National Journal of Clinical Orthopaedics

Journal Information
ISSN / EISSN : 2521-3466 / 2521-3474
Published by: Comprehensive Publications (10.33545)
Total articles ≅ 209
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Prabhav Tijoriwala, Dhruv Patel, Sunny Patel, Ekta Mehta, Janak Rathod
National Journal of Clinical Orthopaedics, Volume 5, pp 01-05; https://doi.org/10.33545/orthor.2021.v5.i4a.318

Abstract:
Introduction: Anterior bridge plating with minimally invasive technique for type A shaft humeral fractures is reported as an acceptable less traumatic and reproducible procedure by several authors. We have evaluated the clinical, radiological, and functional outcome of such fractures in twenty patients, all of which were managed with dynamic compression plate over an average follow- up period of 12 months. Though open reduction and plating technique of humerus shaft fracture is prevailing, this technique also gives favorable outcome.Materials and Methods: Twenty patients with type a humerus shaft fractures were managed by anterior bridge plating using MIPO technique between March 2017 to November 2019 were included in this series. All cases were treated with closed reduction and 10-12 whole 4.5mm dynamic compression plate fixation over anterior aspect in bridging mode using the MIPO technique. The dominant side, gender ratio, surgery time, and fracture union time, and complications were noted. The UCLA shoulder and Mayo elbow performance scores were used for assessing the shoulder and elbow function.Results: Of the Twenty patients in the study, ten were males and ten were females. The mean age was 34.3 years (range 18 to 85 years) twelve out of twenty patients (60%) had the dominant side fractured. Mean surgical time in minutes was 88.98 (range: 50 to 150 minutes). The mean fracture union (radiological) time was 14.3 weeks (range: 10–16 weeks) and clinical union time was 10.4 week. However Shoulder function was excellent in 20 cases (100%) on the UCLA score.Conclusion: This study confirmed a high overall rate of union and excellent functional outcomes. Mini incision anterior bridge technique for type A fracture shaft humerus gives good functional results and should be considered as an effective, cosmetically advanced surgical option in the treatment of type A humeral shaft fractures. It is a safe and less time consuming method for type a humeral shaft fractures when the surgeon is experienced in the technique.
Evdokia Alekaki, Dimitrios Lytras, Paris Iakovidis, Anastasios Kottaras, Ioanna P Chatziprodromidou, Christos Kopsidas
National Journal of Clinical Orthopaedics, Volume 5, pp 109-111; https://doi.org/10.33545/orthor.2021.v5.i3b.301

Abstract:
Obstetric palsy (OP) is the partial or total paralysis of the upper limb due to injury of the brachial plexus during childbirth. Early kinesiotherapy intervention helps to treat motor disorders faster and more effectively by reducing upper limb disability. The aim of this review is to describe recent research data on kinesiotherapy applications in patients with OP. The Google Scholar and PubMed databases were searched with the following keywords: obstetric palsy, kinesiotherapy, rehabilitation. This review included five articles. In conclusion, the application of kinesiotherapy contributes to the better treatment of motor and sensory disorders of the paretic muscles caused by OP as it helps to maintain the range of motion of the glenohumeral joint, to prevent stiffness, to maintain muscle tone, to increase muscle strength and endurance and, consequently, to improve function of the affected limb.
Sunil Kumar Saharan, Kartikeya Sharma
National Journal of Clinical Orthopaedics, Volume 5, pp 16-20; https://doi.org/10.33545/orthor.2021.v5.i3a.285

Abstract:
Introduction: To evaluate the utility of a questionnaire in assessment of low back pain and disability and the correlation between disability score, clinical features and imaging findings in patients with low back pain. Methodology: Here, we included 25 consecutive patients with duration of low back pain for 1 month who were not responding to conservative OPD treatment, and also had no reason to suspect any underlying organic disease. Each patient was analyzed on the basis of history and physical examination and a base line X-ray was taken. Results: Here, mean age of patients is 39.8 years with female predominance. According to Q-score there are 13 out of 25 patients are of modrate category, 11 in severe cateogory and rest in extreme category. We further divide these patients into 2 types i.e concavity right side and concavity left side. There are 5 patient of former category and 1 of later. Conclusion: A back-pain questionnaire should be designed and framed according to the life style of the patient i.e. if the patient cannot read or understand the questionnaire than it should be framed in the local language and should be read by investigator. Clinical examination is also an important tool for assessment of patients especially to support and exclude destructive and compressive lesions and also neurological diseases.
Jaspreet Kaur, Gurwinder Bhatia
National Journal of Clinical Orthopaedics, Volume 5, pp 01-03; https://doi.org/10.33545/orthor.2021.v5.i3a.281

