Open fractures of Tibia treated by unreamed interlocking nailing

Vol 41 | Issue 1 | Jan-Jun 2020 | page: 3-6 | Nirmal Chandra Mohapatra, Udit Saurav Sahoo


Authors: Nirmal Chandra Mohapatra [1], Udit Saurav Sahoo [1]

[1] Department of Orthopaedics, SCB Medical College, Cuttack, Odisha, India.

Address of Correspondence

Dr. Udit Sourav Sahoo
SCB Medical College, Cuttack, Odisha, India.
E-mail: uditsouravsahoo@gmail.com


Abstract

Objective: To assess the clinical outcome of unreamed intramedullary interlocking nailing in open fractures of tibia, and to evaluate the incidence of complications in these open fractures as a result of the same.
Methods: Between June 2018 and May 2019, a total of 56 cases of open tibial shaft fractures were operated on with unreamed interlocking nails at SCB MCH, Cuttack, India. Records of 52 patients (18 women and 34 men) were available for study. Only injuries associated with the tibial shaft were included. Traffic accidents were the cause of fractures. All fractures were classified according to Gustilo and Anderson classification for open fractures. There were 28(53.8%) type-I, 16 (30.7%) type-II, 8 (15.3%) type- IIIA fractures. After thorough debridement under anaesthesia, an unreamed interlocking nail was inserted. All nails were locked proximally and distally.
Results: The patients were followed up for a mean period of 19 months (range, 18–24 months) and were evaluated according to the modified Ketenjian’s criteria. Results were good to excellent in 85.8% cases, and poor in 10.7% cases. Only 2 of 8 patients with type-III fractures had good results. Of 56 patients, 6 had superficial infection, 4 had deep infection, 6 had delayed union, 1 had infected non-union, 3 had malunion, 6 had screw breakage, and 10 had anterior knee pain.
Conclusion: Unreamed interlocking tibial nailing can be safely used for type-I and type-II open injuries even with delayed presentation. Use of unreamed nailing in type-III fractures with delayed presentation has high incidence of complications in this study.
Keywords: Unreamed interlocking nail, Open tibial fractures.


References

1. Bach AW, Hansen Jr ST (1989) Plates versus external fixation in severe open tibial shaft fractures: a randomized trial. Clin Orthop 241:89–94
2. Bonatus T, Olson SA, Lee S, Chapman MW (1997) Non- reamed locking intramedullary nailing for open fractures of the tibia. Clin Orthop 339:58–64
3. Court-Brown CM, McQueen MM, Quaba AA, Christie J (1991) Locked intramedullary nailing of open tibial fractures. J Bone Joint Surg Br 73:959–964
4. Gustilo RB, Anderson JT (1976) Prevention of infection in the treatment of one-thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am 58:453–458
5. Hasenhuttl K (1981) The treatment of unstable fractures of the tibia and fibula with flexible medullary wires. A review of two-hundred and thirty-five fractures. J Bone Joint Surg Am 63:921–931
6. Henley MB, Chapman JR, Agel J, Harvey J, Whorton AM, Swiontkowski MF (1998) Treatment of type II, IIIA, and IIIB open fractures of tibial shaft. A prospective comparison of un- reamed interlocking intramedullary nails and half-pin external fixators. J Orthop Trauma 12:1–7
7. Holbrook JL, Swiontkowski MF, Sanders R (1989) Treatment of open fractures of the tibial shaft: ender nailing versus exter- nal fixation. A randomized prospective comparison. J Bone Joint Surg Am 71:1231–1238
8. Klein MP, Rahn BA, Frigg R, Kessler S, Perren SM (1989) Reaming versus non-reaming in medullary nailing: inter- ference with cortical circulation of the canine tibia. Arch Orthop Trauma Surg 109:314–316
9. Klemm KW, Borner M (1986) Interlocking nailing of complex fractures of the femur and tibia. Clin Orthop 212:89–100
10. Lottes JO (1974) Medullary nailing of the tibia with triflange nail. Clin Orthop 105:53–66
11. Melcher GA, Metzdorf A, Schegel U, Ziegler WJ, Perren SM, Printzen G (1995) Influence of reaming versus nonreaming in intramedullary nailing on local infection rate: experimental investigation in rabbits. J Trauma 39:1123–1128
12. Schandelmaier P, Krettek C, Rudolf J, Kohl A, Katz BE, Tscherne H (1997) Superior results of tibial rodding versus ex- ternal fixation in grade 3B fractures. Clin Orthop 342:164–172
13. Stegemann P, Lorio M, Soriano R, Bone L (1995) Manage- ment protocol for unreamed interlocking tibial nails for open tibial fractures. J Orthop Trauma 9:117–120
14. Tornetta P 3rd, Bergman M, Watnik N, Berlowitz G, Steuer J (1994) Treatment of grade-IIIb open tibial fractures. A pro- spective randomised comparison of external fixation and non- reamed locked nailing. J Bone Joint Surg Br 76:13–19
15. Whittle AP, Russel TA, Taylor JC, Lavelle DG (1992) Treatment of open fractures of the tibial shaft with the use of interlocking nailing without reaming. J Bone Joint Surg Am 74:1162–1171
16. KneifelT, Buckley R. A comparison of one versus two distal locking screws in tibial fractures treated with unreamed tibial nails: a prospective randomized clinical trial. Injury 1996;27:271–3.

How to Cite this Article: Mohapatra N, Sahoo U S. | Open fractures of tibia treated by unreamed interlocking nailing. | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 3-6 .

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Split hand foot malformation: Presentation of a rare case and description of a novel technique in management of split hand Study design: Case report

Vol 41 | Issue 1 | Jan-June 2020 | page: 28-30 | Sudhir Kumar Mahapatra


Authors: Sudhir Kumar Mahapatra [1]

[1] Department of Orthopaedics, IMS & SUM Hospital, Bhubaneswar, Odisha India.

Address of Correspondence

Dr. Anurag Singh,
IMS & SUM Hospital, Bhubaneswar, Odisha India.
E-mail: goanurag007@gmail.com


Abstract

Introduction: High-energy musculoskeletal trauma with extensive soft tissue loss is difficult to treat and underlying fracture makes it more cumbersome. This prolongs hospitalization and regular conventional dressings increase socio-economic burden. Vacuum assisted closure (VAC) was developed to prepare wound for early definitive management. It acts by decreasing edema, exudates, bacterial counts and promotes granulation tissue formation, neovascularization, approximates wound edges.
Aim: To evaluate outcomes, efficacy and limitations of low-cost VAC for management of extensive soft tissue loss and infected wounds.
Materials and Methods: This study was conducted in Dept. Of Orthopedics of a tertiary care hospital from December 2018 to July 2019 on 53 patients, either with extensive soft tissue injury following acute trauma or those with infected-necrotic wound. Forty two patients had acute trauma history while remaining 11 had infected non healing wound. Cultures were sent pre and post VAC application and antibiotic coverage was administered. Low cost VAC was applied after debridement and changed after every 3 – 4 days.
Results: Forty eight cases treated with low-cost VAC were ready for skin graft/flap/secondary suture after 1 to 3 cycles (4 to 12 days) of therapy. Another two cases developed spontaneous re-epithelization. The wound infection was controlled in 70% of the cases. Three patients did not achieve desired result due to limitations of the procedure.
Conclusion: Low-cost VAC has proved to be effective while being substantially cheaper (1/16th of conventional VAC). Its role is limited when the depth of wound is far greater than its length.
Keywords: Low cost VAC, Vacuum assisted closure, wound management, Negative pressure wound therapy, Soft tissue loss, Compound fracture.


