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Publisher: Medknow Publishers   (Total: 429 journals)

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Showing 1 - 200 of 429 Journals sorted alphabetically
Acta Medica Intl.     Open Access   (SJR: 0.101, CiteScore: 0)
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advanced Biomedical Research     Open Access  
Advances in Human Biology     Open Access   (Followers: 3)
Advances in Skeletal Muscle Function Assessment     Open Access  
African J. for Infertility and Assisted Conception     Open Access  
African J. of Medical and Health Sciences     Open Access   (Followers: 2)
African J. of Paediatric Surgery     Open Access   (Followers: 7, SJR: 0.25, CiteScore: 1)
African J. of Trauma     Open Access   (Followers: 1)
Ain-Shams J. of Anaesthesiology     Open Access   (Followers: 3)
Al-Azhar Assiut Medical J.     Open Access  
Al-Basar Intl. J. of Ophthalmology     Open Access   (Followers: 1)
Alexandria J. of Pediatrics     Open Access  
Ancient Science of Life     Open Access   (Followers: 5)
Anesthesia : Essays and Researches     Open Access   (Followers: 10)
Annals of African Medicine     Open Access   (Followers: 1, SJR: 0.258, CiteScore: 1)
Annals of Bioanthropology     Open Access   (Followers: 4)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 14, SJR: 0.308, CiteScore: 1)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3, SJR: 0.434, CiteScore: 1)
Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery     Open Access  
Annals of Indian Psychiatry     Open Access  
Annals of Maxillofacial Surgery     Open Access   (Followers: 6)
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 8, SJR: 0.352, CiteScore: 1)
Annals of Saudi Medicine     Open Access   (SJR: 0.238, CiteScore: 1)
Annals of Thoracic Medicine     Open Access   (Followers: 6, SJR: 0.524, CiteScore: 1)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 13, SJR: 0.152, CiteScore: 0)
Annals of Tropical Pathology     Open Access  
Apollo Medicine     Open Access  
APOS Trends in Orthodontics     Open Access  
Arab J. of Interventional Radiology     Open Access  
Archives of Cardiovascular Imaging     Open Access   (Followers: 1, SJR: 0.187, CiteScore: 0)
Archives of Intl. Surgery     Open Access   (Followers: 10, SJR: 0.302, CiteScore: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Medicine and Surgery     Open Access  
Archives of Pharmacy Practice     Open Access   (Followers: 6, SJR: 0.102, CiteScore: 0)
Archives of Trauma Research     Open Access   (Followers: 3, SJR: 0.37, CiteScore: 2)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access  
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 4)
Asian J. of Andrology     Open Access   (Followers: 1, SJR: 0.856, CiteScore: 2)
Asian J. of Neurosurgery     Open Access   (Followers: 2)
Asian J. of Oncology     Open Access   (Followers: 1)
Asian J. of Transfusion Science     Open Access   (Followers: 1, SJR: 0.35, CiteScore: 1)
Asian Pacific J. of Reproduction     Open Access   (SJR: 0.227, CiteScore: 1)
Asian Pacific J. of Tropical Biomedicine     Open Access   (Followers: 2, SJR: 0.491, CiteScore: 2)
Asian Pacific J. of Tropical Medicine     Open Access   (Followers: 1, SJR: 0.561, CiteScore: 2)
Astrocyte     Open Access  
Avicenna J. of Medicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
Benha Medical J.     Open Access  
Biomedical and Biotechnology Research J.     Open Access  
BLDE University J. of Health Sciences     Open Access  
Brain Circulation     Open Access  
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 1)
Canadian J. of Rural Medicine     Full-text available via subscription   (SJR: 0.202, CiteScore: 0)
Cancer Translational Medicine     Open Access   (Followers: 2)
Cardiology Plus     Open Access  
Chinese Medical J.     Open Access   (Followers: 10, SJR: 0.52, CiteScore: 1)
CHRISMED J. of Health and Research     Open Access  
Clinical Cancer Investigation J.     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 2)
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access  
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 10, SJR: 0.811, CiteScore: 2)
Contemporary Clinical Dentistry     Open Access   (Followers: 4, SJR: 0.353, CiteScore: 1)
Current Medical Issues     Open Access   (Followers: 1)