Abstract:
Background and objectives: Plantar fasciitis is an inflammatory disorder that produces pain and stiffness in the plantar surface of the foot's heel and medial arch. It is particularly common in people in their forties and fifties, as well as those who participate in running activities. Individually, phonophoresis and myofascial release have been utilised in physiotherapy for the treatment of plantar fasciitis and have been shown to be beneficial in lowering discomfort and improving the patient's functional status. The goal of the study was to assess the effectiveness of phonophoresis and myofascial release in the treatment of plantar fasciitis. Method: A total of 20 individuals were divided into two groups, each with ten subjects of both sexes. Phonophoresis treatment was given to group A, while myofascial treatment was given to group B. On the first and tenth days of the intervention, data was obtained from all patients using two parameters: VAS and FFI. Result: This study found a substantial difference between groups A (phonophoresis) and B (non-phonophoresis) (myofascial release). The mean SD VAS for group A was 4.800.94, while that for group B was 3.931.09, with a p value of (0.41), and the mean SD FFI for group A was 0.440.09, while that for group B was 0.310.17, with a p value of (0.015). Conclusion: In patients with plantar fascitis, phonophoresis was found to be more helpful than myofascial release in lowering pain and improving functional status.
Pavankumar Patted, Md. Sadiq, Md Wajid Hussain Diggi
National Journal of Clinical Orthopaedics, Volume 5, pp 174-176; https://doi.org/10.33545/orthor.2021.v5.i3c.316

Abstract:
Introduction: The study was conducted to assess clinical and functional outcome of Proximal Femoral nailing antirotation in intertrochanteric fractures and to determine the rate of union, complications, operative risks and co morbidities associated with intertrochanteric fractures. Intertrochanteric fractures form around half of the total hip fractures in the elderly and pose a number of management dilemmas depending on the fracture configuration and status of the bones. There are numerous implants available for the internal fixation of these fractures ranging from dynamic hip screw which can be combined with trochanteric stabilisation plate; locking plates; intramedullary implants such as proximal femoral nail (PFN), trochanteric femoral nail (TFN) and Gamma nail.Materials and Methods: The fractures were classified according to BOYD and GRIFFIN classification system. 40 patients of intertrochanteric fractures fulfilling the inclusion and exclusion criteria, were managed surgically using Proximal Femoral Nail A. The results were analyzed according to age, type of fracture, operative details and functional outcome using KYLE’s criteria.Results: Totally 40 patients with intertrochanteric fractures were operated with PFNA and were included in the study. The mean age of the patients was around 64 years with minimum age being 52 years and the maximum being 88 years. The mean duration of operation was recorded to be 49.59 min. Complications in this study were seen in 2 patients (5%), Complication was surgical site infection. Conclusion: Our study suggests that the PFNA is a better implant in elderly patients with severe osteoporosis as there is the shorter operating time and easier placement of the helical blade and also allows for early mobilization. The main benefits being the shorter surgical time and the decreased need for fluoroscopy. It has a excellent functional outcome and least least failure rates.
Sunil Patidar, Juzer Hamid, Susheel Soni
National Journal of Clinical Orthopaedics, Volume 5, pp 82-88; https://doi.org/10.33545/orthor.2021.v5.i3b.295

Abstract:
Background: Open tibia fracture, due to high energy or low energy trauma classified according to Gustilo-Anderson classification system. There are five keys to successful treatment: antibiotic therapy, radical debridement and pulsed lavage irrigation, stabilization of fracture with minimal further devascularization, early soft tissue coverage and early bone-grafting. Methods: The study included a total 24 patients of open fracture of tibia shaft type II, IIIA and IIIB (Gustilo) managed in IMCHRC Indore from 01/09/2018 to 01/09/2019. In these study we include pt. of both sex (19 males & 5 females). Results: Open tibia fractures were mostly in males (79.2%) where 70% were young patients with a mean age of 37 yrs. Among these patients 75% sustained high velocity injury. Mean period of fracture union in ENDERS group were 24.05 weeks (range 22 to 28 weeks) while in external fixator group was 27.08 weeks (range 29 to 30 weeks). Among these 24 cases infection detected in 3 cases (all were treated by external fixator; 06 cases belong to Gustilo-Anderson III group). 33.33% mal-alignment in external fixator group in comparison to 16.6% in patients treated with ENDERS nail. Conclusion: Open tibia fracture treated with ENDERS nail united earlier than external fixator and total number of secondary surgeries to achieve union in ENDERS nail was significantly lesser than external fixator group. Infection and mal-alignment rate was also high in external fixation cases.
Pavankumar Patted, Md. Sadiq, Nayeemuddin
National Journal of Clinical Orthopaedics, Volume 5, pp 170-173; https://doi.org/10.33545/orthor.2021.v5.i3c.314