References

1. Morykwas, M. J., L. C. Argenta, E. I. Shelton-Brown, and W. McGuirt. “Vacuum-Assisted Closure: A New Method for Wound Control and Treatment: Animal Studies and Basic Foundation.” Annals of Plastic Surgery 38, no. 6 (June 1997): 553–62. https://doi.org/10.1097/00000637-199706000-00001.
2. Morykwas, M. J., and L. C. Argenta. “Nonsurgical Modalities to Enhance Healing and Care of Soft Tissue Wounds.” Journal of the Southern Orthopaedic Association 6, no. 4 (1997): 279–88.
3. Morykwas, M. J., L. C. Argenta, E. I. Shelton-Brown, and W. McGuirt. “Vacuum-Assisted Closure: A New Method for Wound Control and Treatment: Animal Studies and Basic Foundation.” Annals of Plastic Surgery 38, no. 6 (June 1997): 553–62. https://doi.org/10.1097/00000637-199706000-00001.
4. Argenta, L. C., and M. J. Morykwas. “Vacuum-Assisted Closure: A New Method for Wound Control and Treatment: Clinical Experience.” Annals of Plastic Surgery 38, no. 6 (June 1997): 563–76; discussion 577.
5. Genecov, D. G., A. M. Schneider, M. J. Morykwas, D. Parker, W. L. White, and L. C. Argenta. “A Controlled Subatmospheric Pressure Dressing Increases the Rate of Skin Graft Donor Site Reepithelialization.” Annals of Plastic Surgery 40, no. 3 (March 1998): 219–25. https://doi.org/10.1097/00000637-199803000-00004.
6. McCallon, S. K., C. A. Knight, J. P. Valiulus, M. W. Cunningham, J. M. McCulloch, and L. P. Farinas. “Vacuum-Assisted Closure versus Saline-Moistened Gauze in the Healing of Postoperative Diabetic Foot Wounds.” Ostomy/Wound Management 46, no. 8 (August 2000): 28–32, 34.
7. Philbeck, T. E., K. T. Whittington, M. H. Millsap, R. B. Briones, D. G. Wight, and W. J. Schroeder. “The Clinical and Cost Effectiveness of Externally Applied Negative Pressure Wound Therapy in the Treatment of Wounds in Home Healthcare Medicare Patients.” Ostomy/Wound Management 45, no. 11 (November 1999): 41–50.
8. Eginton, M. T., K. R. Brown, G. R. Seabrook, J. B. Towne, and R. A. Cambria. “A Prospective Randomized Evaluation of Negative-Pressure Wound Dressings for Diabetic Foot Wounds.” Annals of Vascular Surgery 17, no. 6 (November 2003): 645–49. https://doi.org/10.1007/s10016-003-0065-3.
9. Herscovici, Dolfi, Roy W. Sanders, Julia M. Scaduto, Anthony Infante, and Thomas DiPasquale. “Vacuum-Assisted Wound Closure (VAC Therapy) for the Management of Patients with High-Energy Soft Tissue Injuries.” Journal of Orthopaedic Trauma 17, no. 10 (December 2003): 683–88. https://doi.org/10.1097/00005131-200311000-00004.
10. Song, D. H., Wu, L. C., Lohman, R. F., Gottlieb, L. J., & Franczyk, M. (2003). Vacuum Assisted Closure for the Treatment of Sternal Wounds: The Bridge between Débridement and Definitive Closure. Plastic and Reconstructive Surgery, 111(1), 92–97. doi:10.1097/01.prs.0000037686.14278.6a
11. Mouës, C. M., G. J. C. M. van den Bemd, F. Heule, and S. E. R. Hovius. “Comparing Conventional Gauze Therapy to Vacuum-Assisted Closure Wound Therapy: A Prospective Randomised Trial.” Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS 60, no. 6 (2007): 672–81. https://doi.org/10.1016/j.bjps.2006.01.041.
12. Armstrong, David G., Lawrence A. Lavery, and Diabetic Foot Study Consortium. “Negative Pressure Wound Therapy after Partial Diabetic Foot Amputation: A Multicentre, Randomised Controlled Trial.” Lancet (London, England) 366, no. 9498 (November 12, 2005): 1704–10. https://doi.org/10.1016/S0140-6736(05)67695-7.
13. Vuerstaek, J. D. D., Vainas, T., Wuite, J., Nelemans, P., Neumann, M. H. A., & Veraart, J. C. J. M. (2006). State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressings. Journal of Vascular Surgery, 44(5), 1029–1037. doi:10.1016/j.jvs.2006.07.030
14. Llanos, S., Danilla, S., Barraza, C., Armijo, E., Pi??eros, J. L., Quintas, M., … Calderon, W. (2006). Effectiveness of Negative Pressure Closure in the Integration of Split Thickness Skin Grafts. Annals of Surgery, 244(5), 700–705. doi:10.1097/01.sla.0000217745.56657.e5
15. Vuerstaek, Jeroen D. D., Tryfon Vainas, Jan Wuite, Patty Nelemans, Martino H. A. Neumann, and Joep C. J. M. Veraart. “State-of-the-Art Treatment of Chronic Leg Ulcers: A Randomized Controlled Trial Comparing Vacuum-Assisted Closure (V.A.C.) with Modern Wound Dressings.” Journal of Vascular Surgery 44, no. 5 (November 2006): 1029–37; discussion 1038. https://doi.org/10.1016/j.jvs.2006.07.030.
16. “Tools to Compare the Cost of NPWT with Advanced Wound Care: An Aid to Clinical Decision-Making – Wounds International.” https://www.woundsinternational.com/resources/details/tools-to-compare-the-cost-of-npwt-with-advanced-wound-care-an-aid-to-clinical-decision-making.
17. Eginton, Mark T., Kellie R. Brown, Gary R. Seabrook, Jonathan B. Towne, and Robert A. Cambria. “A Prospective Randomized Evaluation of Negative-Pressure Wound Dressings for Diabetic Foot Wounds.” Annals of Vascular Surgery 17, no. 6 (November 2003): 645–49. https://doi.org/10.1007/s10016-003-0065-3.
18. Isago, Tsukasa, Motohiro Nozaki, Yuji Kikuchi, Takashi Honda, and Hiroaki Nakazawa. “Negative-Pressure Dressings in the Treatment of Pressure Ulcers.” The Journal of Dermatology 30, no. 4 (April 2003): 299–305. https://doi.org/10.1111/j.1346-8138.2003.tb00391.x.

