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International Journal of Research in Orthopaedics
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ISSN (Online) 2455-4510
Published by Medip Academy Homepage  [12 journals]
  • Serum levels of monocyte chemoattractant protein-1 has no correlation with
           gender and age in polytrauma

    • Authors: Mosimabale Balogun, Olubunmi Odeyemi, Olugboyega Oyewole, Tolulope Ogunrewo, Richard Omoyeni
      Pages: 515 - 520
      Abstract: Background: Trauma is one of the commonest causes of death among young people with significant increase in morbidity and mortality. Following injuries to tissues, the body responds in an attempt to cause repair of the damaged tissue. Although its significance depends on the interplay of various factors involving neurohormonal and immune responses. Monocyte chemoattractant protein-1 (MCP-1) is a pro-inflammatory chemoattractant produced by the monocyte and causes the further release of chemokines and cytokines needed at the site of tissue injury. It therefore plays a critical role in tissue healing.Methods: This was a prospective hospital-based study carried out at University College Hospital (UCH), Ibadan. Polytrauma patients admitted through the accident and emergency department that met a defined criteria were recruited and had their blood samples taken into an endotoxin free test tube at 48±2 hours after trauma. MCP-1 levels in the serum were estimated though the human MCP-1 enzyme-linked immunosorbent assay (ELISA) kit. This process was carried out using the ELISA technique based on the producer’s guide.Results: 110 patients were recruited for the study. There was no significant difference in gender variations in MCP-1 level (t=-0.935, p=0.351). For the male and female variations in MCP-1 levels, it ranges from 10 to 2841 and 22 to 2687 respectively. Likewise, there was no significant relationship in age variations in MCP-1 values (f=0.959, p>0.05).Conclusions: This study demonstrated no correlation between serum level of monocyte chemoattractant protein-1 with age and gender in polytraumatized patient according to age and gender.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222184
      Issue No: Vol. 8, No. 5 (2022)
  • Conservative treatment for patients with massive prolapsed lumber
           intervertebral discs

    • Authors: M. Nazrul Islam, S. M. Didarul Alam, M. Imran, M. Sahedur Rahman, M. Tanveer Hasan
      Pages: 521 - 524
      Abstract: Background: The natural history of Lumber hernia of nucleus pulpous is not fully known and absolute indications for surgical intervention cannot be established. Several studies have shown that the most giant discs appear to have the greatest tendency to resolve with conservative treatment. The objective of this study is to investigate whether massive prolapsed discs can be safely managed conservatively once clinical improvement has occurred.Methods: Thirty-five patients were studied by clinical assessments and serial magnetic imaging over 3 years. Patients present with intense sciatica but began to show clinical improvement despite massive disc prolapsed. Clinical assessment included the Lasegue test and neurological improvement. The Oswestry disability index was used to measure function and changes in function. Serial MRI studies allowed the measurement of volume changes of the prolapsed disc material over some time. Results: Initial follow-up at an average of 13.2 months showed that 87% had complete and sustained recovery at the initial follow-up. Only four patients required surgery. The average Oswestry disability index improved from 63% to 20%. Volumetric analysis of serial MRI scans showed an average reduction of 69% in disc size. Conclusions: A massive disc prolapsed can pursue a favourable course. If early progress is shown, the long-term prognosis is very good and even massive disc prolapses can be treated conservatively.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222185
      Issue No: Vol. 8, No. 5 (2022)
  • A multicentric retrospective study for the treatment of humerus bone
           fracture following humerus plate fixation with screws

