Indian Journal of Orthopaedics Surgery最新文献_第3页

Split transfer of tibialis anterior for equinovarus foot deformity in cerebral palsy 劈开胫骨前肌移植治疗脑瘫马蹄内翻足畸形

Indian Journal of Orthopaedics Surgery Pub Date : 2023-09-15 DOI: 10.18231/j.ijos.2023.029

M. Kumar, Swati Sinha

{"title":"Split transfer of tibialis anterior for equinovarus foot deformity in cerebral palsy","authors":"M. Kumar, Swati Sinha","doi":"10.18231/j.ijos.2023.029","DOIUrl":"https://doi.org/10.18231/j.ijos.2023.029","url":null,"abstract":": Foot deformities in children with cerebral palsy are common. The various foot deformities are equinus, planovalgus, equinovarus, equinovalgus. Treatment for the flexible foot deformity should be with orthotics and manual therapy initially and then with tendon lengthening. Equinovarus deformity of the foot is a result of the muscle imbalance in which invertors of the foot, posterior and anterior tibialis muscle, overpower evertors. Untreated spastic equinovarus deformity may cause severe fixed foot deformity and painful callosities under metatarsal heads and on the lateral side of foot. To evaluate the effectiveness of split transfer of tibialis anterior for equinovarus foot deformity in spastic cerebral palsy children.40 spastic cerebral palsy (13 diplegic and 27 hemiplegic) children between the age of 5-15 years with equinovarus foot deformity were selected. The procedure adopted in all the cases was tendoachilles lengthening and split anterior tibialis tendon transfer to cuboid. The result was graded as good, fair and poor. In 28 of the cases varus deformity of the forefoot and midfoot got corrected with plantigrade foot, in 10 of the cases forefoot and midfoot supination was corrected but heel was in varus and in 2 of the cases there was no improvement.: Spastic T.A. is most often the cause of varus of forefoot. Split transfer utilises the spastic nature of the muscle to counter balance the deformity caused by the original muscle. Hence, it is better solution to the problem. However accurate diagnosis of deforming muscle, i.e, T.A or T.P. is essential to produce good result.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127665115","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}

引用次数: 0

Macroscopic and histological evaluation of the posterior cruciate ligament in arthritic knees 膝关节关节炎后交叉韧带的宏观和组织学评价

Indian Journal of Orthopaedics Surgery Pub Date : 2023-09-15 DOI: 10.18231/j.ijos.2023.030

Gopi Mohan, Vijay Mohan, Shyam Gopal

{"title":"Macroscopic and histological evaluation of the posterior cruciate ligament in arthritic knees","authors":"Gopi Mohan, Vijay Mohan, Shyam Gopal","doi":"10.18231/j.ijos.2023.030","DOIUrl":"https://doi.org/10.18231/j.ijos.2023.030","url":null,"abstract":"The function of Posterior Cruciate Ligament (PCL) in Total Knee Arthroplasty is currently under debate. Supporters of PCL retention suggest better soft tissue balance as well as proprioception, whereas the adversaries have reported an unstable late flexion. Whether the PCL is retained or removed, the results of knee replacement remains the same. The aim of the present study was to look for the morphologic and histological changes in PCL, that aids in assessing its competence, and to compare these with macroscopic changes. A prospective study was performed on 50 osteoarthritic knees. Both the cruciate ligaments were examined macroscopically during Total Knee Replacement surgery, and classified as normal, fatty, mucinous, or cystic. The PCL was also studied and staged histopathologically, and was compared with its macroscopic appearance. On macroscopic examination, fatty type degeneration was the most common type of degeneration in both PCL and ACL, seen in 68% and 56% cases respectively. Histopathologically, majority of the PCLs (52.4%) were in stage 1 of degeneration. 5 PCLs that appeared macroscopically normal showed degeneration microscopically and 8 PCLs that were histologically normal had fatty as well as mucinous degeneration on macroscopic examination.PCL exhibits degenerative and chronic traumatic modifications of different degrees on microscopic examination. These changes cannot be predicted from macroscopic inspection of the knee at the time of surgery. The frequency of these changes suggests that PCLs in an osteoarthritic knee are of varying quality, and this should be considered by the surgeon while selecting the type of knee replacement.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125809634","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}

引用次数: 0

Easy solutions to difficult problems in lower limbs 下肢难题的简单解决方案

Indian Journal of Orthopaedics Surgery Pub Date : 2023-09-15 DOI: 10.18231/j.ijos.2023.033

