case story specify that this tumor was a recurrence of local tumor, located on the dorsal side of the foot, whose excision had been made in 1995 and for which no anatomo-pathological examination had not been carried out. With the clinical examination, the tumor was multinodular and interested the areas dorsal and plantar, going up with the anterior face of ankle. It infiltrated and enlarge the first interdigital space. The tumor was firm, adherent in the deep plans, with a healthy skin (fig.1). Figure 1 Figure 1 : Clinical aspects Radiography showed a cortical lysis of the first and second métatarsus (fig. 2). An Exceptional Tendinous Fibroma Of The Foot 2 of 4 Figure 2 Figure 2: radiological aspects A complete and total excision was made under loco-regional anesthesia and without tourniquet. Macroscopically the tumor was multinodular, firm and fibrous consistency (fig. 3). Figure 3 Figure 3 : macroscopic aspect The excision carried the flexor tendons sheathe in the tumor, and the anterior capsule of the articulation of tibia and astragal (fig. 4). Figure 4 Figure 4 : after excision The anatomo-pathological examination showed a tendinous fibroma. In the evolution, we note a cutaneous necrosis of the dorsal and intern side of the foot. At 35 days after excision of the tumour, an ischaemia of the big toe was noted (fig. 5), imposing an amputation of the big toe (fig. 6). The healing of wound was done and unfortunately the patient was lost sight of. Figure 5 Figure 5 : necrosis of big toe An Exceptional Tendinous Fibroma Of The Foot 3 of 4 Figure 6 Figure 6 : after amputation of big toe DISCUSSION Only isolated cases of tendinous fibroma on the level of the foot are found in the literature, we didn’t find a case identical to our. This pathology is more often found on the hand than on the foot [ 2 ] This type of tumor is rare and sits at the extremities in 70% of cases, generally in the hand [ 1 ] Some case of fibroma of the sheath of tendon on the level of the wrist were described [ 3 ]. It should however be distinguished from the tumors with giant cells of the tendinous sheaths, which on the IRM can have the same characteristics, with a weak signal in T1 [ 4 ]. However the histology slices on the diagnosis [ 5 ]. The treatment is surgical with a carcinological excision, with a significant risk of recurrence [1, 2]. In our observation we retained a probable r","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"136 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":"114418014","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":"Coronoid Reconstruction Using the Excised Radial Head in Complex Elbow Trauma: A Surgical Tip","authors":"A. Kanawati, P. Lorentzos, Michael R. Anderson, T. Bell","doi":"10.5580/2b6a","DOIUrl":"https://doi.org/10.5580/2b6a","url":null,"abstract":"Complex elbow trauma and instability are challenging injuries to treat (1). They can range from simple dislocations with purely ligamentous injury, which are usual stable injuries, to complex fracture-dislocations with gross instability (2). We present a case of a rare Monteggia Type IIA fracture with a comminuted radial head and coronoid fracture, and ulnohumeral dislocation, treated with open-reduction and internal fixation of the proximal ulna, radial head replacement, coronoid reconstruction using the excised radial head fragment, and lateral collateral ligament repair. Coronoid reconstruction using the excised radial head has only rarely been described in the orthopaedic literature (3-5), but our case is unique in that adequate stability of the elbow was achieved intraoperatively to permit immediate range of motion of the elbow.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"7 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":"126709071","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 Efficacy of Diclofenac versus Aceclofenac in Post Operative Pain in Lower limb fractures: a Double blind, Randomized Study","authors":"Vipin Sharma, B. Awasthi, S. Rana, Seema Sharma","doi":"10.5580/2a94","DOIUrl":"https://doi.org/10.5580/2a94","url":null,"abstract":"INTRODUCTION: Providing effective postoperative analgesia is a significant challenge in patients undergoing orthopedic surgery. Non steroidal anti-inflammatory group of drugs is used mostly to achieve it. This clinical study was done to investigate efficacy of Injectable Aceclofenac over inj. Diclofenac in patients with severe postoperative pain in lower limb fractures. METHODS: 100 patients (aged 18-60 yr) of lower limb fractures were enrolled as per inclusion criteria . They were randomly assigned to Group A or Group B (50 patients each ) .Severe pain was postoperative pain 7 or >7 on Numerical Rating Scale. For postoperative analgesia, in Group A Inj. Aceclofenac ( 12 hourly) and in Group B Inj. Diclofenac (8 hourly) was given . To abort pain in case of no relief Inj. Tramadol was given. Decrease in Numerical Rating Scale score in either the group and","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"36 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":"114812581","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":"Septic Aspergillus Arthritis In A Non- Immuno-Compromised Patient.","authors":"Sachin Gupta, N. Saini, Rohit Sharma, Y. Saini","doi":"10.5580/2b2e","DOIUrl":"https://doi.org/10.5580/2b2e","url":null,"abstract":"A 35 year old male presented to the Outdoor Department with pain and swelling in the right knee and difficulty to bear weight. Diagnostic investigations and culture of the tissue obtained confirmed septic arthritis due to Aspergillus fumigatus.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"69 6 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":"122688698","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}