    • Authors: Tarun Kumar, Mohit Kumar, Bhawana Chawale, Sonika Bhatt, Gaurav Luthra
      Pages: 525 - 531
      Abstract: Background: The goal of this study was to investigate the performance of the humerus bone fixation with screws while treating humerus bone fracture.Methods: The 34 patients’ retrospective data was collected with 1 year of follow up. Humerus fractures were treated by humerus plate fixation in different hospitals and countries, including 26 males and 8 females, with the age range of 32 -74 years (mean 47.4 years). Clinical and radiological follow-ups were conducted at 1 month, 3 months, 6 months and 1 year after surgery to check the bone union and implant-related complications. Ten different plates were used for the treatment of fracture as per the fracture type. The patient's health status was evaluated by the American society of anesthesiologists grade and the visual analogue score (VAS) was also obtained.Results: The progressive decline in the VAS score showed positive results related to pain management. All patients receive continuous physiotherapy under the supervision of physiotherapists, which aids in faster recovery and mobilization. No biomechanical issue related to implant plate and screw loosening, corrosion, bend, or other factors was detected in our 34 patients. Out of 34 patients 91% were satisfied with no pain and the remaining 9% were unsatisfied due to pain. About 85% of patients were happy with aesthetic appearance and the rest 14% of patients were unhappy related to aesthetic appearance.Conclusions: Humerus plate fixation is feasible for the treatment of humerus fracture. The clinical outcomes and prognosis of patients are dependent on the accuracy of intraoperative reduction and surgical expertise.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20221816
      Issue No: Vol. 8, No. 5 (2022)
  • Oral enzyme therapy using trypsin-bromelain-rutoside combination to
           counter pain and swelling in orthopaedic conditions: a single-centre

    • Authors: Rajesh K. Dhadiwal, Bhushan M. Khemnar, James John
      Pages: 532 - 536
      Abstract: Background: Various orthopaedic conditions end up being painful, chronic and progressive, and are associated with persistent inflammation. The present study aimed to evaluate the efficacy and safety of an enzyme-bioflavonoid combination of trypsin-bromelain-rutoside in managing the chronic pain and swelling in out-patients with various orthopaedic conditions.Methods: The study was a prospective, observational study, conducted in 100 patients attending the orthopaedics department at a multi-speciality hospital located in Nashik, Maharashtra, India.  Verbal rating scales were used for grading the pain intensity and extent of swelling at baseline and on days 3 and 8, after being prescribed oral tablets of trypsin-bromelain-rutoside combination. Scores were analysed using paired t test. A 5-point Likert scale was used to evaluate patient- and investigator-reported global assessment of improvement in pain and swelling at days 3 and 8.Results: At baseline, 68 patients reported moderate-severe pain, while 74 patients had moderate swelling. The mean scores for pain and swelling showed statistically significant reduction at both day 3 (p<0.0001) and day 8 (p<0001). By day 8, 98 patients reported good-excellent improvement and the investigator reported good-excellent improvement in 97 patients. No adverse event was reported by any patient.Conclusions: The results indicate that this therapy led to significant improvement in the pain and swelling as early as day 3 and further improvement with continued therapy, and can, thus, provide a safe alternative in patients with various orthopaedic conditions and reduce the need for other analgesic and anti-inflammatory drugs.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222058
      Issue No: Vol. 8, No. 5 (2022)
  • Prevalence and severity of low back pain among postmenopausal women: a
           community-based study in block Hazratbal of Srinagar district

    • Authors: Mohamad Azhar Gilani, Syed Najmul Ain
      Pages: 537 - 540
      Abstract: Background: Menopause brings with it a cluster of symptoms and health problems. Low back ache (LBA) decreases the quality of life both socially and economically by increasing sickness absenteeism. Women are more likely to have backache and more so after menopause. Objective of the study was to find out the prevalence of LBA among postmenopausal women and also to assess the severity of the LBA.Methods: This was a cross-sectional community-based study conducted in block Hazratbal of district Srinagar, the field practice area of the department of community medicine, Government Medical College (GMC), Srinagar. The data was collected over a period of 3 months in 2018 by consecutive sampling by going door to door in the area. A woman who had attained menopause as per the definition was included in the study.Results: A total of 198 women were included. Mean age at the time of contact was 53.56 years. The prevalence of LBA among these women was 77.8% (154 of 198 women) with almost 55% women having moderate LBA and 16% women grading their LBA as severe. Those in late menopause were 4 times more likely to have severe LBA than those in early menopause.Conclusions: The magnitude of LBA among postmenopausal women is huge. About one quarter of these women have severe LBA. Therefore, to maintain a good quality of life of these women, specific measures to tackle this problem must be taken.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222068
      Issue No: Vol. 8, No. 5 (2022)
  • A study of disability in patients with chronic musculoskeletal pain

