Journal of Orthopaedic Diseases and Traumatology最新文献

{"title":"Outcome of Open Reduction and Internal Fixation versus Hemiarthroplasty in Proximal Humerus Complex Fractures","authors":"Chanchal Kumar Singh, G. Khare, Prabhanjan Agrawal","doi":"10.4103/jodp.jodp_24_24","DOIUrl":"https://doi.org/10.4103/jodp.jodp_24_24","url":null,"abstract":"\u0000 \u0000 \u0000 This study compares open reduction and internal fixation (ORIF) versus hemiarthroplasty (HA) in the management of complex proximal humerus fractures.\u0000 \u0000 \u0000 \u0000 Neer three- and four-part fracture-dislocations, surgical neck fracture-dislocations with severe articular impaction, and any head-split fracture treated surgically at our institution were studied retrospectively. Constant–Murley scores, Disability of the Arm, Shoulder, and Hand (DASH), American Shoulder and Elbow Surgeons (ASES) Shoulder, and 36-item Short-Form Health Survey (SF-36) scores were obtained and compared between ORIF versus HA treatment.\u0000 \u0000 \u0000 \u0000 Thirty patients were included in the analysis: 15 treated with ORIF were compared to 15 treated with HA with an average follow-up of 60 months. The mean Constant score (72 ± 15 vs. 54 ± 19; P = 0.005), DASH score (13 ± 17 vs. 29 ± 18; P = 0.006), ASES score (87 ± 13 vs. 66 ± 22; P = 0.003), and SF-36 physical composite score (PCS) (50 ± 11 vs. 40 ± 11; P = 0.02) all favored the ORIF group. Because of the potential confounding variable posed by including younger patients, we performed a subgroup analysis of patients older than 50 years. In this group, the Constant, DASH, ASES, and PCS scores remained significantly better in the ORIF group.\u0000 \u0000 \u0000 \u0000 Results of this retrospective study show improved patient-reported outcomes and quality of life scores in patients undergoing ORIF for complex proximal humerus fractures as compared to patients undergoing HA, despite a higher revision rate in the ORIF cohort. When considering patients older than 50 years, outcomes after ORIF were better than HA.\u0000","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"105 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141667038","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":"Functional and Radiological Outcomes of Conservative Treatment of Upper Limb Diaphyseal and Metaphyseal Fractures (Humerus, Radius, and Ulna) with Extension Casting","authors":"Chanchal Kumar Singh, G. Khare, Roshan Samad, Avnish Sah, Prabharanjan Aggarwal","doi":"10.4103/jodp.jodp_23_24","DOIUrl":"https://doi.org/10.4103/jodp.jodp_23_24","url":null,"abstract":"\u0000 \u0000 \u0000 To manage fractures, either operative or nonoperative techniques are required. If the fracture is significantly displaced or angulated, a closed reduction should be done followed by a period of immobilization with casting or splinting. This treatment method forms the basis of nonoperative approach.\u0000 \u0000 \u0000 \u0000 To evaluate the results of management of upper limb diaphysis and metaphyseal fractures (humerus, radius, and ulna) with the application of extension cast in closed fractures in adults to assess the functional acceptance of the procedure and to assess the efficacy and advantage of this treatment.\u0000 \u0000 \u0000 \u0000 The study included upper arm fracture patients. Fixed criterion was discouraged for a definite sample size and it was considered to take up as many cases as possible from trauma center on every Wednesday in the entire period of data collection, i.e., from September 2020 to May 2022. Forty-two newly diagnosed cases of the fracture of upper extremities whose radiological and clinical records were intact were included in the study. Patients in the extension casting group were followed up from 14 to 22 months, with an average of 17.34 ± 2.61 months. The full-length cast was applied from 4 to 6 weeks with a mean of 5 weeks. All casts were converted to the above elbow cast when the fracture became sticky.\u0000 \u0000 \u0000 \u0000 Radiological evidence of a fluffy callus appeared at an average of 35 days and bony union was achieved at a mean of 3.48 ± 0.59 months. In the current study after 1 year of treatment, the mean range of motion of all joints of the affected limb became normal; the mean Visual Analog Scale (VAS) score after 6 weeks was 8; after 3 months, the mean VAS score was 4; and after 6 months, the mean VAS score was 1. Extension cast allows gravity to work all the time, which is especially beneficial for comminuted fractures. This reduces the chances of limb shortening.