Journal of Orthopaedic Diseases and Traumatology最新文献

{"title":"Functional outcome of intramedullary interlocking nailing versus minimally invasive percutaneous plate osteosynthesis in distal tibia fracture","authors":"R. Jose, K. Vivek, N. Bava, M. Moosa","doi":"10.4103/jodp.jodp_56_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_56_22","url":null,"abstract":"Aims: The aim of the study was to compare the functional outcome of patients with extra-articular distal one-third tibia fracture, treated with intramedullary interlocking nailing (IMILN) with those treated by minimally invasive percutaneous plate osteosynthesis (MIPPO). Settings and Design: This is a prospective study and nonprobability sampling technique. Subjects and Methods: In this study, 60 patients with distal third tibia fractures of AO classification Type 43 A1, A2, and A3 were selected, in which 30 of them were treated with IMILN and the remaining 30 were managed with MIPPO. The patients were regularly followed up, and functional outcome was measured at 4, 8, 12, and 24 weeks using a modified Klemm and Borner scoring system. Statistical Analysis Used: The data collected were subjected to data entry in MS Excel. The data were analyzed using SPSS version 20.0 using Chi-square test. Results: In our prospective study, the functional outcome of MIPPO has shown excellent outcome in 13 patients (43.3%) and good outcome in 13 patients (43.3%), fair outcome in three patients (10%), and only one patient had poor outcome (3.3%). However, in the IMILN group, excellent outcome was seen in 7 patients (23.3%) and good outcome in 15 patients (50%), fair in five patients (16.7%), and poor outcome in 3 patients (10%). Alignment of fracture was anatomical in 13 patients of MIPPO and 7 patients of IMILN. Complications such as nonunion and malunion were more in the IMILN group than MIPPO, whereas superficial wound infection and delayed union were comparable in both. Conclusions: Distal tibial fractures can be effectively treated by both intramedullary nailing and MIPPO with minimal soft tissue injury providing good-to-excellent results, whereas in our present study, we observed that MIPPO had excellent functional outcome when compared to IMILN. Although interlocking intramedullary nailing allows early weight-bearing in patients, malunion and nonunion were more frequently seen, which affects the functional outcome. Therefore, we recommend that MIPPO is considered a very effective modality of treatment in distal third tibia fractures.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"66 - 72"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41549500","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":"Modified tension band wiring of transverse patella fractures through cannulated cancellous screws: An analysis of functional outcomes and complications","authors":"A. Gumaste, Prasanna Baindoor, S. Jeevannavar, K. Shenoy, Ranjan Gurudev","doi":"10.4103/jodp.jodp_58_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_58_22","url":null,"abstract":"Introduction: The management of transverse patella fractures with modified tension band wiring using Kirschner wires, though routinely used is associated with complications such as implant loosening, wire migration, and infection. We hypothesized that using cannulated cancellous screws with tension band wiring through the screws will overcome these complications. Objective: The objective was to assess the functional and radiological outcomes following patellar fracture fixation with modified tension band wiring through cannulated cancellous screws. Materials and Methods: Twenty-four patients with transverse patella fractures fixed with modified tension band wiring through cannulated cancellous screws were included in this retrospective study. Surgical technique involved a vertical incision over the knee, reduction of the fracture initial fixation with Kirschner wires, replaced with cannulated cancellous screws. A stainless steel wire was passed through the lumen of the screws, and tension band was applied. Follow-up at 3, 6, and 12 months was done to assess the radiological union. Functional outcome was assessed with the Bostman scoring. Results: The study included 13 male and 11 female patients with an average age of 39.6 years, with 8 three-part and 16 two-part fractures. The average follow-up was 14 months, and the average time to union was 8.5 weeks. Twelve patients had an excellent, 11 patients a good, and one patient an unsatisfactory functional outcome as per the Bostman score. No infection or implant loosening was observed. Conclusion: The technique of patella fracture fixation with modified tension band through cannulated cancellous screws offers an enhanced stability, minimizing the complications such as implant migration, prominent implant, and refracture. As such, we recommend this technique in all transverse patella fractures.