Journal of Orthopaedic Diseases and Traumatology最新文献

{"title":"Prognostic factors to predict the progression of adolescent idiopathic scoliosis: A narrative review","authors":"Amrit Gantaguru, N. Marathe, Alhad Mulkalwar, A. Mallepally","doi":"10.4103/jodp.jodp_36_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_36_22","url":null,"abstract":"Scoliosis has always presented a challenge to the clinicians both at the stage of decision-making and at the stage of correcting the same. Predicting curve progression is important as it helps in selecting the patients who may benefit from an earlier intervention. Patients can be treated either by brace application or by operative intervention depending on the magnitude of curve and potential of curve progression. In this review, we have summarized the past and present parameters used to predict scoliosis progression with a brief introduction about the future trend in this respect. We identified and reviewed a total of 46 relevant papers written in English language utilizing PubMed, Google Scholar, and Scopus search engines. Many clinicians had come up with various radiological methods such as Risser grading, Tanner–Whitehouse staging (TW2-RUS and TW3) methods, Greulich–Pyle method, Sauvegrain method using only olecranon process radiographs and various clinical methods such as age of menarche and Tanner staging for sexual maturity. Apart from these, recently, various genetic factors such as single-nucleotide polymorphism of various genes, platelet calmodulin, peripheral blood mononuclear cell, impairment in melatonin signaling, DNA-based test called “ScoliScore” and hormones such as serum ghrelin and leptin have been investigated. Changes in brainstem vestibular function and alteration in electrical activities of paraspinal muscles are also studied to predict the curve progression. The two most important dilemmas faced by clinicians while approaching patients with scoliosis are the identification of patients requiring intervention and the right time to intervene in the selected patients. The goal of scoliosis treatment is to halt the progression. Predicting the growth spurt in an individual patient will guide the appropriate timing of intervention which can prevent complications associated with adolescent idiopathic scoliosis so that they can lead a better quality of life.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"117 - 122"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48190367","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 series of transforaminal epidural steroid injections in acute lumbar disc herniation with unilateral radiculopathy","authors":"Jay Turakhiya, Himanshu Parmar, Kushal Zala, N. Maru, Anant Prajapati","doi":"10.4103/jodp.jodp_18_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_18_22","url":null,"abstract":"Objective: To evaluate functional outcomes of patients suffering from unilateral lower limb radiculopathy due to lumbar disc herniation conservatively treated with transforaminal epidural steroid injection (TFESI). Materials and Methods: It is a prospective study of 100 patients. We correlated clinical findings with magnetic resonance imaging. The patients are treated with dexamethasone injection through transforaminal epidural space under C-ARM guidance using Kambin's triangle approach with follow-up at 3 weeks, 6 weeks, 9 weeks, 12 weeks, and 24 weeks. Assessment of functional outcomes is done by visual analog scale (VAS) and modified Oswestry disability index (ODI). Results: Eighty-eight percent of patients significantly improved their radicular pain, according to the VAS scoring system and modified ODI. The mean modified ODI score of preinjection was found to be 64.18; it was reduced to 33.9 at 3 weeks, 30.82 at 6 weeks, 24.04 at 9 weeks, 22.04 at 12 weeks, and 19.38 at 6 months. The t = 18.49 and the P < 0.00001. Preinjection mean VAS was 8, 3.98 at 3 weeks, 3.28 at 6 weeks, 3.04 at 9 weeks, 2.72 at 12 weeks, and reduced to 2.14 at 24 weeks. The t = 19.83 and the P < 0.00001. There were no complications seen during our study. Conclusion: Our study justifies that unilateral lower limb radiculopathy due to lumbar disc herniation can be well managed by TFESI without any complication. It is very less invasive technique, safe, and effective for pain relief.