Journal of Orthopaedic Diseases and Traumatology最新文献

{"title":"Evaluation of the effect of platelet-rich plasma in early osteoarthritis knee using the oxford knee score: A short-term outcome","authors":"B. Gadagoli, K. Nitish, S. Kubsad, J. Sharath, S. Manjunath, B. Suresha, Harish S. Pai","doi":"10.4103/jodp.jodp_41_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_41_22","url":null,"abstract":"Introduction: Osteoarthritis (OA) is classically described as a noninflammatory, degenerative joint disease most commonly occurring in the elderly population. It is characterized by the deterioration of articular cartilage and by the formation of new bone at joint surfaces and margins. Our study aims at evaluating the efficacy of intra-articular platelet-rich plasma (PRP) injections in Grade I and II OA knees. Materials and Methods: A total of 46 patients with Grade I and II (Kellgren and Lawrence grading) primary OA knee were enrolled for a prospective study. Prior consent was taken for intra-articular injection of PRP from all patients. The study group was evaluated using the Oxford Knee Score (OKS) at 3 months and 6 months. Results: In our study, we found decreasing pain and improvement in activities of daily living with an increase in OKS at 3 and 6 months, follow-up indicating long-term pain relief, improvement in function, and decreased stiffness. Conclusion: Our study shows that intra-articular injection of PRP is safe and effective in treating Grade I and Grade II OA knee. We also observed improvement in daily living activities and a reduction in pain in patients with OA of the knee treated with two doses of PRP. PRP therapy is an easy, affordable, and minimally invasive treatment, which is practical to administer for treating degenerative OA of the knee with minimal associated adverse events.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"42 1","pages":"48 - 52"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70813443","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 outcome of distal femur fractures managed by open reduction and internal fixation with locking compression plate","authors":"S. Babu, N. Velagapudi, S. Gani, Suprabha Surapaneni","doi":"10.4103/jodp.jodp_74_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_74_22","url":null,"abstract":"Background: Distal femur fractures are one of the most frequent fractures seen in high-velocity trauma, and they are associated with substantial morbidity if not treated properly. Stiffness, secondary arthritis, shortening, and disturbance in the activity of daily living can occur as a result of this fracture. Open reduction and internal fixation with locking compression plates (LCPs) is the preferred treatment. The anatomic contoured LCP for the distal femur has been found to provide one of the best outcomes in terms of anatomical reduction with joint congruity, soft-tissue healing, fracture union, and functional ability. This study was done to evaluate the functional outcome of distal femur fractures managed with LCP. Materials and Methods: Thirty patients with distal femur fractures were treated at our institute using LCP were analyzed for the outcome in terms of clinical, radiological union, and functional results. Results: Twenty-one patients were male and nine were female. The average age was 41.55 years with a range of 21–60 years. In 22 patients, cause of fracture was road traffic accidents and in eight were fall at various occasions. Twenty-one patients had right-side fractures. The average time for radiological union was 14.2 weeks. The average flexion of the knee was 107.16°. Functional outcome was assessed using Sanders' Functional Evolution Scale. The outcome was excellent in 30%, good in 40%, fair in 17%, and poor in 13%. Conclusion: Locking compression plating is an excellent internal fixation option for both extra- articular and intra-articular distal femur fractures, and it is particularly helpful in osteoporotic metaphyseal fractures.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"96 - 100"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41448697","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":"“Osteomicrobiology,” “Osteoimmunology,” and “Immunoporosis”- promising frontiers to study bone health and homeostasis","authors":"G. Dharmshaktu","doi":"10.4103/jodp.jodp_80_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_80_22","url":null,"abstract":"","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42359471","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":"Joshi's external stabilization system and K-wire fixation in the management of hand fractures – A prospective comparative study","authors":"V. Singh, Sabeel Ahmad, Gobinder Singh, Sukhmin Singh, Kshitij Gupta, R. Kalia","doi":"10.4103/jodp.jodp_40_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_40_22","url":null,"abstract":"Background: Hand fractures can be treated conservatively or surgically, depending on the severity, location, and type of fracture, as in conservative management chance of nonunion, malunion, and stiffness is more if it is displaced or angulated fracture. Various modes of treatment have been used which include K-wire fixation, mini plates, and external fixator application. A modified form of mini-external fixator devised in India is Joshi's External Stabilization System (JESS). Aim: This prospective study was conducted to compare the functional and radiological outcomes following metacarpal/phalangeal fracture fixed with either K-wire or JESS. Materials and Methods: Forty patients with hand fractures (58 fractures – 18 metacarpal and 40 phalanges) were prospectively studied. Twenty patients underwent K-wire fixation and 20 were fixed with JESS, functional and radiological outcomes were assessed, grip strength using dynamometer, visual analog scale (VAS) score, disabilities of the arm, shoulder, and hand (DASH) score, range of motion (ROM) using the American Society for Surgery of the hand scale, tip pinch strength. Student's t-test, Wilcoxon test, Fisher's exact test, and Chi-squared test were used. Results: At 6 months' follow-up, patients fixed with either of the fixation modality showed statistically significant improvement in different outcome variables such as ROM (P < 0.001), quick DASH score (P < 0.001), VAS score (P < 0.001), tip pinch strength (P < 0.001), and hand grip (P < 0.001). All the fractures united at an average 6 weeks. Functional outcomes were excellent in closed fracture fixed with either JESS or K-wire and good to moderate in open injuries. However, overall comparison between K-wire and JESS, no significant difference in these outcome measures was found. Conclusions: K-wires as well as JESS both provide adequate stability and satisfactory results in fractures of the metacarpal and phalanges. This study could not find the superiority of JESS over traditional K-wire fixation.