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"73 - 77"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48364516","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 pediatric unstable diaphyseal both-bone forearm fractures (AO 22-D4 and AO 22-D5), A comparison between the results of intramedullary nailing using titanium elastic nail systems versus K-wires in the rural Indian children: A prospective study","authors":"S. Singh, Prashant Singh, Jitesh Arora, S. Gill, L. Mishra, Pulkesh Singh","doi":"10.4103/jodp.jodp_33_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_33_22","url":null,"abstract":"Background: Forearm fractures constitute the largest group of injuries in the pediatric age group. When treating these injuries, we seek to achieve a complete union while also restoring the appropriate axis and arm length, which determine the upper limb's normal function. Intramedullary fixation (IM fixation) is becoming an increasingly common choice for fracture fixation. Aim: The aim of this study was to compare the functional and radiological results of IM nailing by Titanium Elastic Nail Systems (TENS) versus K-wire in the pediatric displaced diaphyseal both-bone forearm fracture. Settings and Design: This prospective comparative study was conducted in the department of orthopedics at a rural tertiary care center in North India from April 2016 to November 2019. Materials and Methods: In total, 44 children between the age of 8 and 12 years with displaced diaphyseal fracture of both-bone forearm either closed or open were available for follow-up and included in the study. They were divided into two groups randomly. Reduction was done under general anesthesia and fluoroscopic images. First, a close reduction was tried, and if it failed, open reduction was tried. IM fixation was done subsequently either by TENS (Group-A, n = 23) or K-wire (Group-B, n = 21). Patients were followed up for 12 months. Functional and radiological outcomes and complications were compared between both groups. Conclusions: IM nailing is a safe, effective, and valid technique in treating displaced both-bone forearm fractures in the pediatric age group. Both TENS and K-wire are equivalent in terms of clinical results, fracture union time, surgical time, or complication rates.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"20 - 26"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41920057","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":"Type of microbial flora in patients with bone and joint infections: Our experience at a tertiary care center of Eastern India","authors":"Anupama Singh, R. Singh, Bimlesh Bimal, R. Runu","doi":"10.4103/jodp.jodp_46_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_46_22","url":null,"abstract":"Introduction: Bone and joint infections are very common in eastern India. Due to the lack of authentic data on the type of bacteriology in our region, this study was planned. Materials and Methods: After ethical clearance, retrospective data of 2 years from 2019 to 2021 were collected. Out of 115 patients, 77 patients were included in the study whereas 38 were excluded due to nonbacterial infections and incomplete data. Results: The average age of patients was 21.14 years. Pediatric patients were 58.66%. The common clinical condition was chronic osteomyelitis, followed by septic arthritis. The most common bone affected was femur, followed by tibia. The most common organism noted was methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative Staphylococcus aureus (CNSA). Gram-negative infections were also noted. Conclusions: Eastern India has a high incidence of bone and joint infection. MRSA followed by CNSA is the most common isolate affecting large bones such as femur and tibia.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"58 - 61"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43030690","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":"Influence of risk factors for hip injuries and effect of co-morbidities on postoperative complications and outcome after hip fracture surgery in the elderly","authors":"Khazi Asif Hussain, Aluka Sundeep Kund Reddy, Mayani Raju, Chandrashekhar Patnala","doi":"10.4103/jodp.jodp_38_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_38_22","url":null,"abstract":"Background: Older adults who sustain hip fractures usually have multiple comorbidities that may impact their treatment and outcome. This study aims to analyze the risk factors that contribute to falls in elders and analyze the effect of comorbidities on the outcome and the treatment decision-making in elderly patients with hip fractures. Materials and Methods: This cohort study was conducted on patients with hip fractures. We prospectively analyzed 140 cases of geriatric hip fractures who had undergone surgery. The Charlson Comorbidity