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"162 - 166"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49631602","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":"Surgical result of distal humerus fractures in adults: A consecutive series of 55 cases and review of the literature","authors":"Omar Lazrek, M. Krimech, M. Boufettal, B. Allah, M. Lamrani, M. Kharmaz, M. Berrada","doi":"10.4103/jodp.jodp_1_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_1_22","url":null,"abstract":"Introduction: Fractures of the humeral pallet are more and more frequent; this is linked to the increase in road accidents and their violence. Methods: We have collected in our archives 55 cases of fracture of the humeral pallet at the Traumatology–Orthopedics Department of the IBN SINA CHU in RABAT from January 2015 to December 2019. Results: They mainly affect young adults with a clear predominance of men (73%). The trauma most often occurs by direct mechanism (65%). The main cause of these fractures is represented by road accidents (56%), followed by assaults and falls. Supra and intercondylar fractures are the most described anatomical form (65%). The treatment is surgical in all cases, with predominance of the posterior approach. Discussion: Considering the comminution often encountered, only a solid and stable osteosynthesis allows the anatomical restoration of the elbow, by adapting the indications to the types of fractures and by using a more codified technique, to allow an early rehabilitation, better guarantee of recovery of elbow function. The LECESTRE premolded plate is the most used in supra and intercondylar fractures; it seems to be a real progress in osteosynthesis (31.03% good results and 51.72% average results) for this type of fracture. Conclusion: The management of humeral paddle fractures is based on perfect anatomical reduction, by a solid assembly which must allow early rehabilitation ensuring good functionality. Level of Evidence: IV-retrospective study.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"123 - 127"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42417158","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":"Postgraduate orthopedic training – Where are we today?","authors":"R. Runu","doi":"10.4103/jodp.jodp_70_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_70_22","url":null,"abstract":"","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"115 - 116"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49335059","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 assessment of surgically managed ankle fractures","authors":"K. K. Kiran Kumar, C. Lalithmohan, K. Pradeep, P. Chandrashekhar","doi":"10.4103/jodp.jodp_16_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_16_22","url":null,"abstract":"Background: Civilization has made man more prone to injuries. Ankle fractures are one of the most common injuries treated by orthopedic surgeons. Aims and Objectives: The aim of the study is to assess the functional outcome in surgically managed ankle fractures. Materials and Methods: Sixty patients were included in this study with ankle fractures that were surgically treated at NIMS Hospital, Hyderabad. Observations: The study had a male preponderance of 66.6%, with road traffic accidents being the major cause of injury. Supination-external rotation was the most common mechanism of injury and Weber's type B fractures were the most common type of fracture. The associated fractures and injuries noted and the comorbidities seen in these patients have been enumerated. Open reduction and internal fixation under image intensifier control was done in all patients. Postoperatively, patients were immobilized with a plaster splint for a period of 3–6 weeks and were followed up with full weight-bearing walking and active range of movement of ankle exercises. The final outcome as per the Weber's radiological criteria was 66.6% good, 26.6% fair, and 6.8% poor result which showed a good correlation between the immediate postoperative radiological score and the final radiological outcome. The factors that affected the final poor outcome were late presentation, patients with fracture subluxation, post massaging, the presence of long-standing and uncontrolled diabetes, and old age. Conclusion: The present study suggests that anatomical reduction of the ankle fracture and restoration of the joint congruity at the earliest will give a good functional outcome. The postoperative immobilization in a plaster slab up to 3–6 weeks (depending on associated injuries, fracture severity, bone quality, quality of fixation, and patient compliance) does not affect the final outcome with respect to achieving the ankle and subtalar range of movements as most of the patients had achieved full range of motion at the end of 12 weeks.