Neelam Yadav, Sasanka Sekhar Chatterjee

{"title":"Easy solutions to difficult problems in lower limbs","authors":"Neelam Yadav, Sasanka Sekhar Chatterjee","doi":"10.18231/j.ijos.2023.033","DOIUrl":"https://doi.org/10.18231/j.ijos.2023.033","url":null,"abstract":": In clinical practice, all of us have at sometime or other faced with problems where the ideal solutions may not be possible. The reason is mostly economic but even desire of the patient not to undergo complex procedures has to be taken into account. In this article authors describe management of these surgical challenges when compromised confidence of patients and relatives from previous surgeries left him with minimum choices available for secondary surgeries. Here are six such cases where simplest option were chosen achieving best long term outcome both in form and function and with least donor morbidity.: This study describes the retrospective review of a single surgeon experience from his archives of six cases where salvage procedure were done, which fulfilled reconstructive goals as well as decreased apprehension related to failure of surgery. All 6 patients demonstrated complete wound healing by final follow up, without need for further reoperations or recurrence. Surgeon by his depth of knowledge and huge experience was able to manage all these surgical challenges with ease providing optimal form and function following principles of plastic surgery with ingenuity. These procedure not only reduced the surgical morbidity but also hospital stay and overall cost of treatment.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126705988","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}

引用次数: 0

Correlation between onset of ACL injury and incidence of articular cartilage and meniscal injuries 前交叉韧带损伤的发生与关节软骨和半月板损伤的关系

Indian Journal of Orthopaedics Surgery Pub Date : 2023-09-15 DOI: 10.18231/j.ijos.2023.034

Musaab Al-Samarrai, R. Khaffaf

{"title":"Correlation between onset of ACL injury and incidence of articular cartilage and meniscal injuries","authors":"Musaab Al-Samarrai, R. Khaffaf","doi":"10.18231/j.ijos.2023.034","DOIUrl":"https://doi.org/10.18231/j.ijos.2023.034","url":null,"abstract":"Delayed anterior cruciate ligament (ACL) reconstruction surgery may increase the risk of chondral and meniscal injuries but the time interval between injury and surgery is not fully determined and the effect of ACL-deficiency rotational instability may vary among different zones of knee articular cartilage. Purpose To study chondral injuries in ACL-deficiency patients in different articular zones and various durations between ACL injury and reconstruction.: Case series – prospective observational study. Prospective observational study of 212 cases (197 male and 15 female) with specific age group (16-44 years) having ACL injury and managed by arthroscopic ACL reconstruction, articular cartilage injury rate and severity (based on ICRS classification) was assessed in 5 zones of knee articular cartilage and correlated with different durations between injury and surgery as well as correlation with concomitant meniscal injuries. Medial tibia was the most common zone of chondral injury in ACL-deficiency knee (54.2%) while patella was the least common zone (28.8%), severe chondral injuries rate increased from (3%) in patients who were operated within 6 months to (11.1%) in patients of 6-12 months group and higher with longer duration reaching to (63.6%) when ACLR was delayed more than 4 years from injury. Concomitant meniscal injuries were associated with higher rate of severe chondral injuries (20.4%) than cases without meniscal tear (4%), medial meniscal tears were more common (65%) than lateral tears (23.3%) while both menisci were observed in (11.7%), complex meniscal tear was the most common pattern (33.7%) on medial side. Delaying ACL reconstruction surgery will increase frequency of chondral injuries, severe chondral injuries rate is increased after 6 months in medial side and after 2 years on lateral side, concomitant meniscal injury is associated with higher rate of severe chondral lesions.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116770815","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}

引用次数: 0

Pull out suture using the plunger flange of the syringe, a better alternative to the button 使用注射器的柱塞法兰拔出缝合线，这是比按钮更好的选择

Indian Journal of Orthopaedics Surgery Pub Date : 2023-09-15 DOI: 10.18231/j.ijos.2023.031

Amit Vyas, Santosh Batajoo, Sayantani Misra

{"title":"Pull out suture using the plunger flange of the syringe, a better alternative to the button","authors":"Amit Vyas, Santosh Batajoo, Sayantani Misra","doi":"10.18231/j.ijos.2023.031","DOIUrl":"https://doi.org/10.18231/j.ijos.2023.031","url":null,"abstract":": Tendon avulsions within zone 1 of the hand presents challenges for repair. The traditional technique involves using a button to secure the tendon sutured to the bone. This study explores an alternative method utilizing the plunger flange of a syringe.: The study involved patients with zone 1a and 1b injuries. The plunger flange technique was employed by drilling two holes in the plunger, passing a polypropylene suture through them, and securing it with a sterile knot. The technique was compared with the traditional button approach.: The plunger flange technique demonstrated feasibility and effectiveness in tendon avulsion repair. Plunger flanges, which eliminated the need for separate sterilization, were more readily available. Patients could initiate therapy sooner post-surgery. Complications, although limited, resembled those of the traditional button method. The plunger flange technique presents a viable alternative to the button in repairing tendon avulsions. This method is easily accessible, doesn't require separate sterilization, and allows for early therapy initiation. The study suggests that the plunger flange technique could be recommended as a replacement for the button.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"1998 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128231999","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}