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"41 - 47"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45319054","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":"Clinical effect of morphological changes in bone tunnels after anterior cruciate ligament reconstruction","authors":"Abhijeet Subhash, Nishant Kashyap, I. Kumar, R. Runu","doi":"10.4103/jodp.jodp_54_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_54_22","url":null,"abstract":"Background: The effect of tunnel widening on clinical outcomes after anterior cruciate ligament (ACL) reconstruction has not been widely investigated. In this study, ACL reconstructions (ACL-Rs) were done by semitendinosus and gracilis tendon grafts and suspensory fixation on the femoral side. The aim was to study tunnel widening at the end of 1 year postoperative and correlate it with clinical outcomes. Materials and Methods: Fifty-five consecutive patients enrolled in the study underwent arthroscopic ACL-R. All were evaluated clinically using the Lysholm knee score and Tegner activity level preoperatively as well as during subsequent follow-up. Femoral and tibial tunnels were visualized with computed tomography scan which was performed at a mean duration of 1 year (range: 10–14 months). Results: The mean femoral tunnel diameter increased significantly (17.1%) from 8.03 ± 0.05 mm postoperatively to 9.04 ± 0.6 mm at 1 year; the tibial tunnel increased significantly (22.55%) from 9.04 ± 0.04 mm to 11.09 ± 0.8 mm at the same duration. No significant correlation could be established between tunnel widening and clinical evaluation scores. In both clinical evaluation scales, the overall improvement was noticed. Conclusions: Within a limit, neither femoral nor tibial tunnel widening affects the clinical outcome at 1 year of follow-up.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"62 - 65"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48473261","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":"Results of intra-articular distal humerus fracture treated with open reduction and internal fixation","authors":"I. Patel, Tarkik K. Amin, V. Makwana, Mrudul M Prajapati, A. Patel, Dhaval R Modi, Shivam Kavi","doi":"10.4103/jodp.jodp_61_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_61_22","url":null,"abstract":"Introduction: Distal humerus fractures are uncommon injuries that account for fewer than 2% of all adult fractures. The complex shape of the elbow joint, the adjacent neurovascular structures, and the soft-tissue envelope combine to make these fractures difficult to treat. The treatment usually consists of determining the injury mechanism and developing a treatment algorithm to regain full mobility of the joint. Materials and Methods: This is a prospective study of 20 cases of distal humerus intra-articular fracture treated by open reduction and internal fixation at our institute during 2017–2019. All the patients in this study were above 18 years of age. These patients were treated with open reduction and internal fixation either by paratricipital approach for fractures with minimal intra-articular comminution or by olecranon osteotomy approach for fractures with more intra-articular comminution. Results: In this study of 20 patients with distal humerus fracture treated with open reduction and internal fixation with ages ranging from 18–65 years, 13 (65%) were male patients and 7 (35%) were female patients. 12 (60%) patients had fracture on the left side, and 8 (40%) patients had fracture on the right side. 11 (55%) patients sustained fractures following the fall from height, and 9 (45%) patients had fracture due to a road traffic accident. Postoperatively, 2 (10%) patients had superficial infection; both patients recovered with antibiotics. In our study, 17 (85%) patients had excellent results, and 3 (15%) patients had a good result according to the Mayo Elbow Performance Score. Conclusion: Distal humerus intra-articular fractures require anatomical reduction of intra-articular components. Vigorous, active physiotherapy is a must for good results. Rigid internal fixation is best accomplished by low-profile anatomical plate fixation, which provides an optimal biomechanical stability; hence, early mobilization can be started, and a good functional outcome can be achieved with a low complication rate.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"3 - 6"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44366874","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":"Joshi's external stabilization system fixator – A mini solution to avert major disabilities in hand injuries","authors":"Vijaya Thadiparthi, Kartheek Chinnapothula, Soma Mecharla, V. Paka, Jameer Shaik, Srivatsava Talluri, Ravi Pilaka","doi":"10.4103/jodp.jodp_71_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_71_22","url":null,"abstract":"Background: Fractures of hand bones are often considered minor injuries and treatment is either delayed or neglected. These fractures are usually treated conservatively that leaves behind a residual functional deficit. Surgical intervention should be considered for open, unstable, multiple, comminuted, or intra-articular fractures. Standard surgical treatment includes the use of K-wire, plate, or mini-screws which are associated with unsatisfactory results and high complication rates. Joint stiffness is a commonly reported complication with most of the existing devices used for hand bone fractures. There is a deficit of data pertaining to the effectiveness of Joshi's External Stabilization System (JESS) in avoiding joint stiffness. Joshi's external fixator is a reliable treatment of phalangeal and metacarpal fractures of the hand. It is an economical, simple, lightweight, and stable contract. Patients and Methods: We report a prospective cohort study of 30 patients of hand bone fracture, 10–60-year age range, treated by JESS. Functional evaluation was made using the Duncan et al. scoring. Results: The results recorded were excellent in 31.58% of cases, good in 42.11% of cases, fair in 21.05%, and poor in 5.26% of patients. Conclusion: JESS ex-fix for hand is a useful construct that allows early mobilization of nearby joints. It can be considered a suitable choice for the management of phalangeal and metacarpal fractures of hand to deliver good functional outcome.