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"157 - 161"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42714459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The not so familiar silent joint killer: Ochronosis – A case report with review of literature","authors":"G. Bandi, R. Randhi, Jameer Shaik, V. Paka, Raviteja S. Seerapu","doi":"10.4103/jodp.jodp_32_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_32_22","url":null,"abstract":"Ochronosis is rarely considered a cause for knee synovitis due to its rare occurrence. It starts affecting the joint from the third decade onward causing premature joint damage. The damaged joint and surrounding tissue present as blackish decolorated mass and can surprise the operating surgeon, unless diagnosed beforehand. Prior diagnosis helps both the anesthetist and operating surgeon to better handle the associated complications of ochronosis during surgery. Diagnosis is essentially based on prior knowledge of the disease and its markers. Here, we report a rare case of ochronosis of the knee that was treated elsewhere previously as tuberculosis of the knee. A history evaluation along with intraoperative findings helped arrive at the possible diagnosis of ochronosis. Total synovectomy was done. Postoperative improvement of visual analog scale score was significant and the patient was satisfied with the pain relief attained through treatment. Early diagnosis and timely management is critical to avoid unwanted complication related to both anesthesia and surgery pertaining to the disease. Knowledge of skin markers and urine darkening helps in identifying the disease early.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"185 - 189"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42310492","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":"Vitamin D deficiency in proximal femur fractures: An observational, cross-sectional study","authors":"Utkarsh Singh, P. Tiwari, Navneet Singh, G. Kalia, B. Brar","doi":"10.4103/jodp.jodp_29_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_29_22","url":null,"abstract":"Introduction: A proximal femur fracture is the most serious complication of osteoporosis, due to the high mortality and morbidity associated with it. Its risk in the elderly is a function of multiple factors, including bone mineral density, muscle strength, and balance, all of which have been related to Vitamin D status and function. Materials and Methods: This was a prospective hospital-based study conducted over 2 years in the hilly state of Himachal Pradesh, India, to evaluate any correlation between Vitamin D levels and proximal femur fractures (PFFs). We also studied the influence of age and sex on Vitamin D levels in PFFs. Results: In our study, the female patients had lower Vitamin D levels (19.85 ± 5.28) as compared to males (20.436 ± 9.36), but this decrease was not found to be statistically significant (P = 0.2374). There was an average decrease of Vitamin D levels in patients of higher age group (20.770 ± 6.57 vs. 19.692 ± 8.40), but this was not statistically significant (P = 0.613). Thirty-four patients, i.e., 68%, had hypocalcemia, while 16 patients, i.e., 32%, had normal levels of serum calcium. Similarly, 30 patients, i.e., 70%, had hypomagnesemia, while 20 patients, i.e., 40%, had normal serum magnesium levels. The mean level of alkaline phosphatase in PFF was found to be 116.36 IU/L, i.e., within normal limits. The average Vitamin D level in our patients who were adequately exposed to sunlight was 22.5 ± 8.80 ng/ml, while the average Vitamin D level in patients who were inadequately exposed was 16.925 ± 5.98 ng/ml. The mean Vitamin D levels in vegetarian and nonvegetarian patients were 19.17 ± 6.05 ng/ml and 19.83 ± 9.56 ng/ml, respectively. We found that vitamin levels were relatively low (19.46 ng/dL) in patients from high altitudes as compared to patients from low altitudes (22.62 ng/dL), but the difference was insignificant (P = 0.3925). Conclusion: In our study, almost all patients (96%) were suffering from hypovitaminosis D (Vitamin D levels <30 ng/ml), and 38% of our patients had Vitamin D deficiency (Vitamin D levels <20 ng/ml). However, we were unable to find any significant difference in Vitamin D levels when patients of various ages, sex, and altitude were compared with each other.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"173 - 179"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48908590","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":"Nonunion of clavicle treated with precontoured locking compression plate fixation and bone grafting: A long-term outcome","authors":"N. Shah, N. Dar, Badoo Rashid","doi":"10.4103/jodp.jodp_2_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_2_22","url":null,"abstract":"Background: Plate fixation with bone grafting is the treatment of choice for nonunion of the clavicle and the use of precontoured locking compression plate (LCP) has been proposed to have an advantage of minimal hardware prominence and low rate of implant removal surgery. Materials and Methods: The retrospective analysis was performed to assess the long-term efficacy of precontoured LCP and bone grafting in nonunion of the clavicle. Fifteen patients who had undergone the surgery were assessed retrospectively in terms of clinical and radiological