\u0000","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"120 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666530","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":"Randomized clinical trial to assess functional outcome and complication of surgical neck humerus fracture (two part and three part) treated by percutaneous K-wire fixation and Philos plating","authors":"Akash Bhakare, Ganesh N. Pundkar, R. Baitule, Sanjeev Jaiswal, Sagar Kharat, A. Rokade","doi":"10.4103/jodp.jodp_76_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_76_22","url":null,"abstract":"Background: Proximal humeral fracture, whether caused by trauma or osteoporosis, requires meticulously planned individual treatment. The technique and devices used are determined by the quality of bone and soft tissue, age, and reliability of the patients. The purpose of this study is to evaluate the functional outcomes and complications of surgical neck humerus fractures (two part and three part) treated by percutaneous K-wire fixation and PHILOS plating. Methodology: The study includes patients with proximal neck humerus fractures (two-part and three-part) according to Neer's classification who underwent open reduction and internal fixation with a PHILOS locking plate and percutaneous K-wire fixation. Functional outcomes and complications were evaluated by the Shoulder Constant score (SCS). Patients were followed up at 1, 3, and 6 month intervals until fracture union. In this study, a total of 76 patients were chosen and divided into two groups, i.e., Group A and Group B, each comprising 38 patients. Patients of Group A were treated with ORIF PHILOS plating and patients of Group B were treated with closed reduction and internal fixation (CRIF) percutaneous K-wire fixation. Results: ORIF PHILOS plating was used on 20 (26%) of patients who had an excellent SCS. 10 (13%) patients exhibited a good grade, 5 (6%) patients had a fair grade, and the remaining 3 (4%) patients displayed a poor grade. In Group B, 12 (16%) of patients treated with closed reduction with K-wire fixation had excellent grades, 7 (9%) patients had good grades, 16 (21%) received fair grades, and the remaining 3 (4%) received poor grades. After comparing both treatments, a P value was found to be 0.0403, which shows Group A was more efficient than Group B. Conclusion: The results of our study concluded that, as compared to ORIFPHILOS plating treatment with the CRIF K-wire fixation treatment has poor functional outcomes and a high failure rate. In addition, the surgical treatment of proximal neck humerus fractures (two part and three part) in both groups showed that the PHILOS plating provides an excellent way to achieve the goal, including time of union, fewer complications, and good functional outcomes as compared to percutaneous K-wire.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"142 - 148"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41633963","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":"Medical conferences and medical practice","authors":"R. Runu","doi":"10.4103/jodp.jodp_45_23","DOIUrl":"https://doi.org/10.4103/jodp.jodp_45_23","url":null,"abstract":"","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"121 - 123"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48647433","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":"Percutaneous hypodermic needling technique versus monofilament suture repair of partial finger amputation injuries – A comparative study","authors":"S. Baliga, U. Pradhan, Nikhil Sharma, Kushagra Sinha, JowasDayal Rai","doi":"10.4103/jodp.jodp_66_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_66_22","url":null,"abstract":"Context: Partial finger amputations are commonly encountered in the emergency room and are often inadequately treated. Aims: The aim of this study was to compare and evaluate the results of wound debridement, followed by primary wound closure with multiple percutaneous hypodermic needles versus closure with monofilament nonabsorbable sutures. Settings and Design: Comparative prospective study on the management of partial amputations of fingers was conducted in patients between 18 and 60 years at a tertiary care center. Subjects and Methods: We compared two different techniques of management of fingertip injuries. Group A comprised percutaneous hypodermic needling. Group B included suture technique using monofilament nonabsorbable suture. Patients not willing to participate, crush injuries, injuries involving more than 80% of digit circumference and digital arterial injury, complete amputation, and finger injuries with polytrauma were excluded from the study. Statistical Analysis Used: Data were analyzed using SPSS version 21. Results: The right hand (dominant side) was involved more commonly in both groups. Secondary procedures, infection rate, healing time, and the cost of the procedure from primary procedure to complete healing of the digit/s were all higher in Group B. Final appearance of the digit(s) based on skin color was better in Group A. Conclusion: Percutaneous hypodermic needling technique is a simple, novel technique which provides a better result in comparison to suture technique in terms of the requirement for secondary procedures, wound healing time, infection rate, cost of the overall procedure, and the final appearance of the digit on complete healing.