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Luxatio erecta of the hip- A report of five cases and the literature review
Ganesh Singh Dharmshaktu, Navneet Adhikari, Binit Singh
January-April 2020, 3(1):13-16
Hip dislocation is a serious injury which most commonly presents as posterior dislocation. Inferior dislocation is a rare event with a few anecdotal case reports or series described in the literature. This has also been called luxatio erecta of the hip borrowing from similar affliction at shoulder. We report five cases of luxatio erecta of the hip managed by reduction and conservative care in all but one. All five cases were males (mean age 31.8 years, range 18–52 year) with three cases being isolated injuries, whereas associated fracture of ipsilateral superior ramus and shaft femur was found in two separate cases. All were managed conservatively following closed reduction, except the case with shaft femur that was managed by additional operative fixation following the reduction of hip. The results were excellent in all cases without radiological evidence of avascular necrosis during the mean follow-up of 7.6 months (range 4–10 months).
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Acetabulum reconstruction: A demanding surgery
Rajat Charan, Pankaj K Verma, Tushar Chaurasia
January-April 2019, 2(1):1-6
Introduction: Incidence of fracture in acetabulum is rising and requires anatomical reduction and fixation for proper functioning hip joint. Earlier majority of such fractures were treated conservatively with occasional satisfactory results. Its surgical management is technically demanding but is evolving fast. Material and Methods: Eighteen surgically managed patients in last 2 years were included in the study. On admission, patients were stabilized first the associated dislocation was reduced and maintained on traction. Surgery was planned as soon as general condition permitted after radiological evaluation. Surgical approach depends upon site and pattern of fracture. Postoperative radiological results were assigned according to the criteria described by Matta (Matta JM. Fractures of the acetabulum: Accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am 1996;78:1632-45) and functional results were evaluated using Merle d'Aubigne and Postel's system modified by Matta et al. (Matta JM, Anderson LM, Epstein HC, Hendricks P. Fractures of the acetabulum: A retrospective analysis. Clin Orthop Relat Res 1986;230-40) after a minimum 6-month follow-up. Results: According to the Merle d'Aubigne and Postel scoring system modified by Matta, the clinical outcome was excellent in 9 cases (50%), good in 5 cases (27.7%), fair in 3 cases (16.6%), and poor in 1 case (5.5%). In our series, the overall incidence of sciatic nerve palsy was seen in 2 cases (11%), and other nerve damage was not seen. In our study, all patients received mechanical prophylaxis, and just one patient developed pulmonary embolism. This is in concordance with result of an Indian study. (Shrestha D, Dhoju D, Shrestha R, Sharma V. Acetabular fracture: Retrospective analysis of thirty three consecutive cases with operative management. Kathmandu Univ Med J (KUMJ) 2014;12:279-87.) In our study, deep infection was seen in one case, i.e., 5.5%, and two cases (i.e., 11%) had superficial infection. Conclusion: Nowadays open reduction internal fixation is the gold standard for the displaced acetabulum fractures. A good-to-excellent functional outcome was seen in more than 60% of the patients and a good-to-excellent radiological outcome was seen in more than 50% of the patients treated surgically.
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A study - Incidence and pattern of musculoskeletal injuries among patients attending the emergency of tertiary health care center in Central India
Ashish Anand Gupta, Santosh Kumar Mishra, Suresh Uikey, Deepak Maravi
January-April 2019, 2(1):11-14
Introduction: Trauma is the major cause of death and disability in developing country, is responsible for more years of life lost than most human diseases. This study aims to establish the value of a trauma registry by measuring, monitoring, and analyzing etiological factors of common musculoskeletal injuries caused due to several forms of trauma. Materials and Methods: This study has been conducted retrospectively. The patients attending the emergency department in tertiary care hospital were included in this study. Personal data and pattern of injuries sustained were extracted from the casualty admission register of emergency department and trauma unit, case records, and operation records. Results: A total of 6574 injured patients were seen in the emergency department. The most common injury was bony injury (65.38%, n = 4298) and soft-tissue injury 34.62% (n = 2276) and the most common sites were lower limbs in 41.39% of cases, amputation/crush injury in 7.82%, and 32.03% of cases (n = 1377) were of compound fractures. The most common soft-tissue injury was lacerated wound 45.21%. Most commonly associated injury was the head injury in 5.53% of cases. Maximum cases were in the age group of 30-59. Conclusion: Fractures were the most common pattern of injuries frequently associated with other injuries, especially head injuries, particular age group, and time period need special attention, and we need more such institutes near highways.