CytoJ.     Open Access   (Followers: 2, SJR: 0.543, CiteScore: 1)
Delta J. of Ophthalmology     Open Access  
Dental Hypotheses     Open Access   (Followers: 3, SJR: 0.152, CiteScore: 0)
Dental Research J.     Open Access   (Followers: 11, SJR: 0.416, CiteScore: 1)
Dentistry and Medical Research     Open Access  
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 6, SJR: 0.242, CiteScore: 0)
Egyptian J. of Bronchology     Open Access  
Egyptian J. of Cardiothoracic Anesthesia     Open Access  
Egyptian J. of Cataract and Refractive Surgery     Open Access   (Followers: 1, SJR: 1.799, CiteScore: 2)
Egyptian J. of Chest Diseases and Tuberculosis     Open Access   (Followers: 3, SJR: 0.155, CiteScore: 0)
Egyptian J. of Dermatology and Venerology     Open Access   (Followers: 1)
Egyptian J. of Haematology     Open Access   (Followers: 1)
Egyptian J. of Internal Medicine     Open Access   (Followers: 1)
Egyptian J. of Neurology, Psychiatry and Neurosurgery     Open Access   (Followers: 1, SJR: 0.127, CiteScore: 0)
Egyptian J. of Obesity, Diabetes and Endocrinology     Open Access   (Followers: 1)
Egyptian J. of Otolaryngology     Open Access   (Followers: 2)
Egyptian J. of Psychiatry     Open Access   (Followers: 2)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Nursing J.     Open Access  
Egyptian Orthopaedic J.     Open Access   (Followers: 2)
Egyptian Pharmaceutical J.     Open Access  
Egyptian Retina J.     Open Access  
Egyptian Rheumatology and Rehabilitation     Open Access  
Endodontology     Open Access  
Endoscopic Ultrasound     Open Access   (SJR: 0.822, CiteScore: 2)
Environmental Disease     Open Access   (Followers: 3)
Eurasian J. of Pulmonology     Open Access  
European J. of Dentistry     Open Access   (Followers: 2, SJR: 0.749, CiteScore: 2)
European J. of General Dentistry     Open Access   (Followers: 1, SJR: 0.12, CiteScore: 0)
European J. of Prosthodontics     Open Access   (Followers: 3)
European J. of Psychology and Educational Studies     Open Access   (Followers: 11, SJR: 0.113, CiteScore: 0)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.112, CiteScore: 0)
Genome Integrity     Open Access   (Followers: 3, SJR: 0.153, CiteScore: 0)
Glioma     Open Access  
Global J. of Transfusion Medicine     Open Access   (Followers: 1)
Gynecology and Minimally Invasive Therapy     Open Access   (SJR: 0.311, CiteScore: 1)
Hamdan Medical J.     Open Access  
Heart and Mind     Open Access  
Heart India     Open Access   (Followers: 1)
Heart Views     Open Access   (Followers: 2)
Hepatitis B Annual     Open Access   (Followers: 3)
Ibnosina J. of Medicine and Biomedical Sciences     Open Access  
IJS Short Reports     Open Access  
Imam J. of Applied Sciences     Open Access  
Indian Anaesthetists Forum     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 3)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 7, SJR: 0.478, CiteScore: 1)
Indian J. of Burns     Open Access   (Followers: 1)
Indian J. of Cancer     Open Access   (Followers: 1, SJR: 0.361, CiteScore: 1)
Indian J. of Cerebral Palsy     Open Access   (Followers: 1)
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.37, CiteScore: 1)
Indian J. of Critical Care Medicine     Open Access   (Followers: 3, SJR: 0.604, CiteScore: 1)
Indian J. of Dental Research     Open Access   (Followers: 4, SJR: 0.266, CiteScore: 1)
Indian J. of Dental Sciences     Open Access  
Indian J. of Dentistry     Open Access   (Followers: 1)
Indian J. of Dermatology     Open Access   (Followers: 2, SJR: 0.468, CiteScore: 1)
Indian J. of Dermatology, Venereology and Leprology     Open Access   (Followers: 5, SJR: 0.445, CiteScore: 1)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access   (Followers: 1, SJR: 0.791, CiteScore: 1)
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4, SJR: 0.568, CiteScore: 1)
Indian J. of Health Sciences     Open Access   (Followers: 2)
Indian J. of Medical and Paediatric Oncology     Open Access   (SJR: 0.425, CiteScore: 1)
Indian J. of Medical Microbiology     Open Access   (Followers: 1, SJR: 0.503, CiteScore: 1)
Indian J. of Medical Research     Open Access   (Followers: 4, SJR: 0.656, CiteScore: 1)
Indian J. of Medical Sciences     Open Access   (Followers: 2, SJR: 0.102, CiteScore: 0)