    • Authors: Prasad L. Chaudhari, Sachin Y. Kale, Gaurav Kanade, Shikhar D. Singh, Sanjay B. Dhar, Ajay Sharma
      Pages: 541 - 547
      Abstract: Background: Musculoskeletal impairment is the most common cause of chronic pain and subsequent disability world over. Yet their very few Indian studies on this subject. The aim of study was to assess the extent of disability in out-patients suffering from chronic musculoskeletal pain, to determine whether the disability varied with the age and sex of the patient, to assess any correlation between the intensity of pain and the extent of disability, and to evaluate whether the extent of disability depended upon the site, periodicity and duration of pain.Methods: The 200 patients of chronic musculoskeletal pain were assessed for disability using the pain disability questionnaire (PDQ) and pain intensity using the numeric pain rating scale. The patients with mild, moderate and severe disability were compared using non parametric tests to assess the differences related to age, sex, pain intensity, site, duration and periodicity of pain.Results: The 56% patients had mild, 41% had moderate while 3% patients reported severe disability. Disability was higher in patients in the younger age group, higher intensity of pain, heel pain and variable pain. In the regression analysis, pain intensity emerged as the sole predictor of disability.Conclusions: We conclude that 56% patients had mild, 41% had moderate while 3% patients reported severe disability. Disability was higher in patients at the extremes of age, higher intensity of pain, and variable pain. Gender and pain duration did not have any significant association with disability.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222072
      Issue No: Vol. 8, No. 5 (2022)
  • The role of pre operative appendicular magnetic resonance imaging in cases
           of acute bone and joint infection in the paediatric age group

    • Authors: Srijay Sashaank S., Giri Raj J. K., Gopinath Menon P.
      Pages: 548 - 553
      Abstract: Background: Acute haemotogenous osteomyelitis can occur at any age group but is mainly a disease of children. They are a challenge to differentiate as they have overlapping signs and symptoms. Septic arthritis is considered a surgical emergency while acute osteomyelitis, when presented early can be treated with parenteral antibiotics. There is paucity in the approach (imaging guidelines and treatment) for cases where acute septic arthritis is associated with osteomyelitis. We aimed to analyses the role of pre operative appendicular MRI in the cases of acute bone and joint infection in paediatric age group.Methods: This is a prospective study done in 38 children suspected to have acute bone and joint infections. All the patients underwent emergency appendicular MRI in the suspicion of bone and joint infections. Based on the MRI findings, all the patients were classified into cases of isolated septic arthritis and cases of septic arthritis with concomitant osteomyelitis. There was a change in the treatment modality between the two categories of patients.Results: In our study 14 (36.84%) cases of the 38 suspected bone and joint infection had concomitant osteomyelitis with septic arthritis. These 14 cases were seen involving the knee, hip, elbow and shoulder joints. The incidence of septic arthritis with coexisting osteomyelitis was 36.84% in our study, which was diagnosed with pre operative emergency appendicular MRI.Conclusions: Our study concludes that MRI should be included in the work up for suspected bone and joint infections provided MRI is done in a timely fashion without unnecessarily delaying surgical intervention if needed. 
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222073
      Issue No: Vol. 8, No. 5 (2022)
  • A retrospective study of intramedullary tibia nailing system intended for
           tibia fracture