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"78 - 83"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44381623","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 outcome of volar variable angle locking compression plate in distal end radius fractures: A retrospective case record analysis","authors":"K. Pawan Kumar, S. Hawaldar, Manjunath Patil","doi":"10.4103/jodp.jodp_72_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_72_22","url":null,"abstract":"Background: Distal end-of-radius fractures are one of the most common fractures seen worldwide, accounting for approximately one-sixth of all fractures. Closed reduction and cast immobilization have been the mainstay of treatment, but recently open reduction and plating with conventional plates have gained importance as they can be of great value in treating distal end radius fractures. This study is based on the latest innovation in this regard, the effectiveness of the volar variable angle locking compression plate in treating distal end radius fractures. Aim and Objectives: To evaluate the functional outcome associated with volar variable angle locking compression plate for distal end radius fractures and also to study the efficacy of the plate in capturing the fracture fragments. Materials and Methods: A retrospective study involving 30 patients with distal end radius fractures who were treated with open reduction and internal fixation using a volar variable angle locking compression plate. Patients admitted between November 2018 and November 2019 were included in this study. Clinical, functional, and radiological outcomes were used to assess the efficacy of the plate. Results were calculated using the Disabilities of the Arm, Shoulder and Hand (DASH) score questionnaire at the end of 1-year postsurgery. Follow-up data for all patients for 1 year were available in our medical records. The extent of the range of motion (ROM) at the wrist joint was noted. Results: 53.3% of patients had excellent results, 36.7% of patients had good results, while 10% of patients had fair results. Almost all the patients had good ROM postoperatively except two patients. One of them developed wrist stiffness and another patient had reduced ROM due to noncompliance to the treating doctor's advice. Conclusion: Our study signifies the importance fragment specific fixation of distal end radius fractures. Patients were mobilized sooner than other accepted modalities of treatment. We conclude that volar variable angle locking compression plates are superior to the other accepted modalities of treatment for distal end radius fractures.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"84 - 89"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45574030","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":"Antibiotic-impregnated cement-coated intramedullary nail in primary fixation of compound fractures of tibial shaft – A comparative study with external fixator in terms of infection control","authors":"R. Verma, Saurabh Sharma, Chetan G Solanki, A. Prasad, MundalapatiGopala Rao, S. Tandon","doi":"10.4103/jodp.jodp_45_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_45_22","url":null,"abstract":"Introduction: Compound tibial shaft fractures are conventionally managed by debridement and primary stabilization by external fixators, followed by definitive fixation after the wound healing; however, many problems such as infection, difficult soft tissue reconstruction, and psychosocial effects encountered. Hence, a technique of antibiotic-impregnated cement-coated intramedullary nailing has been advocated. Aims: The aim of the study is to compare functional and biological outcomes of antibiotic-impregnated cement-coated nail with external fixators. Settings and Design: This was a prospective interventional study. Subjects and Methods: A total of 20 patients with Compound Grade 3A and 3B (Gustilo and Anderson) tibial shaft fractures who met the inclusion and exclusion criteria from January 2020 to June 2021 were selected. Group 1 was operated with antibiotic-impregnated cement-coated nails. Group 2 was operated with external fixators. Clinical and laboratory parameters were used to evaluate infection control. Final follow-up was taken at 6 weeks. Results: The infection rate after nailing was 10% in Group 1 (1/10) and 50% in Group 2 (5/10). Intraoperative time taken for soft tissue reconstruction procedures after primary fixation such as flap cover and skin grafting was comparatively less in Group 1 (mean time – 32 min ± 6.23) compared to Group 2 (51 min ± 5.83). Duration between primary and definite fixation was comparably less in Group 1 (mean duration 5.7 weeks ± 0.45) compared to Group 2 (6.3 weeks ± 1.004). Conclusions: Primary antibiotic-impregnated cement-coated nail is better than external fixator in terms of infection control and providing stability in compound fractures of shaft of tibia.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"53 - 57"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44121961","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":"Bone names and “ization” in orthopedics","authors":"G. Dharmshaktu","doi":"10.4103/jodp.jodp_53_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_53_22","url":null,"abstract":"Various terms in orthopedics are formed using or incorporating the name of native bones and these terms then describe a clinical entity or a procedure. The term thus created, however, may or may not be directly related to the bone associated. There are a few interesting examples of such terms that are encountered in the orthopedic literature. A short recollection of those few notable terms that have the name of a known bone within their terminology is described here for general reading and knowledge.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"115 - 118"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47253120","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}