How to Cite this Article: Singh A, Panda D, Mishra J, Dash A. | Low-cost vacuum assisted closure therapy for extensive musculoskeletal trauma and infection: Outcomes, efficacy and limitations . | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 28-30.

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Low-cost vacuum assisted closure therapy for extensive musculoskeletal trauma and infection: Outcomes, efficacy and limitations

Vol 41 | Issue 1 | Jan-Jun 2020 | page: 21-25 | Anurag Singh, Damodar Panda, Jitendra Mishra, Aniruddh Dash


Authors: Anurag Singh [1], Damodar Panda [1], Jitendra Mishra [1], Aniruddh Dash [1]

[1] Department of Orthopaedics, IMS & SUM Hospital, Bhubaneswar, Odisha India.

Address of Correspondence

Dr. Anurag Singh,
IMS & SUM Hospital, Bhubaneswar, Odisha India.
E-mail: goanurag007@gmail.com


Abstract

Introduction: High-energy musculoskeletal trauma with extensive soft tissue loss is difficult to treat and underlying fracture makes it more cumbersome. This prolongs hospitalization and regular conventional dressings increase socio-economic burden. Vacuum assisted closure (VAC) was developed to prepare wound for early definitive management. It acts by decreasing edema, exudates, bacterial counts and promotes granulation tissue formation, neovascularization, approximates wound edges.
Aim: To evaluate outcomes, efficacy and limitations of low-cost VAC for management of extensive soft tissue loss and infected wounds.
Materials and Methods: This study was conducted in Dept. Of Orthopedics of a tertiary care hospital from December 2018 to July 2019 on 53 patients, either with extensive soft tissue injury following acute trauma or those with infected-necrotic wound. Forty two patients had acute trauma history while remaining 11 had infected non healing wound. Cultures were sent pre and post VAC application and antibiotic coverage was administered. Low cost VAC was applied after debridement and changed after every 3 – 4 days.
Results: Forty eight cases treated with low-cost VAC were ready for skin graft/flap/secondary suture after 1 to 3 cycles (4 to 12 days) of therapy. Another two cases developed spontaneous re-epithelization. The wound infection was controlled in 70% of the cases. Three patients did not achieve desired result due to limitations of the procedure.
Conclusion: Low-cost VAC has proved to be effective while being substantially cheaper (1/16th of conventional VAC). Its role is limited when the depth of wound is far greater than its length.
Keywords: Low cost VAC, Vacuum assisted closure, wound management, Negative pressure wound therapy, Soft tissue loss, Compound fracture.


References

1. Morykwas, M. J., L. C. Argenta, E. I. Shelton-Brown, and W. McGuirt. “Vacuum-Assisted Closure: A New Method for Wound Control and Treatment: Animal Studies and Basic Foundation.” Annals of Plastic Surgery 38, no. 6 (June 1997): 553–62. https://doi.org/10.1097/00000637-199706000-00001.
2. Morykwas, M. J., and L. C. Argenta. “Nonsurgical Modalities to Enhance Healing and Care of Soft Tissue Wounds.” Journal of the Southern Orthopaedic Association 6, no. 4 (1997): 279–88.
3. Morykwas, M. J., L. C. Argenta, E. I. Shelton-Brown, and W. McGuirt. “Vacuum-Assisted Closure: A New Method for Wound Control and Treatment: Animal Studies and Basic Foundation.” Annals of Plastic Surgery 38, no. 6 (June 1997): 553–62. https://doi.org/10.1097/00000637-199706000-00001.
4. Argenta, L. C., and M. J. Morykwas. “Vacuum-Assisted Closure: A New Method for Wound Control and Treatment: Clinical Experience.” Annals of Plastic Surgery 38, no. 6 (June 1997): 563–76; discussion 577.
5. Genecov, D. G., A. M. Schneider, M. J. Morykwas, D. Parker, W. L. White, and L. C. Argenta. “A Controlled Subatmospheric Pressure Dressing Increases the Rate of Skin Graft Donor Site Reepithelialization.” Annals of Plastic Surgery 40, no. 3 (March 1998): 219–25. https://doi.org/10.1097/00000637-199803000-00004.
6. McCallon, S. K., C. A. Knight, J. P. Valiulus, M. W. Cunningham, J. M. McCulloch, and L. P. Farinas. “Vacuum-Assisted Closure versus Saline-Moistened Gauze in the Healing of Postoperative Diabetic Foot Wounds.” Ostomy/Wound Management 46, no. 8 (August 2000): 28–32, 34.
7. Philbeck, T. E., K. T. Whittington, M. H. Millsap, R. B. Briones, D. G. Wight, and W. J. Schroeder. “The Clinical and Cost Effectiveness of Externally Applied Negative Pressure Wound Therapy in the Treatment of Wounds in Home Healthcare Medicare Patients.” Ostomy/Wound Management 45, no. 11 (November 1999): 41–50.
8. Eginton, M. T., K. R. Brown, G. R. Seabrook, J. B. Towne, and R. A. Cambria. “A Prospective Randomized Evaluation of Negative-Pressure Wound Dressings for Diabetic Foot Wounds.” Annals of Vascular Surgery 17, no. 6 (November 2003): 645–49. https://doi.org/10.1007/s10016-003-0065-3.
9. Herscovici, Dolfi, Roy W. Sanders, Julia M. Scaduto, Anthony Infante, and Thomas DiPasquale. “Vacuum-Assisted Wound Closure (VAC Therapy) for the Management of Patients with High-Energy Soft Tissue Injuries.” Journal of Orthopaedic Trauma 17, no. 10 (December 2003): 683–88. https://doi.org/10.1097/00005131-200311000-00004.
10. Song, D. H., Wu, L. C., Lohman, R. F., Gottlieb, L. J., & Franczyk, M. (2003). Vacuum Assisted Closure for the Treatment of Sternal Wounds: The Bridge between Débridement and Definitive Closure. Plastic and Reconstructive Surgery, 111(1), 92–97. doi:10.1097/01.prs.0000037686.14278.6a
11. Mouës, C. M., G. J. C. M. van den Bemd, F. Heule, and S. E. R. Hovius. “Comparing Conventional Gauze Therapy to Vacuum-Assisted Closure Wound Therapy: A Prospective Randomised Trial.” Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS 60, no. 6 (2007): 672–81. https://doi.org/10.1016/j.bjps.2006.01.041.
12. Armstrong, David G., Lawrence A. Lavery, and Diabetic Foot Study Consortium. “Negative Pressure Wound Therapy after Partial Diabetic Foot Amputation: A Multicentre, Randomised Controlled Trial.” Lancet (London, England) 366, no. 9498 (November 12, 2005): 1704–10. https://doi.org/10.1016/S0140-6736(05)67695-7.
13. Vuerstaek, J. D. D., Vainas, T., Wuite, J., Nelemans, P., Neumann, M. H. A., & Veraart, J. C. J. M. (2006). State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressings. Journal of Vascular Surgery, 44(5), 1029–1037. doi:10.1016/j.jvs.2006.07.030
14. Llanos, S., Danilla, S., Barraza, C., Armijo, E., Pi??eros, J. L., Quintas, M., … Calderon, W. (2006). Effectiveness of Negative Pressure Closure in the Integration of Split Thickness Skin Grafts. Annals of Surgery, 244(5), 700–705. doi:10.1097/01.sla.0000217745.56657.e5
15. Vuerstaek, Jeroen D. D., Tryfon Vainas, Jan Wuite, Patty Nelemans, Martino H. A. Neumann, and Joep C. J. M. Veraart. “State-of-the-Art Treatment of Chronic Leg Ulcers: A Randomized Controlled Trial Comparing Vacuum-Assisted Closure (V.A.C.) with Modern Wound Dressings.” Journal of Vascular Surgery 44, no. 5 (November 2006): 1029–37; discussion 1038. https://doi.org/10.1016/j.jvs.2006.07.030.
16. “Tools to Compare the Cost of NPWT with Advanced Wound Care: An Aid to Clinical Decision-Making – Wounds International.” https://www.woundsinternational.com/resources/details/tools-to-compare-the-cost-of-npwt-with-advanced-wound-care-an-aid-to-clinical-decision-making.
17. Eginton, Mark T., Kellie R. Brown, Gary R. Seabrook, Jonathan B. Towne, and Robert A. Cambria. “A Prospective Randomized Evaluation of Negative-Pressure Wound Dressings for Diabetic Foot Wounds.” Annals of Vascular Surgery 17, no. 6 (November 2003): 645–49. https://doi.org/10.1007/s10016-003-0065-3.
18. Isago, Tsukasa, Motohiro Nozaki, Yuji Kikuchi, Takashi Honda, and Hiroaki Nakazawa. “Negative-Pressure Dressings in the Treatment of Pressure Ulcers.” The Journal of Dermatology 30, no. 4 (April 2003): 299–305. https://doi.org/10.1111/j.1346-8138.2003.tb00391.x.