Indian J. of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian J. of Nephrology     Open Access   (Followers: 2, SJR: 0.347, CiteScore: 1)
Indian J. of Nuclear Medicine     Open Access   (Followers: 2, SJR: 0.23, CiteScore: 0)
Indian J. of Occupational and Environmental Medicine     Open Access   (Followers: 3, SJR: 0.225, CiteScore: 1)
Indian J. of Ophthalmology     Open Access   (Followers: 4, SJR: 0.498, CiteScore: 1)
Indian J. of Oral Health and Research     Open Access  
Indian J. of Oral Sciences     Open Access   (Followers: 1)
Indian J. of Orthopaedics     Open Access   (Followers: 8, SJR: 0.392, CiteScore: 1)
Indian J. of Otology     Open Access   (Followers: 1, SJR: 0.199, CiteScore: 0)
Indian J. of Paediatric Dermatology     Open Access   (Followers: 2)
Indian J. of Pain     Open Access   (Followers: 1)
Indian J. of Palliative Care     Open Access   (Followers: 5, SJR: 0.454, CiteScore: 1)
Indian J. of Pathology and Microbiology     Open Access   (Followers: 2, SJR: 0.276, CiteScore: 1)
Indian J. of Pharmacology     Open Access   (SJR: 0.412, CiteScore: 1)
Indian J. of Plastic Surgery     Open Access   (Followers: 12, SJR: 0.311, CiteScore: 0)
Indian J. of Psychiatry     Open Access   (Followers: 3, SJR: 0.408, CiteScore: 1)
Indian J. of Psychological Medicine     Open Access   (SJR: 0.368, CiteScore: 1)
Indian J. of Public Health     Open Access   (Followers: 1)
Indian J. of Radiology and Imaging     Open Access   (Followers: 4)
Indian J. of Research in Homoeopathy     Open Access  
Indian J. of Respiratory Care     Open Access  
Indian J. of Rheumatology     Open Access   (SJR: 0.119, CiteScore: 0)
Indian J. of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2, SJR: 0.34, CiteScore: 0)
Indian J. of Social Psychiatry     Open Access   (Followers: 2)
Indian J. of Transplantation     Open Access  
Indian J. of Urology     Open Access   (Followers: 3, SJR: 0.434, CiteScore: 1)
Indian J. of Vascular and Endovascular Surgery     Open Access   (Followers: 2)
Indian Spine J.     Open Access  
Industrial Psychiatry J.     Open Access   (Followers: 2)
Intervention     Open Access   (Followers: 1)
Intl. Archives of Health Sciences     Open Access  
Intl. J. of Abdominal Wall and Hernia Surgery     Open Access   (Followers: 1)
Intl. J. of Academic Medicine     Open Access  
Intl. J. of Advanced Medical and Health Research     Open Access  
Intl. J. of Applied and Basic Medical Research     Open Access  
Intl. J. of Clinical and Experimental Physiology     Open Access   (Followers: 1)
Intl. J. of Clinicopathological Correlation     Open Access  
Intl. J. of Community Dentistry     Open Access  
Intl. J. of Critical Illness and Injury Science     Open Access   (Followers: 1, SJR: 0.192, CiteScore: 0)
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 4)
Intl. J. of Environmental Health Engineering     Open Access   (Followers: 1)
Intl. J. of Forensic Odontology     Open Access   (Followers: 1)
Intl. J. of Green Pharmacy     Open Access   (Followers: 3, SJR: 0.142, CiteScore: 0)
Intl. J. of Growth Factors and Stem Cells in Dentistry     Open Access  
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 3)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 3)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 6)
Intl. J. of Mycobacteriology     Open Access   (SJR: 0.535, CiteScore: 1)
Intl. J. of Noncommunicable Diseases     Open Access  
Intl. J. of Nutrition, Pharmacology, Neurological Diseases     Open Access   (Followers: 4, SJR: 0.17, CiteScore: 0)
Intl. J. of Oral Health Sciences     Open Access   (Followers: 2)
Intl. J. of Orofacial Biology     Open Access   (Followers: 1)
Intl. J. of Orofacial Research     Open Access   (Followers: 1)
Intl. J. of Orthodontic Rehabilitation     Open Access  
Intl. J. of Pedodontic Rehabilitation     Open Access  
Intl. J. of Pharmaceutical Investigation     Open Access   (Followers: 1)
Intl. J. of Preventive Medicine     Open Access   (Followers: 1, SJR: 0.623, CiteScore: 1)
Intl. J. of Shoulder Surgery     Open Access   (Followers: 5, SJR: 0.653, CiteScore: 1)
Intl. J. of the Cardiovascular Academy     Open Access   (SJR: 0.105, CiteScore: 0)
Intl. J. of Trichology     Open Access   (SJR: 0.4, CiteScore: 1)
Intl. J. of Yoga     Open Access   (Followers: 14)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 5)