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"186 - 189"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47422039","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 prospective and retrospective study of the outcome of high tibial osteotomy in osteoarthritis of the knee with varus deformity","authors":"Kunal Mondal, Prashant Kumar, Swarnava Dattagupta, D. Jha, P. Pujari","doi":"10.4103/jodp.jodp_4_23","DOIUrl":"https://doi.org/10.4103/jodp.jodp_4_23","url":null,"abstract":"Introduction: Knee osteoarthritis (OA) degenerative condition causes progressive wear in the articular cartilage and rises pressure over the medial compartment of the knee joint which will end up as a varus deformity. High tibial osteotomy (HOT) is one of the surgical managements in treatment of OA. The goal of the treatment is to relieve medial compartment knee pain and slowdown the arthritic progression. Materials and Methods: This prospective observational study was done on 20 patients of all ages and both genders having medial compartment OA with varus deformity of all grades over 24-month duration. Functional evaluation was done by the Knee Society Score, functional score, and the Lysholm score, whereas radiological evaluation was done by calculating various angles in orthoroentgenogram. Results: All the function scores hold high statistical significance. Changes in hip knee axis (HKA), medial proximal tibial angle, and tibial joint angle were statistically significant. All osteotomy sites consolidated in 6 months with not a single case of nonunion. Conclusion: HOT is an effective technique and has excellent functional and radiological outcomes with minimal complications in the management of OA. Appropriate patient selection, proper osteotomy type, and precise surgical techniques are essential for the success of HOT.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"179 - 182"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41514746","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":"Management of Buerger's disease (thromboangiitis obliterans) of the lower limb by horizontal distraction and corticotomy by Ilizarov's technique","authors":"K. Rohit, V. Verma","doi":"10.4103/jodp.jodp_104_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_104_22","url":null,"abstract":"Introduction: Thromboangiitis obliterans (TAO), also known as Buerger's disease, is a disease of unknown etiology affecting small- and medium-sized blood vessels, mainly seen in heavy smokers. The characteristic features of this disease are distal ischemia, with patients having claudication, rest pain, and toe ulcers. The proper management of TAO is still a challenging problem. Various medical and surgical treatments have been tried with a variable success. Since it is a disease characterized by chronic ischemia, achieving neoangiogenesis could have a beneficial effect. Ilizarov has shown that corticotomy and distraction of bony fragments can increase the blood supply to the entire limb. TAO can be managed using this principle of distraction osteogenesis to induce neoangiogenesis. We conducted this study to evaluate the clinical outcomes of longitudinal tibial corticotomy and horizontal distraction with Ilizarov's fixator in Buerger's disease of the lower limb. Materials and Methods: Ten patients with clinically and radiologically proven Buerger's disease admitted to our hospital between 2019 and 2021 who had failed the conservative pharmacological modalities of treatment were included. A lateral tibial corticotomy and distraction was performed by the use of olive wires and two-ring frame with horizontal distraction mechanism. Lateral distraction was started after 10 days at the rate of 0.25 mm 6 h for 25 days to achieve a distraction of 2.5 cm. The frame was removed after consolidation of regenerate. Results: Of the 10 cases, eight patients became pain free, while one had a partial relief of pain and one patient worsened on treatment and underwent below-knee amputation. Three patients had at least one episode of pin site infection which improved with oral antibiotics and dressings. One patient had delayed consolidation of regenerate. The claudication distance improved at each follow-up for all but one patient. Conclusion: Neoangiogenesis by corticotomy and distraction offers a relatively simple and cost-effective surgical option to salvage ischemic limbs from amputations and provide pain relief, ischemic ulcer healing, and improved claudication distance, thus improving the quality of life.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"164 - 168"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49554154","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":"Use of sanitary napkin for dressing in hip surgery: A cost-effective measure","authors":"Shreyanshi Shukla, A. Patil, G. Goutham, K. Harish","doi":"10.4103/jodp.jodp_6_23","DOIUrl":"https://doi.org/10.4103/jodp.jodp_6_23","url":null,"abstract":"Introduction: One of the important factors that promote wound site dryness is the dressing material used. Sanitary napkins have been tried in the past for dressing of wounds in the postoperative period to effectively absorb fluids and secretions. This study was conducted to compare the effectiveness of sterile sanitary napkins when used as dressing in the immediate postoperative period for hip region surgeries in terms of efficacy and cost effectiveness. Methodology: Adult patients aged 18 and above (male and female) undergoing surgeries in the hip region were included in the study and grouped into three groups based on the type of dressing applied in the postoperative period. Results: The total cost of dressings was found to be the highest (>250 rupees) in group receiving commercial dressing compared to the most economical in Group A (sanitary napkins). The presence of soakage was found to be the highest in group getting conventional dressing. Conclusion: Sanitary napkin is a novel innovative option for dressing, being very economical, readily available, easily sterilizable, and can be used in hospitals in remote areas too.