How to Cite this Article: Singh A, Panda D, Mishra J, Dash A. | Low-cost vacuum assisted closure therapy for extensive musculoskeletal trauma and infection: Outcomes, efficacy and limitations . | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 21-25.

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A prospective study of clinical outcomes of management of arthroscopic assisted tibial plateau fractures fixation

Vol 41 | Issue 1 | Jan-Jun 2020 | page: 17-20 | Bibhudutta Mall, Sunil Kumar Dash, Aurobindo Das, Sanket Mishra,
Harekrushna Sahu


Authors: Bibhudutta Mall [1], Sunil Kumar Dash [1], Aurobindo Das [1], Sanket Mishra [1], Harekrushna Sahu [1]

[1] Department of Orthopaedics, Hi-Tech Medical College & Hospital, Bhubaneswar, Odisha India.

Address of Correspondence

Dr. Bibhudutta Mall,
Hi-Tech Medical College & Hospital, Bhubaneswar, Odisha India
E-mail: bibhuduttamail_013@live.com


Abstract

This is a prospective case study about tibia plateau fractures in 28 patients which was managed with arthroscopic assisted internal fixation with plating and with or without bone grafting. In our study we saw domestic fall was a cause of fracture in about 60 yrs age patient with osteoporosis . Intra operative findings showed lateral meniscal tear in 6 patients medial meniscal tear in 1 patient which were repaired or menisectomy was done accordingly. In most of the patient fracture union seen by 4 to 6 months. Radiological Rasmussen score was Excellent in 53.5% in 3 months of follow up where as it improved to 75% by 6 months and 1 year follow up. Clinical Rasmussen score was Excellent in 50% of patients in 3 months where as it was improved to 71.4% by 6 months and 75% by 1 year follow up. Complications like infection in 3 patients , malunion in 2 patients, wound dehiscence in 2 patients. Arthroscopic assisted tibial plateau fixation is a preferred treatment for tibial plateau fracture because arthroscopy gives a precise visualization of pathology in the knee joint which can be meticulously addressed which gives early mobility and excellent range of movements.
Keywords: Intra-articular fracture , Tibial plateau , Arthroscopy-assisted internal fixation.


References

1. Hohl M. Part I: Fractures of the proximal tibia and fibula. In: Rockwood C, Green D, Bucholz R, eds. Rockwood and Green’s Fractures in Adults. Vol 2. 3rd ed. Philadel¬phia, PA: JB Lippincott; 1992:1725-1757.
2. Caspari RB, Hutton PM, Whipple TL, Mey¬ers JF. The role of arthroscopy in the manage¬ment of tibial plateau fractures. Arthroscopy. 1985; 1(2):76-82.
3. Jennings JE. Arthroscopic management of tibial plateau fractures. Arthroscopy. 1985; 1(3):160-168.
4. Schatzker J, McBroom R, Bruce D. The tib¬ial plateau fracture: the Toronto experience 1968-1975. Clin Orthop Relat Res. 1979; 138:.94-104.
5. Caspari RB,Hutton PMJ,Whiplle,Meyers JF.The Role of arthroscopy in the management of tibial plateau fracture
6. Rasmussen PS (1973) Tibial condylarfractures: impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am 55:1331–1350.
7. Arthroscopic-Assisted Fixation of Tibial Plateau Fractures: Patient-Reported Postoperative Activity Levels John Kampa, MD; Ryan Dunlay, MD; Robby Sikka, MD; Marc Swiontkowski, MD
8. Fowble CD, Zimmer JW, Schepsis AA. The role of arthroscopy in the assessment and treatment of tibial plateau fractures. Arthroscopy 1993;9:584-90.
9. Arthroscopy-assisted operative management of tibial plateau fractures. Mehmet Asik Ozgur Cetik Ufuk Talu Yunus V. Sozen.
10. Roerdick WH,Oskam J,Vierhout Pam.Arthroscopically assisted osteosynthesis of tibial plateau fracture in patients older than 77 years.Arthroscopy2001;17:826-831
11. Medium-term results of percutaneous, arthroscopically-assisted osteosynthesis of fractures of the tibial plateau T. Scheerlinck, C. S. Ng, F. Handelberg, P. P. Casteleyn.
12. arthroscopic assisted management of tibial plateau fractures; a novel technique Younis kamal
13. Yi-Sheng Chan et al: Arthroscopy assisted surgery for tibial plateau fractures. Chang Gung Med j 2011;34:239-47.