    • Authors: Pallavi Sharma, Arpit Jain, Gaurav Luthra
      Pages: 554 - 558
      Abstract: Background: The aim of the study was to investigate the performance of the intramedullary tibia nail in the treatment of tibia fractures, mostly shaft fractures. The objective of this study was to assess the post-operative complication due to the treatment involving tibia nails.Methods: This was a retrospective study to study the results obtained after tibia nail surgery. A total of 32 patients were selected based on inclusion and exclusion criteria (25 males and 7 females; average age- 37 years). The fracture was classified according to AO classification, the nailing device is intended for 41-A1/A2, 42 and 43-A1/A2/A3 types of fractures. The patients with at least three visits within 180 days were selected for data collection.Results: The clinical outcomes include pain scale assessment from the baseline/enrolment to the last follow up which shows no pain (93.7%) and mild pain (6.7%) after 180 days. No implant-related problems like implant loosening.Conclusions: For the treatment of tibia shaft fracture which can either be closed or open, intramedullary tibia nailing devices like KN-2T and KN-5T have been concluded to be the good approach.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222091
      Issue No: Vol. 8, No. 5 (2022)
  • Distal radius fractures: a prospective study of the clinical and
           radiological outcomes in surgically managed patients

    • Authors: Tanveer Ali, Irfan U. Ashraf, Sayyidah A. T. N. Qadri, Imtiyaz A. Beigh
      Pages: 559 - 564
      Abstract: Background: Objective of the research was to evaluate radiological and functional outcome in fractures of the distal radius treated by various surgical methods.Methods: 89 patients with distal radius fractures were randomly divided into three groups according to a computer-generated table of randomization. 40 patients were managed by K wire fixation. 22 patients were managed by external fixator. 27 patients were managed by volar plating technique. Anatomical restoration was evaluated by posterior-anterior and lateral radiographs obtained preoperatively and at 09 months of follow up to evaluate radial height (RH), radial inclination (RI) and volar tilt (VT). Functional outcome was evaluated using Mayo scoring system.Results: According to Mayo score, in K-wire group 72.5% (n=29) patients had excellent to good outcome, 17.5% (n=7) had fair outcome while as 10% (n=4) patients had poor outcome. In external fixator group 72.7% (n=16) patients had excellent to good outcome while as 27.3% (n=6) had fair outcome. In volar plating group 81.5% (n=22) patients had excellent to good outcome while as 18.5% (n=5) had fair outcome.Conclusions: In our study we found that volar locked plating provides advantage in dorsally or volarly displaced intra-articular fractures with excellent to good radiological outcome. However, in type B (partial intra-articular fractures) fractures, volar locking compression plate (LCP) and external fixator provide almost equivocal results. Percutaneous pinning can be recommended for extra-articular or simple intra-articular fracture patterns, with a loss of volar and/or RI but without significant radial shortening.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222186
      Issue No: Vol. 8, No. 5 (2022)
  • General health and functional improvement among patients with unstable
           extracapsular proximal femoral fractures managed with proximal femoral
           nail by using SF-36 score

    • Authors: Amit Kumar Verma, Priyanka Dhiman, Vipin Sharma
      Pages: 565 - 570
      Abstract: Background: Proximal femoral nail is emerging as the treatment of choice for unstable extra capsular proximal femoral fractures. This study comprises of functional evaluation of the treated patients by using SF 36 score.Methods: This was a prospective hospital-based study done on 54 patients with unstable proximal femoral fractures classified according to the AO/ASIF classification system and were treated by using PFN in the department of Orthopaedics DRPGMC, Tanda. Functional outcome was assessed by using SF-36 score on, 14th postoperative day, at three months and six months.Results: Our study has mean scores of short form-36 subscales as physical function 70.6, role limitation due to physical health 68.1, role limitation due to emotional health 90, energy/fatigue 66, emotional wellbeing 78, social functioning 67.7, pain 75 and general health 73.3.Conclusions: The results of this study confirm that intramedullary nailing with the use of a PFN in unstable proximal femoral fractures is a safe method. A significant change was seen in quality of life postoperatively as evidenced by various scores used in present study. Weaknesses of this study include a short follow-up period and the inclusion of a small study group.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222187
      Issue No: Vol. 8, No. 5 (2022)
  • Functional results of minimally invasive cheap fixation technique for all
           types of intertrochanteric femoral fractures using enders nail and
           cannulated cancellous screws

