Journal of Orthopedics and Joint Surgery最新文献

{"title":"Posterior Malleolus Fractures in Trimalleolar Fracture Dislocations of the Ankle Fixed with Anteroposterior Screws vs Posterior Plating: A Clinical Outcome Study","authors":"A. Chandramohan, D. Jayaramaraju, D. Agraharam, Ramesh Perumal, R. Shanmuganathan","doi":"10.5005/jp-journals-10079-1008","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1008","url":null,"abstract":"\u0000\u0000\u0000Fracture dislocations of the ankle are rare injuries with often poor outcomes due to posttraumatic arthritis and instability of the ankle. A concomitant fracture of the posterior malleolus occurs in 7–44% of all ankle fractures.\u0000\u0000\u0000\u0000To study the outcomes in operated cases of posterior malleolus fractures fixed using percutaneous anteroposterior (AP) screws vs posterior buttress plating and to study which is advantageous.\u0000\u0000\u0000\u0000Our study was conducted between December 2013 and December 2015. All operated cases of posterior malleolus fractures in trimalleolar fracture dislocations of the ankle joint were included. Polytrauma cases and open injuries were excluded. Among 28 cases, 24 cases were available for final follow-up. The average age was 47.2 years, and road traffic accident was the predominant cause in 80% of the cases. In 9 cases, buttress plating, and in 15 cases, percutaneous AP screws were used as decided by senior surgeon. All cases were followed up at periodic intervals. Mean follow-up is 28.5 months.\u0000\u0000\u0000\u0000Average union time is 14.2 weeks. Ankle fracture scoring system designed by Phillips et al. was used. The outcome is the sum of the clinical score (follow-up), the anatomical score (postoperative), and arthritis score (follow-up). A minimum score is 0, and the maximum score is 150. In posterior plating group, the average score was 128 out of 150. In AP screws group, the average score was 114 out of 150. Improper reduction and articular step were noticed in three cases and developed ankle arthritis in subsequent radiographs. There were no infections in our series.\u0000\u0000\u0000\u0000Posterior plating gave better results due to stable anatomical reduction and by early physiotherapy, while AP screws group had relatively moderate outcome due to articular step off and late arthritic changes.\u0000\u0000Arunkamal C, Dheenadhayalan J, Agraharam D, et al. Posterior Malleolus Fractures in Trimalleolar Fracture Dislocations of the Ankle Fixed with Anteroposterior Screws vs Posterior Plating: A Clinical Outcome Study. J Orth Joint Surg 2019;1(1):11–14.\u0000","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132160273","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":"Double Patella Syndrome Following Hoffa's Fat Pad Lesion","authors":"A. Karthick, A. Devadoss, S. Devadoss, Jayakumar Subbiah","doi":"10.5005/jp-journals-10079-1006","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1006","url":null,"abstract":"","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"8 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120912740","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":"Short-term Outcome Analysis of Proximal Fibular Osteotomy in Management of Osteoarthritis Knee","authors":"T. Gopi, V. Thirunarayanan, K. Manimaran, S. Cheralathan","doi":"10.5005/jp-journals-10079-1005","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1005","url":null,"abstract":"Ab s t r Ac t Aim: Proximal fibular osteotomy (PFO) for osteoarthritis (OA) knee is an emerging concept with good early results. This short-term study aimed to analyze the usefulness of PFO in Indian patients with OA knee with regard to pain relief and correction of deformity. Materials and methods: This study involves a surgical technique where 2 cm of proximal fibular bone is resected, and patient is permitted fullweight-bearing walking as early as possible. Subjective and objective outcome analyses done using Lysholm knee scoring sheet and radiographs, respectively. Minimum follow-up time was 6 months. Results: We had a of total of 20 knees in 18 patients, with average age of 56.1 years. The average visual analog score reduced by 6.8 points, and the average Lysholm knee score improved by an average of 34 points at the end of follow-up. The mean alpha angle correction achieved was 3.738°. The calculation of Pearson’s correlation coefficient between the amount of correction of alpha angle and reduction of visual analog scale during the immediate postoperative period was −0.186. Among the 20 knees, we had four cases of weakness of extensor hallucis longus. Conclusion: Through our short-term prospective cohort study, we conclude that PFO helps in improvement of pain and function, in patients suffering from medial compartment OA knee. The effectiveness of proximal tibiofibular joint mechanism in immediate pain relief is evident in our study by subjective and objective means. A proper selection of case with regard to severity and duration of disease and patellofemoral involvement is vital in getting good results. Clinical significance: Proximal fibular osteotomy is an emerging concept in the management of OA of knee and gives the patient, more years, with native knee to walk.