How to Cite this Article: Mall B, Dash S, Das A, Mishra S, Sahu H. | A prospective study of clinical outcomes of management of arthroscopic assisted tibial plateau fractures fixation | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 17-20.

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Outcome of Differential period of immobilization (4 weeks Vs 6 weeks ) of Colles’ Type Fractures of the Distal Radius in Geriatric population: A prospective study

Vol 41 | Issue 1 | Jan-Jun 2020 | page: 11-16 | Nirmal Chandra Mahapatra, Ramesh Chandra Maharaj, Jugaratna Khatua, Debi Prasad Nanda


Authors: Nirmal Chandra Mahapatra [1], Ramesh Chandra Maharaj [1], Jugaratna Khatua [1], Debi Prasad Nanda [1]

[1] Dept Of Orthopedics, SCB Medical College & Hospitals, Cuttack, Odisha India.

Address of Correspondence

Dr. Debi Prasad Nanda,
SCB Medical College & Hospitals, Cuttack, Odisha India
E-mail: drdebiortho@gmail.com


Abstract

Background: Perkin-Colles’ fracture however may leave behind a deformed wrist.
Aim: To evaluate how the period of immobilization in conservative treatment of extra-articular Colle’s type fractures of the distal radius affects functional outcome.
Objective: One group was immobilized for 4 week another group for 6 weeks.
Null Hypothesis: There is no difference between two groups in terms of functional outcome.
Methods: This prospective study included 70 patients and was carried in S.C.B. Medical College in Department of Orthopedics from 2017-19.One group was immobilized for 4 week another group for 6 weeks. Standard radiographs were made of both wrists in two directions after the fracture, then of the injured side on day 11 following repositioning, and at 3month and 6 month. Anatomical results were assessed by evaluating the dorsal angulation, loss of radial inclination, and loss of radial length. Functional results were assessed by the evaluation of pain, range of active motion, grip strength, and appearance of the wrist joint.
Results: 1-No Statistically significant difference between two groups in terms of functional outcome in 6 months 2- Statistically significant difference between two groups in terms of functional outcome in 3 months.
Conclusion: In long term follow up there is no difference in functional outcome with respect to period of immobilization rather it is more related to the radiological (anatomical) outcome.
Keywords: Casts, Conservative, Mayo score, Colles’ fracture, hand strength, prospective studies, radiography, range of motion, articular; treatment failure.


References

1-Ark J, Jupiter JB. The rationale for precise management of distal radius fractures. Orthop Clin North Am 1993;24:205-10.
2-Jupiter JB. Fractures of the distal end of the radius. J Bone Joint Surg Am 1991;73:461-9.
3-Alfram PA, Bauer GC. Epidemiology of fractures of the forearm: a biomechanical investigation of bone strength. J Bone Joint Surg Am 1962;44:105-14.
4-Hesp R, Klenerman L, Page L. Decreased radial bone mass in Colles’ fracture. Acta Orthop Scand 1984;55:573-5.
5-Cassebaum WH. Colles’ fracture: a study of end results. JAMA 1950;143:963-5.
6-Golden GN. Treatment and prognosis of Colles’ fracture. Lancet 1963;1:511-5.
7-Bacorn RW, KurtkZeJF. Colles’ fracture : a study of two thousand cases from the New York State Workman’s Compensation Board. IBone Joint Surg (Am] 1953;35-A:643-58.
8-Gartland JJ Jr, Werley CW Evaluation of healed Colles’ fractures. I Bone Joint Surg [Am] 1951 ;33-A:895-907.
9-Golden GN. Treatment and prognosis of Colles’ fracture. Lancet 1963;i:51 1-5.
10-Pool C. Colles’ fracture: a prospective study of treatment. I Bone Joint Surg [Br] 1973;55-B:540-4.
11-Sarmiento A, Pratt GW, Berry NC, Sinclair WF. Colles’ fractures: functional bracing in supination. I Bone Join: Surg [Am] 1975;57-A :311-7.
12-van der Linden W, Erlcson R. Colles’ fracture : how should its displacement be measured and how should it be immobilized? I Bone Joint Surg [Am] 1981 ;63-A :1285-8.
13-Coosiey WP Ill, Dobyns JH, LInscbeld RL Complications of Colles’ fractures. I Bone Joint Surg (Am] l980;62-A :613-9.
14-Lidstrom A. Fractures of the distal end of the radius: a clinical and statistical study of end results. Ada Orthop ıcand 1959; Suppl 41.
15-Muller ME, Allgower M, Schneider R, Willenegger H. Manual of internalfixation: techniques recommendedby the AO Group. 2nd ed. Berlin etc : Springer-Verlag, 1979.
16-Salter RB, Slmnioiids DF, Malcolm BW, Rumble U, Macmichael D, aemeiits ND. The biological effect ofcontinous passive motion on the healing of full-thickness defects in articular cartilage: anexperimental investigation in the rabbit. J Bone Joint Surg [Am] 1980;62-A:1232-5l.
17-Stewart HD, Innes AR, Burke FD. Functional cast-bracing for Colles’ fractures : a comparison between cast-bracing and conventional plaster casts. J Bone Joint Surg (Br] l984;66-B :749-53.
18-Müller ME. The comprehensive classification of fractures of long bones. In:Müller ME, Allgöwer M, Schneider R, Willenegger H, editors. Manual of internal fixation. 3rd ed. Heidelberg-New York: Springer-Verlag; 1991. p. 134-5.
19-Bilic R, Ruzic L, Zdravkovic V, Boljevic Z, Kovjanic J. Reliability of different methods of determination of radial shortening. Influence of ulnar and palmar tilt. J Hand Surg Br1995;20:97-101.
20-Cooney WP. Management of Colles’ fractures. J Hand Surg Br1989;14:137-9.
21-Altissimi M, Antenucci R, Fiacca C, Mancini GB. Long term results of conservative treatment of fractures of the distal radius. Clin Orthop 1986;(206):202-10.
22-Metz VM, Gilula LA. Imaging techniques for distal radius fractures and related injuries. Orthop Clin North Am 1993;24:217-28.
23-Mann FA, Wilson AJ, Gilula LA. Radiographic evaluation of the wrist: what does the hand surgeon want to know? Radiology 1992;184:15-24.
24-Taleisnik J, Watson HK. Midcarpal instability caused by malunited fractures of the distal radius. J Hand Surg [Am] 1984;9:350-7.
25-Scheck M. Long-term follow-up of treatment of comminuted fractures of the distal end of the radius by
transfixation with Kirschner wires and cast. Am J Orthop 1962;44-A:337-51.
26-Friberg S, LundströmB. Radiographic measurements on the radio-carpal joint in distal radial fractures. Acta Radiol Diagn (Stockh) 1976;17:869-76.
27-Young BT, Rayan GM. Outcome following nonoperative treatment of displaced distal radius fractures in
low-demand patients older than 60 years. J Hand Surg Am2000;25:19-28.
28-Solgaard S. Function after distal radius fracture. Acta Orthop Scand 1988;59:39-42.
29- Boyd LG, Horne JG. The outcome of fractures of the distal radius in young adults. Injury 1988;19:97-100
30-Jenkins NH, Mintowt-Czyz WJ. Mal-union and disfunction in Colles’ fracture. J Hand Surg Br1988;13:291-3.