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Journal Cover
Indian Journal of Orthopaedics
Journal Prestige (SJR): 0.392
Citation Impact (citeScore): 1
Number of Followers: 8  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0019-5413
Published by Medknow Publishers Homepage  [429 journals]
  • Complex hindfoot and ankle trauma: The management status in 2018

    • Authors: Mandeep S Dhillon
      Pages: 217 - 219
      Abstract: Mandeep S Dhillon
      Indian Journal of Orthopaedics 2018 52(3):217-219

      Citation: Indian Journal of Orthopaedics 2018 52(3):217-219
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_216_18
      Issue No: Vol. 52, No. 3 (2018)
       
  • Calcaneal fractures – Should we or should we not
           operate?

    • Authors: Stefan Rammelt, Bruce J Sangeorzan, Michael P Swords
      Pages: 220 - 230
      Abstract: Stefan Rammelt, Bruce J Sangeorzan, Michael P Swords
      Indian Journal of Orthopaedics 2018 52(3):220-230
      The best treatment for displaced, intraarticular fractures of the calcaneum remains controversial. Surgical treatment of these injuries is challenging and have a considerable learning curve. Studies comparing operative with nonoperative treatment including randomized trials and meta-analyses are fraught with a considerable number of confounders including highly variable fracture patterns, soft-tissue conditions, patient characteristics, surgeon experience, limited sensitivity of outcome measures, and rehabilitation protocols. It has become apparent that there is no single treatment that is suitable for all calcaneal fractures. Treatment should be tailored to the individual fracture pathoanatomy, accompanying soft-tissue damage, associated injuries, functional demand, and comorbidities of the patient. If operative treatment is chosen, reconstruction of the overall shape of the calcaneum and joint surfaces are of utmost importance to obtain a good functional result. Despite meticulous reconstruction, primary cartilage damage due to the impact at the time of injury may lead to posttraumatic subtalar arthritis. Even if subtalar fusion becomes necessary, patients benefit from primary anatomical reconstruction of the hindfoot geometry because in situ fusion is easier to perform and associated with better results than corrective fusion for hindfoot deformities in malunited calcaneal fractures. To minimize wound healing problems and stiffness due to scar formation after open reduction and internal fixation (ORIF) through extensile approaches several percutaneous and less invasive procedures through a direct approach over the sinus tarsi have successfully lowered the rates of infections and wound complications while ensuring exact anatomic reduction. There is evidence from multiple studies that malunited displaced calcaneal fractures result in painful arthritis and disabling, three-dimensional foot deformities for the affected patients. The poorest treatment results are reported after open surgical treatment that failed to achieve anatomic reconstruction of the calcaneum and its joints, thus combining the disadvantages of operative and nonoperative treatment. The crucial question, therefore, is not only whether to operate or not but also when and how to operate on calcaneal fractures if surgery is decided.
      Citation: Indian Journal of Orthopaedics 2018 52(3):220-230
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_555_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • The “Open-Envelope” Approach: A limited open approach for
           calcaneal fracture fixation

    • Authors: Sharad Prabhakar, Mandeep S Dhillon, Ankit Khurana, Rakesh John
      Pages: 231 - 238
      Abstract: Sharad Prabhakar, Mandeep S Dhillon, Ankit Khurana, Rakesh John
      Indian Journal of Orthopaedics 2018 52(3):231-238
      Background: Minimally invasive surgery (MIS) has a significant and evolving role in the treatment of displaced intra articular calcaneal fractures (DIACFs), but there is limited literature on this subject. The objective was hence to assess the clinicoradiological outcomes of DIACFs fixed with an innovative open-envelope MIS technique. Materials and Methods: 42 closed Sanders Type 2 and 3; DIACFs were included in this study. The Open-envelope approach was developed, which is essentially a limited open, dual incision, modified posterior longitudinal approach allowing excellent visualisation and direct fragment manipulation. The main outcome measures were American Orthopaedic Foot and Ankle Score (AOFAS) hindfoot score and preoperative and postoperative radiological angles. Results: The Bohler angle improved from a preoperative mean of 14.3° (range 0°–28°) to a postoperative mean of 32.46° (range 22°–42°). The Gissane angle improved from a preoperative mean of 135.83° to a postoperative mean of 128.33°. The postoperative improvement in Bohler and Gissane angles was highly significant (P < 0.001). The AOFAS scores at 6 months were excellent in nine patients, good in 15 patients, and fair in six patients. Three patients had residual valgus deformity of the heel. Conclusions: Open-envelope technique minimized soft tissue complications and achieved acceptable radiological reductions with good clinical outcomes.
      Citation: Indian Journal of Orthopaedics 2018 52(3):231-238
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_576_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • The posterolateral approach for calcaneal fractures

    • Authors: Dror Lakstein, Alexander Bermant, Evgeny Shoihetman, David Hendel, Zeev Feldbrin
      Pages: 239 - 243
      Abstract: Dror Lakstein, Alexander Bermant, Evgeny Shoihetman, David Hendel, Zeev Feldbrin
      Indian Journal of Orthopaedics 2018 52(3):239-243
      Background: Conventionally, the extended lateral approach (ELA) served as the standard extensile approach for intraarticular calcaneal fracture fixation. However, this approach has a high rate of wound complications. The purpose of this study was to describe an alternative approach, the posteriorlateral approach (PLA) and compare it to the ELA regarding soft tissue complications and functional outcome. Materials and Methods: 32 patients operated through PLA and 66 patients treated through ELA were included in this retrospective study. Major and minor soft tissue complications up to 3 months postoperatively were recorded. Eighteen patients of the PLA group and 32 patients of the ELA group were available for 1-year functional outcome assessment with the American Foot and Ankle Score (AOFAS) score. Results: The PLA group had no major complications requiring surgical intervention. Six patients (19%) had minor wound complications. The ELA group had 8 (12%) major complications and 9 (14%) minor complications. There were no significant differences in AOFAS scores at 1-year followup. PLA is a safe and efficient approach for open reduction and internal fixation of displaced intraarticular calcaneal fractures. Conclusion: In selected cases when fracture comminution and displacement may not be adequately treated through a less invasive approach, it is a good alternative with less concern about wound complications as in ELA.
      Citation: Indian Journal of Orthopaedics 2018 52(3):239-243
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_545_16
      Issue No: Vol. 52, No. 3 (2018)
       
  • Crush fractures of the anterior end of calcaneum

    • Authors: Mandeep Dhillon, Ankit Khurana, Sharad Prabhakar, Siddharth Sharma
      Pages: 244 - 252
      Abstract: Mandeep Dhillon, Ankit Khurana, Sharad Prabhakar, Siddharth Sharma
      Indian Journal of Orthopaedics 2018 52(3):244-252
      The anterior end of calcaneum fractures can present as inversion injuries, stress fractures or as a part of displaced intraarticular calcaneum fracture. Rarely, these may occur due to abduction injury from a laterally directed force that crushes the anterior calcaneum instead of the cuboid, and has associated medial column injuries which are unrecognized. Compression fractures of the anterior calcaneum are actually lateral column shortening injuries with poor outcomes in the few published reports. We describe three patients with compression fractures of the anterior end of calcaneum resulting from foot abduction injury which were managed by reduction and column length restoration via distraction by external fixator. All three fractures showed good to excellent outcomes using the American Orthopedic Foot and Ankle Society midfoot score at followup >1 year. Awareness of this injury pattern is important, and appropriate measures to reduce and maintain the fracture reduction are needed to avoid long term disability.
      Citation: Indian Journal of Orthopaedics 2018 52(3):244-252
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_575_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • Plate fixation of talus fractures: Where, when, and how?