Index (CCI) and American Society of Anesthesiologists (ASA) of each geriatric hip fracture patient were calculated based on data retrieved from the medical records. Clinical assessment was assessed using a modified Harris hip score during each visit. Results: The mean age of patients was 72.21 ± 12.2 years. The mean CCI was 1.02 ± 0.3, and ASA was 2.0 ± 0.53, and both were significantly associated with time-to-surgery (P < 0.001) and surgical treatment (P < 0.001). The length of hospital stay, duration of postoperative intensive care, and hospital expenses were associated with both CCI (P = 0.037) and ASA (P = 0.002). Greater the CCI and ASA, more chances of developing postoperative complications (χ2 = 15.724, P = 0.001). Delirium is the most common postoperative complication 15.7%, and pulmonary infection 11.4% is the most lethal complication. Conclusions: Patients with high CCI, ASA grading, and revision surgery are at high risk of developing postoperative complications, morbidity, and mortality. With efficient medical co-management of these patients, orthogeriatric care offers the best chance for a successful outcome.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"32 - 40"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43144171","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 study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st Year","authors":"T. Channappa, M. Jayaram, H. Shivakumar, C. Karan","doi":"10.4103/jodp.jodp_75_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_75_22","url":null,"abstract":"Background: Fractures of hip are one of the most common injuries sustained by the elderly. They occur predominantly in patients aged over 60 years. For many, this fracture is often a terminal event resulting in death due to comorbidities and cardiac, pulmonary, or renal complications. The incidence of morbidity and mortality after hip fractures was evaluated in this study. Methodology: We included 102 patients who were divided into two groups; 54 patients with fracture neck treated by hemiarthroplasty as arthroplasty group, and 48 with intertrochanteric fracture treated by internal fixation with proximal femoral nail or with dynamic hip screw as internal fixation (IF) group were followed up for 1 year. The preexisting medical comorbidities, intraoperative findings, and postoperative complications were documented. The final functional results were evaluated using Merle d'Aubigne score at the end of 1 year. Results: This is a descriptive cohort study from the local population. The mean age was 74.5 years. We noted a total mortality of 17.6%. Diabetes mellitus and anemia were the most common comorbidities. Binary logistic regression analysis was performed to predict the survival status among the study patients. We found that male patients with anemia to be most associated with mortality. Excellent results were noted in 39% of cases of arthroplasty and 60% of cases of IF. Morbidity experienced was greater in extracapsular fracture type, who were less mobile during the postoperative period. Conclusion: Hip fractures are on a rising trend in the elderly population, especially in the Indian subcontinent. Mortality and morbidity in elderly patients in the 1st year are significant. Age and preexisting comorbidities contribute to morbidity. Morbidity leads to loss of independence and requirement of social support. The goal of treatment in fractures of the hip must be the restoration of the patient to their preinjury status at the earliest possible time.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"101 - 105"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46684244","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":"Open anatomical dual tunnel reconstruction of acromiao-clavicular joint using autogenous semitendinosus graft","authors":"Sai Sathwik Matta, Anil Nathi, Sivananda Pathri, B. Sista, V. Paka, Jameer Shaik, Chandana Pathri","doi":"10.4103/jodp.jodp_73_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_73_22","url":null,"abstract":"Background: The primary constraint to the dislocation of an acromioclavicular (AC) joint is its ligaments. They prevent vertical and horizontal translations in the joint. Reconstruction of these ligaments is of prime importance for restoring the AC joint. There is uncertainty regarding the surgical treatment protocol for Rockwood's type III injury. Patients and Methods: We report a prospective cohort study on 20 patients aged between 15 and 45 years, presenting with Rockwood type III or higher rank of AC joint dislocation for open double-tunnel anatomical reconstruction of AC joint using autogenous semitendinosus graft. Patients were evaluated at the end of follow-up of 2 years using the Constant–Murley outcome scoring system. Results: Clinical and radiological evaluation performed revealed excellent results in 15, good in three, and fair in two, with no poor results recorded. Conclusion: Open double-tunnel reconstruction with semitendinosus graft is a vital technique for Rockwood type III or higher grade of AC joint dislocation management to deliver a pain-free shoulder with good strength, well-retained range of movements, and near normal regain of activities.