How to Cite this Article: Mahapatra N C, Maharaj R C, Khatua J, Nanda D P. | Outcome of Differential period of immobilization (4 weeks Vs 6 weeks ) of Colles’ Type Fractures of the Distal Radius in Geriatric population: A prospective study. | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 11-16 .

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From Editors Desk

Vol 41 | Issue 1 | Jan-Jun 2020 | page: 1 | Nirmal Chandra Mohapatra


Authors: Nirmal Chandra Mohapatra [1]

[1] Department of Orthopaedics, SCB Medical College, Cuttack, Odisha, India

Address of Correspondence

Dr. Nirmal Chandra Mohapatra,
SCB Medical College, Cuttack, Odisha, India.
E-mail: ojot.editor@gmail.com


From Editors Desk

The purpose of our journal has been to serve as a permanent, transparent and open platform for the presentation, scrutiny, and discussion of Orthopaedic research in our state. This we have endeavoured since the very inception of our journal in 19–. Despite the multitude of impressive articles and sustained enthusiasm with which the previous editors and authors carried on, we realised that a massive change was needed in order to maintain our utility and contribute to our goals in this everchanging changing world. We had to sit down, introspect and decide how we could do things better. The shortcomings were glaring. We lacked indexing in any major form. In this technologically savvy age, our online presence and article submission system was archaic. Despite having such a senior and talented pool of orthopaedic surgeons our peer-review system was abysmal. Our editorial/reviewer teams have to be moulded in order to solve the problems of deprecation into the journals working methods. All this requires not only a coordinated effort on the part of the editors & reviewers but it also needs the sustained support of the authors and the entire orthopaedic community of the state. There are many issues that need to be tackled. We lack subspeciality focus, an online submission system, a proper peer review system, our articles are submitted just in the nick of time and yet it is expected to be published early (without a proper peer-review or constructive criticism) and finally, we lacked a professional vetting system for the submitted articles. We decided to rope in professional publishers and approached the Indian Orthopaedic Research Group. The changes that we attempt to bring in will require long term planning, patience (for the results will require a lot of time to present) and probably also require cajoling for acceptance by our whole fraternity. But these changes are absolutely mandatory and this piece of the editorial is probably akin to Nokia CEOs infamous “burning platform” memo (before Nokia/Symbian sank in 2011), except that we envision a very successful transition. The effect of these changes will be apparent over the next 2 to 3 volumes and we hope these will set in motion improvements that last a foreseeable future.

Professor (Dr) Nirmal Chandra Mohapatra
Editor-in-Chief
The Odisha Journal of Orthopaedics and Trauma


How to Cite this Article: Mohapatra N C |From Editors Desk | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 1.  


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Negative pressure wound therapy… A healing touch approach to difficult wounds in orthopedic practice… A systematic review

Vol 41 | Issue 1 | Jan-Jun 2020 | page: 41-45 | Bikram Kar, Buddhadeb Nayak, Harshal Sakale, Alok C Agrawal


Authors: Bikram Kar [1], Buddhadeb Nayak [1], Harshal Sakale [1], Alok C Agrawal [1]

[1] Department of Orthopaedics, SCB Medical College, Cuttack, Odisha India.

Address of Correspondence
Dr. Buddhadeb Nayak,
SCB Medical College, Cuttack, Odisha India.
E-mail: buddhadeb9188@gmail.com


Abstract

The routine use of Negative Pressure Wound Therapy (NPWT) in big and complex wounds has gained the momentum over the past couple of years .In addition to surgical debridement for treating tissue defects around open fractures and chronic non healing ulcers, contaminated wounds in orthopaedic trauma, open fractures with soft tissue defects, its usage is frequently seen with increasing evidence to aid closed incisions having high risk of wound breakdown. Also the evidence for its use on skin grafts is now well established.
This review will analyze the available literature in order to summarize the current understanding of NPWT in terms of its mechanism of action, its applications, complications, contraindications and its future. Research on the application of NPWT in treating chronic non-healing wounds has largely taken the form of case studies, single-center studies, non-randomized controlled trials, with few randomized controlled trials (RCTs). Our aim is to summarize the current and emerging indications for negative pressure wound therapy in Orthopaedic trauma and the existing evidence for its use.
Keywords: Negative pressure wound therapy, Open fractures, Trauma, Wound management.