Abstract:
Background: The study was conducted to assess clinical and functional outcome of Proximal Femoral nailing in intertrochanteric fractures and to determine the rate of union, complications, operative risks and co morbidities associated with intertrochanteric fractures.Intertrochanteric fractures form around half of the total hip fractures in the elderly and pose a number of management dilemmas depending on the fracture configuration and status of the bones. There are numerous implants available for the internal fixation of these fractures ranging from dynamic hip screw which can be combined with trochanteric stabilisation plate; locking plates; intramedullary implants such as proximal femoral nail (PFN), trochanteric femoral nail (TFN) and Gamma nail.Materials and Methods: The fractures were classified according to BOYD and GRIFFIN classification system. 40 patients of intertrochanteric fractures fulfilling the inclusion and exclusion criteria, were managed surgically using Proximal Femoral Nail. The results were analyzed according to age, type of fracture, operative details and functional outcome using KYLE’s criteria.Results: Totally 40 patients with intertrochanteric fractures were operated with PFN and were included in the study. The mean age of the patients was around 68 years with minimum age being 52 years and the maximum being 88 years. The mean duration of operation was recorded to be 54.59 min. Complications in this study were seen in 3 patients (8%). Complication was surgical site infection 2 patients (5%), greater trochanteric fracture 1 patient (2.5%).Conclusion: The proximal femoral nail acts as a buttress to prevent medialisation of the shaft & provides more effective load transfer. It has a chance of failure in the comminuted and severely osteoporotic fractures. It is superior implant for both stable & unstable fractures. It also has advantages of having decreased blood loss, decreased operating time, decreased complication rates.
Ajeet Hundekar, Santosh Mared, Prakash Wali
National Journal of Clinical Orthopaedics, Volume 5, pp 24-27; https://doi.org/10.33545/orthor.2021.v5.i3a.317

Abstract:
Introduction: Intertrochanteric (peritrochanteric) fractures include the fractures in the region extending from the extrascapular basilar neck region to the region along the lesser trochanter of femur. Usually occurs in the elderly age group as a result of low-Energy trauma such as accidental fall due to osteoporosis and poor bone quality but high velocity trauma in young individuals can also result in similar fracture. Epidemiological reports by (Gill esult JB, 2007) reported a life-time risk of hip fractures at 50 years of age as 5.6% for men and 20% for women. And, interestingly peritrochanteric fractures constitute around 34% of all hip fractures.Aim of the study: The aim of the study is to compare and analyze the functional outcome of patients with Unstable Trochanteric fractures managed with Proximal Femoral Nailing Anti-rotation II (PFN AII) against Proximal Femoral Nailing (PFN)Objective of the study: Comparative analysis of functional outcome in the management of unstable trochanteric fractures by Proximal Femoral Nailing Anti-rotation II (PFN AII) against Proximal Femoral Nailing (PFN).
A Manoharan, T Kalaiyarasan, Nedunkilli V
National Journal of Clinical Orthopaedics, Volume 5, pp 152-156; https://doi.org/10.33545/orthor.2021.v5.i3c.308

Abstract:
Background: Lower limb fractures constitute one third of all fractures. The most common fractures involves around the shaft of femur. Distal femur fractures constitute 3-6% of all femur fractures and 1% of all orthopaedic trauma [1]. Distal femur fractures can be either supracondylar or condylar type. Condylar type involves in two planes, sagittal & coronal planes (Hoffa Fracture). The incidence of Hoffa fracture is 8.7 to 13% of all distal femur fractures [2]. Material and Methods: Eighteen cases of Hoffa’s fracture fixed with cancellous screws between from June 2017 – June 2019 at Stanley medical college hospital, Chennai.Results: The mean follow up period was 24 months. The results were analyzed using knee society score. The outcome was excellent in 65%, good in 15%, fair in 10% and poor in 10 % by Knee society Conclusion: we conclude that the early anatomical reduction and rigid fixation with screws provide best results with minimal complications.
Siddaram Patil N, Shiv Sandeep, Chinni Ganesh
National Journal of Clinical Orthopaedics, Volume 5, pp 93-95; https://doi.org/10.33545/orthor.2021.v5.i3b.297

Abstract:
Introduction: Enchondroma is a benign tumor, commonly seen in long short bones. An enchondroma is a type of non-cancerous bone tumor that begins in cartilage. Cartilage is the gristly connective tissue from which most bones develop. Cartilage plays an important role in the growth process. There are many different types of cartilage in the body. Enchondroma is a benign tumor, commonly seen in long short bones. Aim: Generalafter skeletal maturity, enchondroma do not grow and rarely cause pain. Endosteal scalloping may occur with enchondroma. Reporting this unusual location, Intra-Medullary and long bone, in Femur distal third marrow, in our case.
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