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Journal of Clinical Orthopaedics and Trauma

Khatri Kavin, Sharma Vijay, Lakhotia Devendra, Farooque Kamran
AIM: To determine patient satisfaction in the patients of displaced intraarticular calcaneal fractures treated with standard lateral approach. METHOD: The patients of displaced calcaneal fractures (Sander's type II and III) treated between March 2009 and March 2012 were included in the retrospective review and functional outcome was evaluated using American Orthopaedic Foot and Ankle Society (AOFAS) hind foot score, Creighton Nebraska Health Foundation Assessment (CNHFA) scale and foot function index (FFI)...
October 2016: Journal of Clinical Orthopaedics and Trauma
Tobias K A Baring, Ravi Popat, Ali Abdelwahab, Barry Ferris
: We present the results of short- to medium-term follow-up of 10 patients following ulna head replacement. The mean age of patients was 63.2 years (range 48-81 years), with the mean duration of follow-up being 48 months (12-88 months). The indications for the procedure were primary osteoarthritis (n = 3), post-traumatic osteoarthritis (n = 4), failed Darrach's procedure (n = 2) and rheumatoid arthritis (n = 1). Two patients required revision (20%), one for gross aseptic loosening of the stem and another for an initially oversized head...
October 2016: Journal of Clinical Orthopaedics and Trauma
Vivek Machhindra Morey, Bhavuk Garg, Prakash P Kotwal
Glomus tumours are rare benign vascular neoplasms commonly found in the hand particularly in subungual region. Though, its aetiology remains largely unknown, several hypotheses have been made to explain the etiopathogenesis and cause of pain. These tumours usually present as a bluish or pinkish red discolouration of the nail plate with classical triad of localised tenderness, severe pain, and cold sensitivity. Nevertheless, differential diagnosis of other painful tumours, such as leiomyoma, eccrine spiradenoma, haemangioma, neuroma, osteochondroma, or mucous cyst should always be kept in mind while evaluating a patient with severe pain in the tip of the finger...
October 2016: Journal of Clinical Orthopaedics and Trauma
Manoj Kumar, Sanjeev Bhoi
Hemorrhagic shock (HS) is the major cause of death during trauma. Mortality due to HS is about 50%. Dysfunction of hematopoietic progenitor cells (HPCs) has been observed during severe trauma and HS. HS induces the elevation of cytokines, granulocyte-colony stimulating factor (G-CSF), peripheral blood HPCs, and circulating catecholamines, and decreases the expression of erythropoietin receptor connected with suppression of HPCs. Impaired HPCs may lead to persistent anemia and risk of susceptibility to infection, sepsis, and MOF...
October 2016: Journal of Clinical Orthopaedics and Trauma
Mayank Gupta, Vijay Kumar Jain, Gaurav Kumar Upadhyaya, Rajendra Kumar Arya
Poliomyelitis is on the verge of eradication. But the survivors of polio are still living with its consequences in different parts of the world and so will continue to be seen for almost a century. Fractures in the polio-affected limb are a common entity in these patients and are difficult to manage using the common fracture management protocols. This article gives a comprehensive review of the challenges faced in fixation of fractures in polio affected limbs and possible solutions to overcome them. Knowledge of treating these fractures is important to a trauma surgeon as such scenarios are not uncommon in daily practice...
October 2016: Journal of Clinical Orthopaedics and Trauma
Sanjay Agarwala, Anshul Sobti, Siddhant Naik, Sameer Chaudhari
BACKGROUND: Valgus high tibial osteotomy (HTO) is a well-established treatment option for patients with early osteoarthritis of the medial compartment of the knee. It is achievable with either open-wedge or closed-wedge technique. The aim of the study was to compare the radiological and clinical outcomes following HTO done with open- and closed-wedge techniques. MATERIAL AND METHODS: Two groups of patients undergoing HTO and fixation with locking plates were compared...