References

1. Huang C, Leavitt T, Bayer LR, Orgill DP. Effect of negative pressure wound therapy on wound healing. CurrProbl Surg. 2014;51:301-331.
2. Malmsjö M, Borgquist O. NPWT settings and dressing choices made easy. Wounds International. 2010;1:1-6.
3. Chariker ME, Jeter KF, Tintle TE, Ottsford JE. Effective management of incisional and cutaneous fistulae with closed suction wound drainage. Contemp Surg. 1989;34:59 63.
4. Campbell PE, Smith GS, Smith JM. Retrospective clinical evaluation of gauze-based negative pressure wound therapy. Int Wound J. 2008;5:280-286.
5. Malmsjo M, Ingemansson R, Martin R, Huddelston E. Negative pressure wound therapy using gauze or polyurethane open cell foam: similar early effects on pressure transduction and tissue contraction in an experimental porcine wound model. Wound Repair Regen. 2009;17(2):200–5.
6. Campbell PE, Smith GS, Smith JM. Retrospective clinical evaluation of gauze based negative pressure wound therapy. Int Wound J. 2008;5:280–6.
7. Kaufman M, Pahl D. Vacuum-assisted closure therapy: wound care and nursing implications. Dermatol Nurse. 2003;4:317–25.
8. Bickels J, Kollender Y, Wittig JC , et al. Vacuum-assisted closure after resection of musculoskeletal tumours. ClinOrthopRelat Res. 2005;441:346–50.
9. Shirikawa M, Isseroff R. Topical negative pressure devices. Arch Dermatol. 2005;141(11):144
10. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997;38:563-576; discussion 577
11. Kairinos N, Solomons M, Hudson DA. Negative-pressure wound therapy I: the paradox of negative-pressure wound therapy. PlastReconstr Surg. 2009;123:589-598; discussion 599-600.
12. Kairinos N, Solomons M, Hudson DA. The paradox of negative pressure wound therapy–in vitro studies. J PlastReconstrAesthet Surg. 2010;63:174-179.
13. Scherer SS, Pietramaggiori G, Mathews JC, Prsa MJ, Huang S, Orgill DP. The mechanism of action of the vacuum-assisted closure device. PlastReconstr Surg. 2008;122:786-797]
14. Borgquist O, Ingemansson R, Malmsjö M. The influence of low and high pressure levels during negative-pressure wound therapy on wound contraction and fluid evacuation. PlastReconstr Surg. 2011;127:551-559
15. Lancerotto L, Bayer LR, Orgill DP. Mechanisms of action of microdeformational wound therapy.Semin Cell Dev Biol. 2012;23:987-992. [PubMed] [DOI]
16. Younan G, Ogawa R, Ramirez M, Helm D, Dastouri P, Orgill DP. Analysis of nerve and neuropeptide patterns in vacuum-assisted closure-treated diabetic murine wounds. PlastReconstr Surg. 2010;126:87-96.
17. Armstrong DG, Lavery LA. Diabetic Foot Study Consortium.Negative pressure wound therapy after partial diabetic foot amputation: a multicntre randomized controlled trial. Lancet. 2005; 366(9498):1704
18. Rivilis I, Milkiewicz M, Boyd P, Goldstein J, Brown MD, Egginton S, Hansen FM, Hudlicka O, Haas TL. Differential involvement of MMP-2 and VEGF during muscle stretch- versus shear stress-induced angiogenesis. Am J Physiol Heart Circ Physiol. 2002;283:H1430-H1438.
19. Quinn TP, Schlueter M, Soifer SJ, Gutierrez JA. Cyclic mechanical stretch induces VEGF and FGF-2 expression in pulmonary vascular smooth muscle cells. Am J Physiol Lung Cell Mol Physiol. 2002; 282:L897-L903.
20. Urschel JD, Scott PG, Williams HT. The effect of mechanical stress on soft and hard tissue repair; a review. Br J Plast Surg. 1988;41:182-186.
21. Orgill DP, Manders EK, Sumpio BE, Lee RC, Attinger CE, Gurtner GC, Ehrlich HP. The mechanisms of action of vacuum assisted closure: more to learn. Surgery. 2009;146:40-51.
22. N. Kairinos, et al Wound Healing Southern Africa, Volume 10 Number 2, Dec 2017, p. 6 – 14.

How to Cite this Article: Kar B, Nayak B, Sakale H, Agrawal A C. | Negative pressure wound therapy… A healing touch approach to difficult wounds in orthopedic practice… a systematic review. | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 41-45 .

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The significance of peer review in orthopaedic publications

Vol 41 | Issue 1 | Jan-June 2020 | page: 26-27 | Sundar Narayan Mohanty, Saswat Samant, Udayan Das, Bhabani Shankar Mohapatra, Debobrata Saha, Nishant Gupta


Authors: Sundar Narayan Mohanty [1], Saswat Samant [1], Udayan Das [1], Bhabani Shankar Mohapatra [1], Debobrata Saha [1], Nishant Gupta[1]

[1] Department of Orthopaedics, Hi-Tech Medical College & Hospital, Bhubaneswar, Odisha India.

Address of Correspondence
Dr. Satya Ranjan Patra,
Hi-Tech Medical College, Bhubaneswar, Odisha India.
E-mail: drsatyarp@gmail.com


Abstract

The purpose peer review is to enable authors to reach high & accepted standards during the dissemination of research data by the scrutinization of their research data by experts of the same field. Peer review also has its own share of demerits and points for criticism. Various new modifications have been proposed yet a more robust system is yet to be fully developed. It is expected that we make the most of this method to ensure that our fellow orthopaedicians get the most valid and filtered high-quality results from our research..
Keywords: Peer review, manuscript, orthopaedics, publications


References

1. Kelly J, Sadeghieh T, Adeli K. Peer Review in Scientific Publications: Benefits, Critiques, & A Survival Guide. EJIFCC. 2014;25(3):227–243. Published 2014 Oct 24.
2. Tippmann S. (2014). “New Avenues For Peer Review: An (Audio) Interview With Eva Amsen.” Peer Review Watch.Web. http://peerreviewwatch.wordpress.com/2014/04/05/new-avenues for- peer-review-an-audio-interview-with-Eva-amsen
3. Meadows A. (2013). “A New Approach to Peer Review – an Interview with Keith Collier, Co-founder of Rubriq.” Wiley Exchanges. Web. Retrieved July 07, 2014 from http://exchanges.wiley.com/blog/2013/09/17/a-newapproachto- peer-review-an-interview-with-Keith-collierco-founder-of-rubriq/
4. Ware M. (2008). “Peer Review: Benefits, Perceptions and Alternatives.” PRC Summary Papers, 4:4-20.
5. “Peer Review 101.” (2013). The American Physiological Society. Web. Retrieved from https:// www.the-aps.org/mm/SciencePolicy/Agency-Policy/ Peer-Review/PeerReview101.pdf
6. Schley D. (2009).”Peer Reviewers Satisfied with System.”Times Higher Education. Web. Retrieved, from http://www.timeshighereducation . co.uk/408108.article
7. “Peer Review”. (2014). Elsevier Publishing Guidelines. Web. Retrieved June 24, 2014, from http://www.elsevier. com/about/publishing-guidelines/peer-review
8. Hall SA, \Vi!cox AJ. The btl’ of epidemiologic manuscripts: a study of papers submitted to Epidemiology. Epidemiology 2007: 11->:262-265.

How to Cite this Article: Mohanty S N, Samant S, Das U, Mohapatra B S, Saha D, Gupta N. | The significance of peer review in orthopaedic publications. | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 26-27.

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Fracture of C1 vertebra managed with unilateral trans-articular screw fixation- Report of two cases

Vol 41 | Issue 1 | Jan-June 2020 | page: 34-37 | Hemanta Kumar Bamidi, Satya Ranjan Patra, Siddhartha Shankar Mohanty, Kishore Chandra Das


Authors: Hemanta Kumar Bamidi [1], Satya Ranjan Patra [1], Siddhartha Shankar Mohanty [1], Kishore Chandra Das1y [1]

[1] Department of Orthopaedics, Hi-Tech Medical College & Hospital, Bhubaneswar, Odisha India.

Address of Correspondence
Dr. Satya Ranjan Patra,
Hi-Tech Medical College, Bhubaneswar, Odisha India.
E-mail: drsatyarp@gmail.com


Abstract

Fracture of C1 vertebrae nearly accounts for 2-13% of cervical spine injury. The fracture may be stable or unstable. If both anterior and posterior arch of atlas is fractured then it is considered an unstable type and needs surgical intervention. Various fixation methods have been described by researchers. We describe two cases of unstable C1 fractures managed with trans-articular screw fixation by minimal invasive technique. Trans-articular screw fixation is a less invasive and safe method for unstable C1 fractures.
Keywords: C1 vertebrae [atlas], Jefferson fracture, Dens fracture, Trans-articular screw fixation.