    • Authors: Michael Swords, Harrison Lakehomer, Michael McDonald, Jay Patel
      Pages: 253 - 257
      Abstract: Michael Swords, Harrison Lakehomer, Michael McDonald, Jay Patel
      Indian Journal of Orthopaedics 2018 52(3):253-257
      Talus fractures are rare orthopedic injuries. Surgical fixation is challenging for treating surgeons. The clear majority of fractures require operative treatment. The indication and use of plates in fixation of talus fractures are reviewed. Specific applications including fractures of the lateral process, posterior fractures, extreme comminution, bone grafting, and spring plating to hold key segments are reviewed in this article.
      Citation: Indian Journal of Orthopaedics 2018 52(3):253-257
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_645_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • Management of talar body fractures

    • Authors: SR Sundararajan, Abdul Azeem Badurudeen, R Ramakanth, Shanmuganathan Rajasekaran
      Pages: 258 - 268
      Abstract: SR Sundararajan, Abdul Azeem Badurudeen, R Ramakanth, Shanmuganathan Rajasekaran
      Indian Journal of Orthopaedics 2018 52(3):258-268
      Fractures of talar body are uncommon injuries often associated with fractures of other long bones and in polytraumatized patients. The integrity of the talus is essential for the normal function of the ankle, subtalar, and midtarsal joints. The relative infrequency of this injury limits the number of studies available to guide treatment. They occur as a result of high-velocity trauma and are therefore associated with considerable soft tissue damage. Axial compression with supination or pronation is the common mechanism of injury. Great care is necessary for diagnosing and treating these injuries. Clinically, talar body fractures present with soft tissue swelling, hematoma, deformity, and restriction of motion. Associated neurovascular injury of the foot should be carefully examined. The initial evaluation should be done with foot, and ankle radiographs and computed tomography is often done to analyze the extent of the fracture, displacement, intraarticular extension, comminution, and associated fractures. Differentiating talar neck from body fractures is important. Optimal treatment relies on an accurate understanding of the injury and the goals of treatment are the restoration of articular surface and axial alignment. Indications for nonoperative management are seldom indicated and are few as in nonambulatory patients, or in with multiple comorbidities who are not able to tolerate surgery. Splinting, followed by short leg casting for 6 weeks until fracture union should be undertaken. Surgery is indicated in most of the cases, and different approaches have been described. Sometimes, a dual approach with a malleolar osteotomy is necessary for articular restoration. Clinical outcomes depend on the severity of the initial injury and the quality of reduction and internal fixation. The various complications are avascular necrosis, malunion, infections, late osteoarthritis, and ankylosis of subtalar joint.
      Citation: Indian Journal of Orthopaedics 2018 52(3):258-268
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_563_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • Surgical treatment of posteromedial talus fractures: Technique description
           and results of 10 cases

    • Authors: Michael Swords, John Shank, Stephen Benirschke
      Pages: 269 - 275
      Abstract: Michael Swords, John Shank, Stephen Benirschke
      Indian Journal of Orthopaedics 2018 52(3):269-275
      Background: The aim of this study is to describe a surgical technique for successful treatment of posteromedial talar body fractures and establish treatment recommendations for fractures of the posterior aspect of the talus. Materials and Methods: Ten patients treated operatively for a posteromedial talar body fractures entering both the subtalar and ankle articulations with a minimum of 1-year followup were identified from a trauma database. Age, mechanism of injury, associated injuries, time to surgery, complications, the range of motion, secondary procedures, and need for arthrodesis were evaluated. Results: Followup averaged 4.8 years (1–10). Eight of ten patients had high-energy mechanisms of injury. Six patients had associated medial subtalar dislocations with two open. Associated injuries were common. No surgical complications occurred. The range of motion was present but decreased. No arthrodesis procedures were performed. Conclusions: Operative fixation of posteromedial talus fractures with the described surgical technique resulted in acceptable outcomes in this series of patients with improved outcomes when compared to prior reports in the literature.
      Citation: Indian Journal of Orthopaedics 2018 52(3):269-275
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_646_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • Talar body reconstruction for nonunions and malunions