October 2016: Journal of Clinical Orthopaedics and Trauma
Raju Vaishya, Vipul Vijay, Gyanendra Kumar Jha, Amit Kumar Agarwal
INTRODUCTION: Chronic ACL insufficiency with associated varus malalignment due to knee osteoarthritis (OA) is challenging to treat surgically. A combined ACL reconstruction (ACLR) with medial open wedge high tibial osteotomy (HTO) without using any metallic implant for HTO is an effective technique. MATERIALS AND METHOD: All the patients attending the outpatient department ACL injury and with associated medial compartment OA (Kellegren's grade 2 and grade 3) were considered for inclusion in the study...
October 2016: Journal of Clinical Orthopaedics and Trauma
Raju Vaishya, Vipul Vijay, Vikas P Birla, Amit Kumar Agarwal
INTRODUCTION: Restoration of mechanical axis (MA) is one of the most important aims of treatment of knee arthritis. The measurement of MA is often done on hip knee ankle (HKA) radiographs (LLR), but its measurement is often difficult and variable. We studied to check if inter-observer variability in the measurement of MA is dependent on the experience of the observer. MATERIALS AND METHODS: 48 patients (70 knees) underwent measurement of MA on HKA radiographs. The measurement was done by five observers of different experience...
October 2016: Journal of Clinical Orthopaedics and Trauma
Siddharth R Virani, Aditya A Dahapute, S S Bava, Saurabh R Muni
INTRODUCTION: Open tibial fractures are associated with a high incidence of mainly osteomyelitis. Negative pressure wound therapy (NPWT) is a novel form of treatment that uses subatmospheric pressure to effect early wound healing. OBJECTIVES AND STUDY DESIGN: To determine the effect of NPWT on incidence of deep infections/osteomyelitis after open tibial fractures using a prospective randomized study design. MATERIALS AND METHODS: Ninety-three open tibial fractures were randomized into two groups receiving NPWT and the second group undergoing periodic irrigation, cleaning and debridement respectively...
October 2016: Journal of Clinical Orthopaedics and Trauma
Tyler Smith, Leah Elson, Christopher Anderson, William Leone
Despite technological advances in operative technique and component materials, the total knee arthroplasty (TKA) revision burden, in the United States, has remained static for the past decade. In light of an anticipated exponential increase in annual surgical volume, it is important to thoroughly understand contemporary challenges associated with technologically driven TKA. This descriptive literature review harvested 69 relevant publications to extrapolate patient trends, benefits, costs, and complications associated with computer-assisted surgery, patient specific instrumentation, and intra-operative sensors...
October 2016: Journal of Clinical Orthopaedics and Trauma
Thaddeus Chika Agu, Mathew Emeka Ojiaku
BACKGROUND: Major limb amputation is a common orthopaedic trauma procedure and it is indicated mainly for traumatic gangrene and for trauma related limb conditions. The loss of a limb is devastating to the patient even when it is done to save life. The aims of the study are to highlight the indications for major limb amputations and to find out if there are any concurrent pattern changes. PATIENTS AND METHODS: This is a retrospective study analysing medical records of all the patients, who had major limb amputations over a period of 8 years, between October 2007 and September 2015 in a private orthopaedic and trauma centre in the south-east sub-region of Nigeria...
October 2016: Journal of Clinical Orthopaedics and Trauma
Brendan J Quirk, Kumar Sannagowdara, Ellen V Buchmann, Eric S Jensen, David C Gregg, Harry T Whelan
OBJECTIVE: Evaluate the effect of near-infrared light (NIR) on immediate production of ATP by osteoblasts and fibroblasts in vitro, and the healing process of rat femur fractures with intramedullary fixation. BACKGROUND: NIR is one potential treatment option for complications of fracture healing, which has shown to stimulate cellular proliferation and to enhance the healing process. METHODS: Cell culture - MC3T3-E1 and 3T3-A31 cells were subjected to NIR at 660 nm, 830 nm, or both combined...
October 2016: Journal of Clinical Orthopaedics and Trauma
Phillip M Mitchell, Svetlana A Gavrilova, Ashley C Dodd, Basem Attum, William T Obremskey, Manish K Sethi
BACKGROUND: Involvement in patient care is critical in training orthopedic surgery residents for independent practice. As the focus on outcomes and quality measures intensifies, the impact of resident intraoperative involvement on patient outcomes will be increasingly scrutinized. We sought to determine the impact of residents' intraoperative participation on 30-day post-operative outcomes in the orthopedic trauma population. METHODS: A total of 20,090 patients from the American College of Surgeons National Surgical Quality Improvement Program database from 2006 to 2013 were identified...