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":" 33","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113947188","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":"Distal Tibia Delayed Union with Fibular Shortening Causing Syndesmotic Instability and Anterolateral Impingement","authors":"A. Cantrell, Joshua Wilson, A. Haleem, Seth M. Boydstun","doi":"10.5005/jp-journals-10079-1009","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1009","url":null,"abstract":"Debate continues in the current orthopedic literature regarding advantages of performing concurrent fibular stabilization in combined distal tibial and fibular fractures. In this case report, we present the correction of tibial malalignment, fibular fixation, and syndesmotic restoration in a 21-year-old male after a high-energy injury where he sustained a fracture of the tibia and fibula at the same level that was initially managed with tibial nailing alone. After initially having delayed union, valgus malalignment and resultant syndesmotic pain and instability following the index surgery, he underwent revision surgery resulting in favorable recovery with cessation of his pain and correction of his malalignment. How to cite this article: Cantrell AJ, Wilson JA, Haleem A, et al. Distal Tibia Delayed Union with Fibular Shortening Causing Syndesmotic Instability and Anterolateral Impingement. J Orth Joint Surg 2019;1(1):31–34.","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134370560","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":"Avascular Necrosis of Femur in Case of Severe Aplastic Anemia: A Case Report","authors":"A. Mahajan, M. Kalra, Himani Dhingra, Geeta Mandhani","doi":"10.5005/jp-journals-10079-1004","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1004","url":null,"abstract":"","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130331260","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":"Analysis of Efficacy of Tranexamic Acid in Reduction of Blood Loss and Postoperative Blood Transfusions Following Orthopedic Trauma Surgery","authors":"P. Kingsly, M. Sathish, N. D. M. Ismail","doi":"10.5005/jp-journals-10079-1007","DOIUrl":"https://doi.org/10.5005/jp-journals-10079-1007","url":null,"abstract":"\u0000\u0000\u0000Perioperative and postsurgical hemorrhage is common in invasive surgical procedures, including orthopedic surgery. Tranexamic acid (TXA) is a pharmacologic agent that acts through an antifibrinolytic mechanism to stabilize formed clots and to reduce active bleeding. It has been used successfully in orthopedics to reduce perioperative blood loss, particularly in total hip and knee arthroplasty and spine surgery. Ischemia increases fibrinolysis, related to the proteolytic action of plasmin, with a subsequent fibrinogen scission, which limits postoperative coagulation and favors bleeding. Tranexamic acid being antifibrinolytic acts to prevent this effect from taking place. This study was designed to assess the efficacy of TXA in reducing blood loss and postoperative blood transfusions following the fixation of fracture of both bones of leg with intramedullary interlocking nailing of tibia done by open method.\u0000\u0000\u0000\u0000Randomized, prospective, comparative study.\u0000\u0000\u0000\u0000In this study, patients were randomly allocated into two groups of 25 each. Group I received inj. TXA and group II received inj. normal saline. Preoperative hemoglobin (Hb), postoperative Hb, total blood volume (BV), blood loss, and Hb loss were compared between two groups. Statistical analysis was done with Fisher's t test and Fisher's exact test.\u0000\u0000\u0000\u0000The mean blood loss in TXA and placebo group was 249.02 ± 57.04 mL and 543 ± 83.64 mL, respectively, and found to be highly significant (p value < 0.001). A number of patients required blood transfusion were significantly low in TXA group than in placebo group (p < 0.01).\u0000\u0000\u0000\u0000This study indicated that TXA results in significant reduction in blood loss (nearly 60%) and amount of blood transfusion required in patients undergoing surgery. Routine administration of TXA may benefit patients undergoing surgery where significant blood loss is expected.\u0000\u0000Kingsly P, Sathish M, Ismail NMDM. Analysis of Efficacy of Tranexamic Acid in Reduction of Blood Loss and Postoperative Blood Transfusions Following Orthopedic Trauma Surgery. J Orth Joint Surg 2019;1(1):27–30.\u0000","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133591953","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":"Secretary's Message","authors":"Dr A Francis Roy","doi":"10.5005/jojs-1-1-vi","DOIUrl":"https://doi.org/10.5005/jojs-1-1-vi","url":null,"abstract":"","PeriodicalId":369299,"journal":{"name":"Journal of Orthopedics and Joint Surgery","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130898708","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}