    • Authors: Marcos Hideyo Sakaki, Rodrigo Sousa Macedo, Alexandre Leme Godoy Dos Santos, Rafael Trevisan Ortiz, Rafael Barban Sposeto, T&#250;lio Diniz Fernandes
      Pages: 276 - 283
      Abstract: Marcos Hideyo Sakaki, Rodrigo Sousa Macedo, Alexandre Leme Godoy Dos Santos, Rafael Trevisan Ortiz, Rafael Barban Sposeto, Túlio Diniz Fernandes
      Indian Journal of Orthopaedics 2018 52(3):276-283
      Background: Talar body and neck nonunions and malunions may undergo a reconstructive surgery when joint cartilage is still viable, and no talar collapse or infection has occurred. This is a rare condition and the studies supporting the procedure have small number of cases. The objective of the present study is to report a case series of six patients who underwent talar reconstructions. Materials and Methods: Six patients with talar malunions or nonunions who underwent surgical treatment were reviewed in this retrospective study. There were three nonunions and two malunions of the talar body and one malunion of the talar neck. Clinical evaluation included all the parameters used in the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale. Arthritic degeneration of the ankle joint was assessed according to a modified Bargon scale. Results: The mean followup was 86 months (range 24-282 months). There were no cases of postoperative avascular necrosis of the talus. Four of the six patients in our series required a subtalar fusion as part of the reconstruction procedure. The average preoperative AOFAS hindfoot score was 34, and at the time of the last evaluation, it was 74. The mean preoperative score on the modified Bargon scale for the tibiotalar joint was 1.17. At the last followup, it rose to 1.33. Three different deformities of the talus were identified (a) flattening of the talus (b) extra-articular step and (c) intraarticular step. Conclusion: Reconstruction of talar nonunions and malunions improved function in selected patients with a low risk of complications. Three different anatomical patterns of talar nonunions and malunions were identified.
      Citation: Indian Journal of Orthopaedics 2018 52(3):276-283
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_423_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • Management options in avascular necrosis of talus

    • Authors: Mandeep S Dhillon, Balvinder Rana, Inayat Panda, Sandeep Patel, Prasoon Kumar
      Pages: 284 - 296
      Abstract: Mandeep S Dhillon, Balvinder Rana, Inayat Panda, Sandeep Patel, Prasoon Kumar
      Indian Journal of Orthopaedics 2018 52(3):284-296
      Avascular necrosis (AVN) of the talus can be a cause of significant disability and is a difficult problem to treat. The most common cause is a fracture of the talus. We have done a systematic review of the literature with the following aims: (1) identify and summarize the available evidence in literature for the treatment of talar AVN, (2) define the usefulness of radiological Hawkins sign and magnetic resonance imaging in early diagnosis, and (3) provide patient management guidelines. We searched MEDLINE and PUBMED using keywords and MESH terminology. The articles' abstracts were read by two of the authors. Forty-one studies met the inclusion criteria of the 335 abstracts screened. The interventions of interest included hindfoot fusion, conservative measures, bone grafting, vascularized bone graft, core decompression, and talar replacement. All studies were of Level IV evidence. We looked to identify the study quality, imprecise and sparse data, reporting bias, and the quality of evidence. Based on the analysis of available literature, we make certain recommendations for managing patients of AVN talus depending on identified disease factors such as early or late presentation, extent of bone involvement, bone collapse, and presence or absence of arthritis. Early talar AVN seems best treated with protected weight bearing and possibly in combination with extracorporeal shock wave therapy. If that fails, core decompression can be considered. Arthrodesis should be saved as a salvage procedure in late cases with arthritis and collapse, and a tibiotalocalcaneal fusion with bone grafting may be needed in cases of significant bone loss. Role of vascularized bone grafting is still not defined clearly and needs further investigation. Future prospective, randomized studies are necessary to guide the conservative and surgical management of talar AVN.
      Citation: Indian Journal of Orthopaedics 2018 52(3):284-296
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_608_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • Cuboid injuries

    • Authors: Ippokratis Pountos, Michalis Panteli, Peter V Giannoudis
      Pages: 297 - 303
      Abstract: Ippokratis Pountos, Michalis Panteli, Peter V Giannoudis
      Indian Journal of Orthopaedics 2018 52(3):297-303
      Cuboid fractures are rare injuries. A number of different treatment methods have been proposed including plaster immobilization, open reduction, and internal fixation or external fixation. Bone grafting is commonly used to restore bony length. The majority of the current literature suggests that the loss of length of the lateral column and articular congruency are the two criteria opting for the surgical management of these fractures. Nevertheless, the exact indications and ideal management of these fractures are not established mainly due to the rarity of these injuries and the paucity of literature.
      Citation: Indian Journal of Orthopaedics 2018 52(3):297-303
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_610_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • Arthroscopic and endoscopic management of posttraumatic hindfoot stiffness

    • Authors: Tun Hing Lui
      Pages: 304 - 308
      Abstract: Tun Hing Lui
      Indian Journal of Orthopaedics 2018 52(3):304-308
      Ankle, hindfoot, and toe stiffness can result from hindfoot trauma. It can be due to capsular fibrosis, tendon adhesion, muscle fibrosis, or malunion. For symptomatic stiffness that is resistant to nonoperative treatment, operative treatment should be considered. It is important to tackle the sources of stiffness, and careful preoperative clinical assessment is the key for proper formulation of the surgical plan. Whenever possible, arthroscopic/endoscopic surgery is preferable to open surgery because less extensive dissection and small surgical incisions allow immediate vigorous mobilization of the foot and ankle.
      Citation: Indian Journal of Orthopaedics 2018 52(3):304-308
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_337_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • Posterior malleolus fractures in trimalleolar ankle fractures: Malleolus
           versus transyndesmal fixation