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Role of platelet-rich plasma versus corticosteroid injection in the treatment of plantar fasciitis: A comparative study
Deepankar Verma, Saurabh Kumar, Ish Kumar Dhammi, Rajnand Kumar, Rajat Kapoor, Anurag Mittal
May-August 2019, 2(2):26-30
Introduction: Platelet-rich plasma (PRP) is promoted nowadays as an ideal autologous biological blood-derived product. It enhances wound healing, bone healing, tendon healing and is currently being widely used. Aims and Objectives: A prospective cohort study was conducted to assess the efficacy of autologous PRP injection and to compare it with corticosteroid injection in the treatment of plantar fasciitis (PF). Materials and Methods: Fifty patients were included in the study and divided into two groups. Group I (25 patients) received PRP injection and Group II (25 patients) were given steroid injection. Patients were clinically assessed at different intervals. Functional outcome was evaluated on the basis of the visual analog scale (VAS) and foot and ankle ability measure (FAAM) scores. Plantar fascia thickness was assessed pre- and post-injection by ultrasound. Results: PRP and corticosteroid injection groups at the initial visit had VAS score of 8.86 and 8.60, respectively, which was reduced to 1.52 and 3.10 at the end of 6 months. The PRP and corticosteroid injection groups at the initial visit had FAAM score of 29.2 and 30.8, respectively, which increased to 84.2 and 68.3 at the end of 6 months. After injection, the PRP group had a significant reduction (34.80%) in the thickness of plantar fascia as compared to corticosteroid group (29.54%). Conclusion: Treatment of PF with PRP extract reduces pain and significantly increases function, exceeding the effect of steroid on long-term follow-up.
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Coccydynia: A lean topical review of recent updates on physical therapy and surgical treatment in the last 15 years
Ganesh Singh Dharmshaktu, Navneet Adhikari, Binit Singh
September-December 2019, 2(3):44-48
Coccydynia is disabling painful condition resulting from various factors and often not given serious importance. The chronic or recurrent pain affects activities of daily living and overall quality of life. Not only it is a poorly understood disorder with newer findings related to its anatomy, radiology, and the management periodically supplementing the medical literature but also it is managed in casual manner in clinical settings. There are various treatment options in both conservative and operative methods of its treatment and knowledge of which is important for its optimal management. A relevant topical review of recent advances on its management is presented here as handy guide for busy practitioners.
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Distal radius plating: Role and significance
Harshal Sakale, Alok C Agrawal, Shilp Verma, Bikram Kar
May-August 2020, 3(2):45-48
Distal radius fractures are a very common fracture. They occur mostly due to fall on an outstretched hand. They represent around 17% of all adult fractures. They occur most commonly in young males due to high energy trauma and older females due to osteoporosis. There are various treatment options available for fracture fixation, such as close reduction and manipulation, followed by cast application, close reduction and external fixator application, close reduction with percutaneous K-wire fixation, and open reduction and internal fixation with distal radius plate. Displaced intra-articular fractures are mostly managed with open reduction and distal radius plate fixation. Different fracture patterns require different types of distal radius plates such as T-plate, buttress plate, and variable angle plate. This article outlines the role of plating in distal radius fractures.
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Complications of distal radius fractures
Mukund Madhav Ojha, Alok Chandra Agrawal, Bikram Kesari Kar, Harshal S Sakale
May-August 2020, 3(2):58-60
Distal end radius fractures are the most common fracture encountered by orthopedic surgeons, accounting for 17.5% of all adult fractures. Numerous complications arising during the course of management of these fractures are broadly categorized as immediate (nerve injury, compartment syndrome, and skin injury), early (loss of reduction, tendon rupture, stiffness of joints, and infection), and late complications (maluinon, delayed/nonunion, complex regional pain syndrome, and joint arthropathy). It is imperative for a surgeon to have thorough knowledge of these complications and methods required to prevent and manage them.
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