October 2016: Journal of Clinical Orthopaedics and Trauma
Rajendra Kumar Beniwal, Abhishek Bansal
INTRODUCTION: Regular monitoring of tissue compartmental pressures and hence a timely intervention in patients with impending compartment syndrome has been shown to prevent morbidity and permanent disability. MATERIAL AND METHODS: Intra-compartmental pressure in flexor compartment of forearm and various compartments of legs following recent trauma presenting within 6 h of injury was carried out in 30 subjects using Whitesides' technique and patients were classified into 3 categories for treatment purposes i...
October 2016: Journal of Clinical Orthopaedics and Trauma
Jonathan Wright, Nick Aresti, Charlotte Heuveling, Livio Di Mascio
AIMS: Decision-making in management of clavicle fractures is often based on the degree of displacement and shortening present on plain radiographs. We aimed to evaluate whether plain radiographs provide an accurate representation of the true displacement present, which can be difficult to image in orthogonal planes. METHODS: Consecutive high-energy trauma patients with midshaft clavicular fractures requiring further CT imaging of the thorax/abdomen for other associated injuries between 2009 and 2012 were evaluated...
October 2016: Journal of Clinical Orthopaedics and Trauma
Raju Vaishya, Hitesh Lal
No abstract text is available yet for this article.
October 2016: Journal of Clinical Orthopaedics and Trauma
Anurag Tiwari, Nishit Bhatnagar, Ankit Thora, Amit Sharma, Hari Kishan, Saikat Jena
Trapping of fingers in metallic bands is a commonly encountered situation. The children, elderly people, and psychiatric patients are the usual victims. The constricting object in the digit causes obstruction to lymphatic and venous drainage leading to oedema distal to the constriction, which leads to further neurovascular compromise and presents as a surgical emergency. A 7-year-old boy presented to us with his right middle finger being stuck in a steel door latch. Multiple attempts were made to remove the trapped finger with conventional methods, and subsequently, it was removed by electric-driven metal cutting saw, which was not previously described in medical literature to the best of our knowledge...
July 2016: Journal of Clinical Orthopaedics and Trauma
Anshul Dahuja, Jae Hyuk Yang, Jung-Ro Yoon, Shiraz Bhatty
In this report, we present a case with difficult arthroscopic posterolateral portal formation due to loose body located in posterior compartment. These loose bodies are responsible for pain, decreased range of motion and cartilage damage in the knee joint. By making the posterior trans-septal portal prior, posterolateral portal could be made without difficulty completing the planned arthroscopic procedure.
July 2016: Journal of Clinical Orthopaedics and Trauma
R John, M S Dhillon, K Syam, S Prabhakar, P Behera, H Singh
BACKGROUND: Sports-related knee injuries occur commonly in athletes. However, there is no published epidemiological study from India till date. OBJECTIVES: The purpose of this study was to identify common injuries sustained by Indian athletes participating in different sports and to study various associated demographic features. A secondary objective was to investigate different factors, which may affect return to sport by the athlete. STUDY DESIGN: Cross-sectional study (observational study)...
July 2016: Journal of Clinical Orthopaedics and Trauma
Ashish Devgan, Rajesh Rohilla, Milind Tanwar, Aditya Jain, Karan Siwach, Radika Devgan
BACKGROUND: Arthroscopic debridement has been a gold standard procedure for anterior ankle impingement, both in cases of osseous and soft tissue impingement. There is sparse literature on comparative outcome with respect to functional results between the two types of impingement post-arthroscopic debridement. METHODS: Our study included 14 patients diagnosed as cases of anterior ankle impingement on the basis of clinical and radiological examination. They were segregated into two groups (on the basis of cause of impingement (osseous versus soft tissue))...
July 2016: Journal of Clinical Orthopaedics and Trauma
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