    • Authors: Bilgehan Tosun, Ozgur Selek, Umit Gok, Halil Ceylan
      Pages: 309 - 314
      Abstract: Bilgehan Tosun, Ozgur Selek, Umit Gok, Halil Ceylan
      Indian Journal of Orthopaedics 2018 52(3):309-314
      Background: In ankle fractures involving the posterior malleolus, the issue of which types of fractures require posterior malleolus fixation is still controversial. Recent studies have demonstrated that trimalleolar fractures adversely affect the functional outcomes in comparison to bimalleolar fractures of the lateral and medial malleolus. The purpose of this study was to assess the effects of posterior malleolus fixation on the functional and radiological outcomes. Materials and Methods: Reduction quality, development of posttraumatic ankle osteoarthritis, and functional outcomes in 49 consecutive trimalleolar ankle fractures were evaluated retrospectively in patients with and without posterior malleolus fixation. Group I consisted of 29 patients, in which posterior malleolar fracture was left untreated. Twenty patients in Group II, posterior malleolar fragment was fixed directly by screws alone or plate screw. Twenty-one of these 49 patients were male (43%). The mean age was 47 years (range 20-82 years). Results: The mean followup was 12 to 51 months with a mean of 15 months (range 12-51 months). Statistically significant differences were found between Group I and Group II in terms of ankle arthrosis. American Orthopaedic Foot and Ankle Society score was significantly lower in Group I compared to Groups II. Conclusions: These results demonstrate that posterior malleolar fracture fixation is closely related to successful radiological and functional outcomes after trimalleolar fractures. Transyndesmal screw fixation may not be needed in the cases where the posterior malleolar fracture fixated. For these reasons, we recommend that all posterior malleolar fractures have to be fixed regardless of size.
      Citation: Indian Journal of Orthopaedics 2018 52(3):309-314
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_308_16
      Issue No: Vol. 52, No. 3 (2018)
       
  • A modified broström repair with transosseous fixation for chronic
           ankle instability: A midterm followup study in soldiers

    • Authors: Pei-Wei Weng, Chih-Yu Chen, Yang-Hwei Tsuang, Jui-Sheng Sun, Chian-Her Lee, Cheng-Kung Cheng
      Pages: 315 - 321
      Abstract: Pei-Wei Weng, Chih-Yu Chen, Yang-Hwei Tsuang, Jui-Sheng Sun, Chian-Her Lee, Cheng-Kung Cheng
      Indian Journal of Orthopaedics 2018 52(3):315-321
      Background: Various surgical techniques are available to reduce chronic instability of the lateral ankle ligament complex. The most effective method for these procedures remains controversial. This report presents a surgical technique that is similar to the Broström procedure and uses a modified, nonaugmented repair technique. Materials and Methods: 38 soldiers with a history of chronic lateral ankle instability and poor ankle function underwent plication of the anterior talofibular ligament-lateral capsule complex with transosseous fixation of the calcaneofibular ligament through a fibular bone tunnel between 2004 and 2007. This study included 33 men and 5 women with a mean age of 25.6 years (range 18–36 years) at the time of surgery. Each patient was confirmed to have a history of chronic lateral ankle instability after an inversion injury, and symptoms had been noted for at least 1 year. The patients were followed up with stress radiographs, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional score, and the Sefton assessment system. The mean followup period was 77.6 months (range 66-89 months). Results: At the last evaluation, the talar tilt reduced from an average of 13.9° ± 2.4° before surgery to 3.8° ± 1.8° after surgery, and anterior drawer displacement reduced from 9.6 ± 2.9 mm to 2.3 ± 1.6 mm. The mean AOFAS ankle-hindfoot scale score for functional stability increased from 71.6 ± 4.0 points preoperatively to 95.6 ± 4.0 points postoperatively. As evaluated by the Sefton assessment system, 36 patients (95%) reported an excellent or good functional outcome. All patients resumed normal daily activities and active military duty after the surgery. Conclusion: The procedure described here could be considered a viable alternative option to anatomic reconstruction such as the modified Broström procedure and might be appropriate for the general population.
      Citation: Indian Journal of Orthopaedics 2018 52(3):315-321
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_265_16
      Issue No: Vol. 52, No. 3 (2018)
       
  • Screw intramedullary elastic nail fixation in midshaft clavicle fractures:
           A clinical outcome in 36 patients