引用次数: 0

Fragility fracture in a 28 yr old male 一例28岁男性脆性骨折

Indian Journal of Orthopaedics Surgery Pub Date : 2023-09-15 DOI: 10.18231/j.ijos.2023.035

Shivang Kala, Gagandeep Gupta, Abhishek Singh

引用次数: 0

Modified McLaughlin procedure in posterior locked fracture-dislocation of the shoulder 改良McLaughlin手术治疗肩部后路锁定骨折脱位

Indian Journal of Orthopaedics Surgery Pub Date : 2023-09-15 DOI: 10.18231/j.ijos.2023.038

R. M. Kopparthi, Prashant Tonape, Janapamala V S Kishore, Rahul Salunkhe

引用次数: 0

Giant cell tumor of distal femur with pathological fracture: A case report 股骨远端巨细胞瘤伴病理性骨折1例

Indian Journal of Orthopaedics Surgery Pub Date : 2023-09-15 DOI: 10.18231/j.ijos.2023.040

Shubham Prakashrao Vaidya, Sushil H Mankar, R. Sakhare, Satyajeet Deshpande, Ambar Daware

{"title":"Giant cell tumor of distal femur with pathological fracture: A case report","authors":"Shubham Prakashrao Vaidya, Sushil H Mankar, R. Sakhare, Satyajeet Deshpande, Ambar Daware","doi":"10.18231/j.ijos.2023.040","DOIUrl":"https://doi.org/10.18231/j.ijos.2023.040","url":null,"abstract":"Giant cell tumor of bone (GCTB) is a mostly benign bone tumor which can occasionally progress to malignancy, usually in chronic cases. It is a common benign and aggressive bone tumor that affects patients aged 20-45 years. A case of giant cell tumor (GCT) of the distal femur is reported here with an intraoperative complication. A 37-year female presented with a 1-month history of painful swelling over her left knee. On clinical examination, the patient had tenderness and swelling on the anterolateral aspect of the knee extending from the distal part of the femur towards the lateral aspect of the knee. Swelling was well-defined, smooth, firm, and uniform in consistency with dimensions of about 12cm x 8 cm. Knee movement was restricted. An X-ray of the affected knee revealed a soft tissue mass arising from the distal femur on its lateral aspect. MRI revealed a soft tissue mass with the cortical breach. In this case, we planned for curettage with bone grafting and bone cementing using a sandwich technique, but while handling the limb, an medial cortical breach occurred, which was then fixed with the help of a distal femur lateral locking plate and cement in the second setting due to unavailability of distal femur plates during the initial surgery. Following surgery, a sample was sent for histopathology, which s/o high-grade giant cell tumor. Because of the high risk of recurrence, the tumor should be completely removed. Finally, the Knee function recreated to minimize the loss. Another options were enblock excision with arthrodesis of the affected joint but that causes joint stiffness other is arthroplasty of the affecting joint with the help of custom-made prostheses but this procedure is too costly thus we opted for the extended curettage with bone cement with bone grafting (Sandwich technique) with plating.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127608110","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}

引用次数: 0

Firecracker (Sutli Bomb) explosion in hand and Diwali celebration: A unique case 手握爆竹(Sutli Bomb)爆炸和排灯节庆祝:一个独特的案例

Indian Journal of Orthopaedics Surgery Pub Date : 2023-09-15 DOI: 10.18231/j.ijos.2023.039

Dheeraj Makkar, Ravi Sauhta

引用次数: 0

Atypical chondroblastoma of the distal femur with exophytic mass: A rare presentation and diagnostic dilemma 股骨远端非典型成软骨细胞瘤伴外生性肿块:一种罕见的表现和诊断困境

Indian Journal of Orthopaedics Surgery Pub Date : 2023-09-15 DOI: 10.18231/j.ijos.2023.036

Shaunak Patwardhan, Sandeep A Patwardhan

引用次数: 0