    • Authors: Ansari Muqtadeer A. Aziz, Altamash A. Patel, Pratik P. Rathod
      Pages: 571 - 576
      Abstract: Background: The objective was to study functional results of fixation of intertrochanteric fractures of femur using enders nail and cannulated cancellous screws.Methods: This was a prospective observational study. The study was conducted on 30 patients of intertrochanteric femoral fractures who underwent fixation by enders nailing and cannulated cancellous screws in Department of Orthopaedics, GMCH, Aurangabad from January 2018 to January 2021. Patients were assessed functionally using Harris hip score, visual analogue score, and radiological assessment at 3, 6, and 12 months.Results: All patients showed radiological union within 3 months. Functional assessment was done with Visual analogue scale (VAS) in which mean VAS score was 0.9 (range 0-3), mean Harris hip score which was 86 (range 81-90). One patient developed superficial infection at incision site which was treated by giving appropriate antibiotics and one patient complained of prominent nail on medial side of knee which was treated by implant removal after union of fracture.Conclusions: Fixation of intertrochanteric femur fractures using enders nailing and cannulated cancellous screws achieves good stability with minimal complications and improved patients’ outcome in terms of less intraoperative blood loss, less chances of infection, less operative time with minimal patient morbidity and good functional outcome.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222188
      Issue No: Vol. 8, No. 5 (2022)
  • Functional evaluation of surgical fixation of distal radius

    • Authors: Ramdas Maloth
      Pages: 577 - 580
      Abstract: Background: Distal radius fractures are the most recurrent fractures happening in the upper extremity. We conducted a prospective hospital-based clinical study on the management of distal radius fractures with surgical fixation. To assess functional outcome and to assess the effectiveness of surgical fixation in the intra-articular distal end of radius fractures.Methods: This prospective study comprised 40 patients treated with surgical fixation. The patients were followed up at six weeks, three months, 6 months and one year after surgery. The assessment of pain, range of motion, grip strength and activity were assessed and scored according to Gartland and Werley scoring systems. Radiographic measurements were also evaluated.Results: Gartland and Wereley scoring were used to evaluate the overall functional results. Excellent to good results were in 85% of patients, and fair to poor results were seen in 15% of patients. Two patients developed pin site infections.Conclusions: Surgical fixation used for ligamentotaxis is an effective method of treating intra articular distal radius fractures.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222189
      Issue No: Vol. 8, No. 5 (2022)
  • The role of lateral and medial posterior tibial slope in anterior cruciate
           ligament injuries: a case-control study

    • Authors: Ankith Chacko, Ranjith T. C., Murukan Babu, Ajith Toms, Susan John
      Pages: 581 - 586
      Abstract: Background: The anterior cruciate ligament (ACL) is one of the major stabilisers of the knee   and is the most frequently involved ligament in knee injuries and related functional instability. The objective of the study was to compare the lateral posterior tibial slope (LPTS) and medial posterior tibial slope (MPTS) among those with ACL injury and those with the intact ligament.Methods: MRI of 65 (male-43, female-22) ACL injured and 65 (male-58, female-7) ACL intact knees were studied. Using RadiAnt DICOM viewer software, the slopes of both medial and LPTS s were measured. The statistical analysis was performed by IBM SPSS 25. Associations between various factors were assessed using the Chi square test for categorical variables and independent t test were done for quantitative variables. P<0.05 had been considered statistically significant.Results: Among cases the mean LPTS was 10.230±3.930 and mean MPTS was 6.610±3.490. Among controls, mean LPTS was 8.460±3.630, mean MPTS was 5.510±2.910. Case had a statistically significant (p=0.009) steeper LPTS than control population. MPTS of cases were steeper than the control population with no statistical significance (p=0.055).Conclusions: In this study, the LPTS was significantly increased among patients with ACL injury as compared with ligament-intact controls. LPTS measurements should be considered as a significant independent modifiable risk factor for ACL injury.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222190
      Issue No: Vol. 8, No. 5 (2022)
  • Posterior capsular infiltration with local anaesthetic cocktail during
           total knee arthroplasty: a prospective comparative study