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"90 - 95"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48479288","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":"Causes of revision after total hip arthroplasty in patients undergoing revision total hip arthroplasty younger than 50 years of age","authors":"Hemant H. Mathur, Kashyap L Zala, Jimmy Chokshi","doi":"10.4103/jodp.jodp_100_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_100_22","url":null,"abstract":"Background and Aims: Young patients undergoing revision total hip arthroplasty (THA) have different indications and causes of failure of THA. This retrospective cohort study examines the causes of failure of THA in a patient younger than 50 years. Subjects and Methods: Clinical and demographic data of 146 revision THA (130 patients) were gathered from case records of patients who underwent revision THA at our institute between January 1, 2018, and December 31, 2021. Fifty-two hips (46 patients) were younger than 50 years at the time of revision. Baseline characteristics, cause for revision, implants revised, and duration of survival were noted. Statistical Analysis: Chi-squared test was implemented to find a correlation, and P < 0.05 was considered statistically significant. Results: We had 52 hips, 46 patients (28 females), and the mean age at primary THA was 33.9 years, the mean age at revision THA was 44.5 years, and the mean survival of implants was 10.6 years. The most common diagnosis for primary THA was avascular necrosis of the femoral head (21 hips, 40.38%), followed by inflammatory arthritis. The most common cause of failure was aseptic loosening (27 hips, 51.92%). As compared to the overall population undergoing revision THA (60/146 hips, 41.09%), patients younger than 50 years having more frequency of aseptic loosening as a cause of failure of THA and less frequency of periprosthetic joint infection, instability, and fracture; but statistically significant difference was not found (P = 0.38). No correlation was found between the type of implants used (P = 0.84) and diagnosis at index THA (P = 0.78), with the cause of failure of THA. Conclusions: Aseptic loosening of THA is the most common mode of failure in patients younger than 50 years.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"111 - 114"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42695794","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":"Orthogonal dual plating: A reliable choice for complex distal humerus fractures","authors":"Anil Nathi, Gopal M. Shinde, B. Sista, Sivananda Pathri, V. Paka, Jameer Shaik, Pramoda Nakka, Chandana Pathri","doi":"10.4103/jodp.jodp_30_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_30_22","url":null,"abstract":"Background: Distal humerus fractures are difficult to manage and perfect intra-articular reduction is a prerequisite for a successful outcome. Dual plating is the norm, and this may be in the form of orthogonal or parallel plating. Controversy regarding the choice between these modes of plating is a topic of debate. Aims and Objectives: To show that perpendicular or orthogonal plating is an adequate mode of treatment option to handle all patterns of distal humerus fractures compared to later-introduced parallel plating. Patients and Methods: We, here, report a case series of 30 cases of AO type C distal humerus fractures, in patients aged between 20 and 60 years, managed by orthogonal plating. All patients were operated between 2015 and 2019 by a single surgeon at our institute. Results: A total of 22 (73.33%) patients showed good or excellent results. Six (20%) patients had fair results. Two (6.66%) patients had poor results. About 86% of the total patients were satisfied with their outcomes. Conclusion: Orthogonal plating offers a satisfactory outcome in AO type C distal humerus fracture with reasonable functional output through early mobilization due to the inherent stability offered by the construct.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"13 - 19"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42622668","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":"District residency program: seeking opportunity in the disruption","authors":"G. Dharmshaktu","doi":"10.4103/jodp.jodp_77_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_77_22","url":null,"abstract":"","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"119 - 119"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70813531","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}