    • Authors: Wasudeo Mahadeo Gadegone, Vijayanand Lokhande
      Pages: 322 - 327
      Abstract: Wasudeo Mahadeo Gadegone, Vijayanand Lokhande
      Indian Journal of Orthopaedics 2018 52(3):322-327
      Background: Surgical stabilization of displaced midshaft clavicle fracture can be achieved by an intramedullary nail or plate. When intramedullary nail is used, one of the dreaded complications is the migration of nail. We have used a screw intramedullary device with screw mechanism at one end which can get hold in the medial cancellous bone, thus preventing chances of nail migration. The aim of our study was to evaluate the clinical outcome following elastic stable screw intramedullary nailing for the fixation of midshaft clavicle fractures. Materials and Methods: 36 patients of midshaft clavicular fractures, who met inclusion criteria, were included in this retrospective study. There were 28 males and 8 females. The mean age was 36.6 years. Twenty one patients were managed by close reduction and fixation with screw intramedullary nail. Fifteen patients required mini-open reduction. Followup examination was done at 1 month, 3 months, and 6 months using patient's subjective evaluation, functional outcome, radiographic assessment, and other complications. Results: Union was achieved at average of 11.6 weeks in 31 cases and five patients went to delayed union. The average followup was 6 months. The average constant score was 90%. Three patients had medial nail protrusion which required early removal after union. Conclusion: Screw intramedullary nail is a safe, minimally invasive surgical technique with a lower complication rate, faster return to daily activities, excellent cosmetic and good functional results, and can be used as an equally effective alternative to plate fixation in displaced midshaft clavicle fractures.
      Citation: Indian Journal of Orthopaedics 2018 52(3):322-327
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_381_16
      Issue No: Vol. 52, No. 3 (2018)
       
  • The use of tubular retractors for translaminar discectomy for cranially
           and caudally extruded discs

    • Authors: Arvind G Kulkarni, Shashidhar Bangalore Kantharajanna, Abhilash N Dhruv
      Pages: 328 - 333
      Abstract: Arvind G Kulkarni, Shashidhar Bangalore Kantharajanna, Abhilash N Dhruv
      Indian Journal of Orthopaedics 2018 52(3):328-333
      Background: The conventional interlaminar approach is adequate for access to most disc herniations in lumbar spine surgery. The access to cranially and caudally migrated disc fragments, by conventional interlaminar fenestration, requires an extension of the fenestration with the potential destruction of the facet joint complex and consequent postsurgical instability. To describe the technique and results of the translaminar technique of targeted discectomy using tubular retractors for the surgical treatment of cranially and caudally extruded discs. Materials and Methods: The study period extended from January 2008 to December 2014. All patients with lumbar herniated discs who failed conservative management were selected for surgery and underwent routine erect radiographs and magnetic resonance imaging (MRI) of the lumbar spine. The patients with cranially or caudally migrated discs were included in this study. The technique involves approaching migrated disc through an oval window (sculpted through an 18 mm tubular retractor using a burr) in the lamina precisely over the location of the migrated disc as predicted by the preoperative MRI (inferior lamina for inferior migration and superior lamina for superior migration). The perioperative parameters studied were operative time, blood loss, complications, Oswestry Disability Index (ODI), and visual analog scale (VAS) for leg pain before surgery and at last followup. In the study, 4 patients underwent a postoperative computed tomography-scan with a three-dimensional reconstruction to visualize the oval window and to rule out any pars fracture. All technical difficulties and complications were analyzed. Results: 17 patients in the age group of 41–58 years underwent the translaminar technique of targeted discectomy. The migration of disc was cranial in 12 patients and caudal in 5 patients. Fourteen of the affected discs were at the L4–L5 level and three were at the L5-S1 level. The mean VAS (leg pain) scale improved from 8 to 1 and the mean ODI changed from 59.8 to 23.6. There were no intraoperative or postoperative complications encountered in this study. Furthermore, no patient in the present study required a conventional laminotomy or medial facetectomy. There was no evidence of iatrogenic pars injury or instability at the last followup. There were no recurrences till the last followup. Conclusions: The targeted translaminar approach preserves structures important for segmental spinal stability thus causing minimal anatomical disruption. This approach allows access to the extruded disc fragment and intervertebral disc space comparable to classical approaches.
      Citation: Indian Journal of Orthopaedics 2018 52(3):328-333
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_364_16
      Issue No: Vol. 52, No. 3 (2018)
       
  • Combined ipsilateral fracture of the tibial pilon, talar body, and
           calcaneus: Outcome at 4 years

    • Authors: Henriette Bretschneider, Stefan Rammelt
      Pages: 334 - 338
      Abstract: Henriette Bretschneider, Stefan Rammelt
      Indian Journal of Orthopaedics 2018 52(3):334-338
      Combined fractures of the talar body and the adjacent bones are rare. We present a case of a 35-year-old male with a complex foot and ankle trauma resulting in an unusual combined ipsilateral fracture of the anterolateral tibial plafond, talar body, and sustentaculum tali of the calcaneus. To the best of our knowledge, this particular combination of fractures has not yet been reported in the literature. The combination of talar body fracture with fractures of the adjacent bones was treated by a bilateral open reduction with anatomic reconstruction of the joint surfaces resulting in an excellent clinical outcome at 4-year followup.
      Citation: Indian Journal of Orthopaedics 2018 52(3):334-338
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_412_17
      Issue No: Vol. 52, No. 3 (2018)
       
  • Legends of Indian orthopedics: Prof. B Mukhopadhaya

    • Authors: DK Taneja, Bhavuk Garg
      Pages: 339 - 340
      Abstract: DK Taneja, Bhavuk Garg
      Indian Journal of Orthopaedics 2018 52(3):339-340

      Citation: Indian Journal of Orthopaedics 2018 52(3):339-340
      PubDate: Mon,7 May 2018
      DOI: 10.4103/ortho.IJOrtho_227_18
      Issue No: Vol. 52, No. 3 (2018)
       
 
 
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