    • Authors: Vikram I. Shah, Javahir A. Pachore, Jayesh Patil, Darshan Rajani
      Pages: 587 - 592
      Abstract: Background: Total knee arthroplasty offers a stable joint with excellent long-term results in osteoarthritis knee patients. The procedure is also associated with post-operative pain which can lead to delayed functional recovery in few patients. This comparative study was aimed to evaluate the effiсасy of а lосаl anaesthetic сосktаil injection with and without роsteriоr сарsulаr infiltration for роst-орerаtive раin соntrоl and early functional reсоvery in раtients undergoing simultaneous bilateral TKА.Methods: This was a prospective comparative study which involved 50 participants undergoing bilateral TKA where one knee, received LIA in anterior, medial and lateral structures of the knee as well as posterior capsule (group A) and contralateral knee received LIA in anterior, medial and lateral structures, identical to the former knee, but excluding posterior capsule region (group B). Pre-operative and post-operative parameters such as VAS, KSS and knee ROM in both knees of all the patients were noted and compared to evaluate the efficacy of PCI.Results: Comparison of VAS scores, post-operatively showed that VAS on rest and on movement was lower in group A than group B at all the time frames (p value <0.0001*). Post-operative knee ROM was higher in group A (p<0.0001). Knee society score was observed to be higher in group A than group B on 15th day and at 1 month (p<0.0001).Conclusions: The study successfully demonstrates that posterior capsular infiltration when included in LIA technique provides a better pain control and also early functional recovery after TKA.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222191
      Issue No: Vol. 8, No. 5 (2022)
  • Clinical performance of tibia bone plate system for fixation of tibia

    • Authors: Sonika Bhatt, Mohit Kumar, Tarun Kumar, Bhawana Chawale, Gaurav Luthra
      Pages: 593 - 597
      Abstract: Background: In this study, we aimed to investigate the performance of the tibia plates system while treating the tibia fracture fixation. The objective of this study was to reduce the post-operative complications of proximal and distal tibia fracture by using indigenously manufactured implants (plates and screws).Methods: In this retrospective study, we studied the results of the tibia plate system in treatment of tibia fracture. A total of 34 consecutive patients were included in this study (24 males, 10 females and average age 48.6 years). Fracture type was classified as per the Muller AO classification of fracture. According to the AO classification, proximal and distal tibia fractures 41-A, 41-B and 41-C was observed with one year follow up period followed by physical exercises after one month of the surgery. The fractures were treated with wise-lock proximal and distal tibia plates.Results: The outcomes of clinical treatment were obtained in our study; no pain (88.2%), mild pain (11.7%) after 1 year follow up. The follow up of patients was taken on 1 month, 6 months and 1 year according to visual analog scale (VAS) score. No implant related problem have been found like loosening, bending and corrosion. X-ray was used to check the union, non-union. Functional outcomes were assessed with VAS.Conclusions: Treatment of tibia fracture with wise-lock proximal and distal tibia plate shows good outcomes with less complications.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20221813
      Issue No: Vol. 8, No. 5 (2022)
  • Old but effective during this lockdown period a modifies pin plaster
           technique to treat distal tibia fractures

    • Authors: Prashanth Dhanraj, Prathyush Chitithoti, Krishna Sai Sunkoj, Marupakala Nithil
      Pages: 598 - 601
      Abstract: There are various methods for treating fractures of the distal tibia. The purpose of this study was to introduce a modified technique of ‘pin in plaster’ in treating the distal 1/3rd tibia fractures. Fifteen patients with fractures of the distal tibia AO classification A1 and A2 were followed for one-year post-application of the cast. Patients were excluded if they had complicated fractures or grade III b fractures or crush injuries, with multiple injuries or any pathological fractures or with any nerve or vascular injuries. Range of movement and functional results were calculated periodically at the 3rd and 6th months. Three cases developed pin tract infection in the study, all of which were treated with oral antibiotics successful. The fibula was fixed with plating in selected cases There were no cases of nerve injuries and no cases of tendon injury. All the cases that were treated were successful and completely weight-bearing by the end of the 4th month. Our modified technique is simple quick and effective to restore anatomic congruity and maintain the reduction in fractures of the distal tibia.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222192
      Issue No: Vol. 8, No. 5 (2022)
  • Traumatic posterior dislocation of hip with ipsilateral fracture of shaft
           of the femur: external maneuvers reduction and osteosynthesis by screw
           plate about a case and review of literature at Tambacounda regional
           hospital in Senegal