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"183 - 185"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43473185","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":"Percutaneous transpedicular vertebroplasty using calcium phosphate cement for osteoporotic vertebral fractures: A prospective study of functional outcomes","authors":"Swapnil Priyadarshi, V. Singhal, Sameer Gupta","doi":"10.4103/jodp.jodp_99_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_99_22","url":null,"abstract":"Context: Vertebral compression fractures are the most common osteoporotic fracture in old age group causing incapacitating pain and producing significant disability. Approximately one-third of these patients do not respond to traditional conservative treatments. Percutaneous vertebroplasty (PV) is a minimally invasive treatment option being increasingly used and traditionally being done using polymethyl methacrylate (PMMA), but it has some disadvantages. Calcium phosphate cement (CPC) is a new entity with many benefits over PMMA such as it being biodegradable, little or no heat generation during polymerization, and remodeling into healthy bone. Aims: The aim of this study was to analyze the functional outcome, restoration of wedge angle, and vertebral height after vertebroplasty in osteoporotic vertebral wedge compression fractures. Subjects and Methods: In our study, a total of 21 symptomatic patients (between 55 and 80 years of age), refractory to conservative treatment, having kyphosis and vertebral wedge collapse were included in the study. Pre- and postoperative comparisons were done clinically (Oswestry Disability Index and Visual Analog Scale [VAS] score) and radiologically. Statistical Analysis Used: SPSS software version 22.0 was used for statistical analysis. Results: Preoperatively in all patients, Oswestry disability score was >60% and VAS score >7 indicating severe disability. On subsequent follow-ups at 15 days, 1 month, 3 months, 6 months, and 9 months, we found a significantly reduced VAS score (<2) and Oswestry disability score (<20%) in 19/21 (90%) patients indicating very minimal residual disability in majority of the patients. Conclusions: Our study shows that PV using CPC is a promising new procedure with the benefits of quick improvement in mobility, decreased pain-related doctor visits, decreased nonsteroidal anti-inflammatory drugs usage postoperatively, and overall increased quality of life.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"607 ","pages":"157 - 163"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41280689","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":"Demographic evaluation of prevalence of vitamin D deficiency in a district of central Haryana","authors":"Kanika Siwach, Ritu Baloda, R. Kapoor, Pooja Sauhta, Karan Siwach","doi":"10.4103/jodp.jodp_3_23","DOIUrl":"https://doi.org/10.4103/jodp.jodp_3_23","url":null,"abstract":"Background: Many studies show a high prevalence of Vitamin D deficiency across various populations the world over. This cross-sectional study was carried out to assess the prevalence of Vitamin D deficiency in a district located in central Haryana. Aim: The aim is to study the prevalence of Vitamin D deficiency in a district of central Haryana across various population characteristics such as gender, education, locality, occupation, and dietary habits. Materials and Methods: Healthy volunteers (n = 300) of either sex were enrolled and their fasting plasma samples were tested for 25-hydroxy Vitamin D (25 [OH] D) levels. Data were compiled as percentages and means across different population characteristics. Statistical analysis was done using Chi-square test and Fisher's exact test. Results: A high overall prevalence (90%) of Vitamin D deficiency was observed in the study subjects. There was a significant difference in the prevalence of Vitamin D insufficiency between rural and urban subjects (P < 0.05) and among the subjects pursuing different occupations (P < 0.05). Conclusions: There seems to have a high prevalence of Vitamin D deficiency in the population of a small district located in central Haryana. Lower prevalence is displayed by those subjects who have greater opportunities for sunlight exposure, such as rural individuals, farmers, and housewives.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"174 - 178"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49121376","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}