outcome for 4.1 years (range 2–7 years). The outcome was assessed using clinical and functional assessment by QuickDASH scoring and visual analog scale (VAS) system, radiological assessment in terms of union, time of return to previous activities, and any adverse results during the surgery or in the postoperative follow-up. Results: The radiological consolidation was achieved in all patients in a mean period of 18 weeks (range14–20 weeks). All patients returned to their previous activity level in a mean period of 5.9 months (range 2.5–9 months). There was a statistically significant improvement in QuickDASH and VAS scores (P < 0.05); however, one patient had symptomatic hardware prominence. Conclusion: The use of precontoured LCP in nonunion clavicle is a well-tolerated surgery giving promising results with most patients returning to previous activity level with the advantage of minimal hardware prominence and low rate of implant removal surgery.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"128 - 131"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44952895","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 mid-shaft clavicle fracture treated with precontoured superior plate placement: A retrospective study","authors":"K. Chandan, Santosh Kumar, A. Arya, Rajeev Kumar, P. Verma","doi":"10.4103/jodp.jodp_5_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_5_22","url":null,"abstract":"In the olden days, clavicle fractures have been treated with conservative management like strapping and bed rest. Fractures of the clavicle are one of the most common injures of the human skeleton. This study was undertaken to observe the rate of union, functional outcome and complications of fracture middle third clavicle treated with open reduction and internal fixation (ORIF) with precontoured superior plate placement. Methods: A total of 30 patients were operated with anatomical precontoured plates from December 2018 to December 2020 and functional outcomes were assessed through 6 months. Results: A total of 30 patients were included in the study. There were 27 males and 3 females. The mean age of the patient in the ORIF group was 31.03 years (age between 20 and 50 years). The mean time to union was 15 weeks. In our study, none of the patients had nonunion, implant failure and infection. Four patients developed scar hypertrophy, Three patients developed hypoesthesia below the incision site and one patient developed screw loosening. Conclusion: It is possible to obtain a good fracture union, less soft tissue stripping and good patient satisfaction with superior plate placement for fracture middle third clavicle.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"110 - 114"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49344958","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":"Outcome of cemented hemiarthroplasty of hip in elderly patients operated for neck of femur fracture","authors":"Sudeep Kumar, Anup Kumar, Alapati Hari Venkata Bramesh, K. Charan Teja, M. A. Abdul Razek, R. Kumar","doi":"10.4103/jodp.jodp_6_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_6_22","url":null,"abstract":"Introduction: Femoral neck fractures are a common entity in elderly patients. This commonly occurs following trivial injury and the insult is compounded by osteoporosis in this age group. Cemented hemiarthroplasty is recommended by several studies and by several registries, due to low comorbidities compared to uncemented hemiarthroplasty. Significantly improved mobility scores, low pain scores make this a treatment of choice. Materials and Methods: This study included 108 patients who presented with fracture neck of the femur with an average age of 68.30 years and were operated with hemiarthroplasty by two consultant orthopedic surgeons in a standard operative setting over 5 years with modular bipolar prosthesis using lateral approach (Hardinge approach). Patients on follow-up were evaluated using Oxford Hip Score and Forgotten Joint Score. Results: The mean Oxford Hip Score was 39.46 suggestive of satisfactory joint function which may not require any further treatment. The mean Forgotten Joint Score was 83.46 suggestive of high degree of forgetting artificial joint. Conclusion: A very high Oxford Hip Scores and very high Forgotten Joint Scores after surgery suggests that the patients have retained or regained their independence and are doing good. This goes on to suggest that in spite of advancements in surgical techniques and implants for osteosynthesis, hemiarthroplasty done in indicated cases gives a good functional outcome and a lasting solution for these fractures.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"78 - 82"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42947638","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}