    • Authors: Mohamed Sidibe, Mohamed Lamine Bah, Fodé Mahamoud Sylla, Minkailou Camara, Alhassane Soumah, Serge Ntungwanayo
      Pages: 602 - 605
      Abstract: Traumatic hip dislocation associated with an ipsilateral femoral fracture is a rare injury. It occurs in a high-energy traumatic context. The classic mechanism consists of a fall with landing on the hip, which initially dislocates and the femur fracture occurs secondarily by adduction of the proximal fragment. The diagnosis is difficult in front of the fracture whose signs mask the vicious attitude of the dislocation. We reported the case of a passenger of a motorcycle who collided with a parked car.  He was ejected from the motorcycle and landed on his right hip. We performed X-rays of hip and lower limb at his admission which revealed a dislocation of hip in its high posterior variety and a medio-diaphyseal fracture of femur on same side. Reduction of dislocation by external maneuvers was made and osteosynthesis of femur with screwed plate performed 48 h later. After 16 months of care, functional and radiological results sufficient.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222193
      Issue No: Vol. 8, No. 5 (2022)
  • Isolated trochlear shear fracture of the distal humerus: a case report

    • Authors: Saeb Mefleh Mistarihi, Ehab Hamzeh Azam, Naser Fuad Shari, Motaz Mohammad Ali Al Qasaimeh, Mohammad Jumah Hawasheh
      Pages: 606 - 608
      Abstract: Laugier was the first to describe an isolated humeral trochlea fracture in 1853. We report the case of a patient with an isolated fracture of the trochlea and discuss the underlying mechanisms and the clinical, radiological features of this pathology and surgical management of this rare fracture. The elbow arthrotomy was done via an anteromedial approach, with the interval through the flexor-pronator muscles medially and the brachialis muscle laterally. The trochlea was temporally fixed by two Kirschner wires, and the definitive fixation was obtained by two cannulated. Herbert screws from anterior to posterior. The elbow was immobilized and splinted in a flexed position (70 degrees) for two weeks to allow soft tissue healing and minimize pain. After cast removal, rehabilitation of elbow was established and actively assisted mobilization for three months. The isolated trochlea fracture is a rare injury and usually, it is associated with other injuries such as elbow dislocation. Few studies in the literature described such fracture and the anteromedial approach; most of these studies described the use of a direct medial approach to the elbow. Several fixation methods were described in the literature, including k-wires, AO compression screws, and headless compression screws. Isolated fracture of the trochlea is rare. The mechanisms causing this fracture are complex; the usual mechanism of isolated trochlear fractures is falling on the palm with the elbow extended and supinated. In our report, the patient disclosed that he felt directly on his flexed elbow. Trochlear fractures require open reduction and internal fixation to achieve anatomical reduction, with excision of the small osteochondral fragments that may be complicated by arthritic changes.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222194
      Issue No: Vol. 8, No. 5 (2022)
  • A case of mucoid hypertrophic degeneration of anterior cruciate ligament
           with ganglion cyst causing extension block treated with arthroscopic
           debridement of the cyst and partial debulking surgery

    • Authors: Vicky T. Jain, Shubham N. Katti, Vijay P. Yadav, Prithviraj A. Paigude
      Pages: 609 - 612
      Abstract: Mucoid degeneration of anterior cruciate ligament (ACL) is an uncommon cause of knee pain and restriction of movements. It uncommonly presents with a coexisting ACL ganglion cyst. Typically present between ages of 40-60 years, however, the true incidence and symptoms are variable. We present our experience with one such case with loss of knee extension treated with arthroscopic debulking. The patient regained both full range of motion and resolution of symptoms after the treatment.
      PubDate: 2022-08-25
      DOI: 10.18203/issn.2455-4510.IntJResOrthop20222057
      Issue No: Vol. 8, No. 5 (2022)
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