References

1. Marcon RM et al, Cristante AF, Teixeira WJ, NarasakiDK, Oliveira RP,Fractures of cervical spine. Clinics (Sao Paulo). 2013;68(11):1455-61
2. Matthissen C, Yohan R.Epidemiology of atlas fractures-a national registry based cohort study of 1537 cases. Spine J.2015;15(11):2332-7. doi:10.1016/j.spinee.2015.06.052.
3. Keith D. Williams, Campbell Operative Orthopaedics,13th Editions, page no 1785.
4. Hadley MN, CurtisDA, Garrett M, Consiglieri G Acute traumatic atlas fractures:management and long term outcome.Neurosurgery.1988;23(1):31-5.
5. Josten C Jarvers JS, Glasmacher S, Spiegl UJ, ArchOrthop Trauma Surg. 2018 Nov;138(11):1525-1531. doi: 10.1007/s00402-018-3013-y. Epub 2018 Jul 28.
6. Toussaint P, Desenclos C, Peltier J, Le Gars D. Neurochirurgie. 2003 Nov;49(5):519-26. French.
7. Wright N M Lauryssen C. J Neurosurg. 1998 Apr;88(4):634-40. Review.
8. Aravind kumar, international journal of spine surgery, vol.13, No.4, 2019, pp.345-349
9. Lleu M, Charles YP, Blondel B, et al.C1 fracture: analysis of consolidation and complications rates in a prospective multicenter series.OrthopTraumatol Surg Res. 2018;104(7):1049-1054.
10. Panjabi M ,Dvorak J, Crisco J III, Oda T, HilibrandA, Grob D. Flexion extension and lateral bending of upper cervical spine in response to alar ligament transections. J Spinal Disord. 1991;4(2):157-167.

How to Cite this Article: Bamidi H K, Patra S R, Mohanty S S, Das K C. | Fracture of C1 vertebra managed with unilateraltrans articular screw fixation- report of two cases. | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 34-37 .

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Small patella syndrome – A case report with review of literature

Vol 41 | Issue 1 | Jan-June 2020 | page: 38-40 | Kishore Chandra Das, Satya Ranjan Patra, Hemanta Kumar Bamidi, Siddhartha Shankar Mohanty


Authors: Kishore Chandra Das [1], Satya Ranjan Patra [1], Hemanta Kumar Bamidi [1], Siddhartha Shankar Mohanty [1]

[1] Department of Orthopaedics, Hi-Tech Medical College, Bhubaneswar, Odisha India.

Address of Correspondence
Dr. Satya Ranjan Patra,
Hi-Tech Medical College, Bhubaneswar, Odisha India.
E-mail: drsatyarp@gmail.com


Abstract

Small patella syndrome (SPS) or Hypoplastic patella syndrome (HPS) is a rare autosomal dominant disorder due to mutations in the TBX4 gene, characterized by the absence or hypoplasia of the patella with various anomalies of the pelvis and feet. We describe a case of a patient with hypoplastic patella of both knees presenting with pain and difficulty in walking; he was managed conservatively with non-steroidal anti-inflammatory drugs and an extension brace for three weeks followed by physiotherapy focusing on range of motion and quadriceps strengthening exercise.
Keywords: Small patella syndrome, Hypoplasia, Nail-patella syndrome, Patella aplasia-hypoplasia, Ischiopatella dysplasia, Ischio-pubic-patella syndrome or Scott-Taor syndrome, Hypoplastic patella syndrome, Ischiopubic synchondrosis


References

1. Bongers EM, Duijf PH, van Beersum SE, Schoots J, Van Kampen A, Burckhardt A, Hamel BC, Losan F, Hoefsloot LH, Yntema HG, Knoers NV, van Bokhoven H. Mutations in the human TBX4 gene cause small patella syndrome. Am J Hum Genet. 2004;74:1239–1248.
2. Scott JE, Taor WS. The “small patella” syndrome. J Bone Joint Surg Br. 1979;61:172–1753
3. Kozlowski K, Nelson J. Small patella syndrome. Am J Med Genet. 1995;57:558–56
4. Mangino M, Sanchez O, Torrente I, De Luca A, Capon F, Novelli G, Dal-lapiccola B. Localization of a gene for familial patella aplasia-hypoplasia (PTLAH) to chromosome 17q21-22. Am J Hum Genet 1999;65:441-7.
5. Dreyer SD, Zhou G, Baldini A, Winterpacht A, Zabel B, Cole W, Johnson RL, Lee B. Mutations in LMX1B cause abnormal skeletal patterning and renal dysplasia in nail patella syndrome. Nat Genet 1998;19:47-59.
6. Braun HS. Familial aplasia or hypoplasia of the patella. Clin Genet 1978;13:350-2.
7. Kiss I, Mándi A, Szappanos L. Patella a/hypoplasia occurring in familial way. Medical Genetics. Proceedings of the Symposium at Debrecen, Hajduszoboszló, AkádémiaiKiadó, Budapest 1977. Cited by Braun HS. Clin Genet 1978;13:350-2
8. Mangino M, Sanchez O, Torrente I, De Luca A, Capon F, Novelli G, Dal- lapiccola B. Localization of a gene for familial patella aplasia-hypoplasia (PTLAH) to chromosome 17q21-22. Am J Hum Genet 1999;65:441-7.
9. Dreyer SD, Zhou G, Baldini A, Winterpacht A, Zabel B, Cole W, Johnson RL, Lee B. Mutations in LMX1B cause abnormal skeletal patterning and renal dysplasia in nail patella syndrome. Nat Genet 1998;19:47-59.
10. Goeminne L, Dujardin L. Congenital coxa vara, patella aplasia and tarsal synostosis: a new inherited syndrome. Acta Genet Med Gemellol 1970;19: 534-45.
11. Habboub HK, Thneibat WA. Ischio-pubic-patella hypoplasia: is it a new syndrome? PediatrRadiol 1997;27:430-1.
12. Bernhang AM, Levine SA. Familial absence of the patella. J Bone Joint Surg Am 1973;55:1088-90.
13. Braun HS. Familial aplasia or hypoplasia of the patella. Clin Genet 1978;13: 350-2.
14. Kiss I, Mándi A, Szappanos L. Patella a/hypoplasia occurring in familial way. Medical Genetics. Proceedings of the Symposium at Debrecen, Hajduszoboszló, AkádémiaiKiadó, Budapest 1977. Cited by Braun HS. Clin Genet 1978;13:350-2.
15. GUIDERA K. J., SATTERWHITE Y., OGDEN J. A., PUGH L., GANEY T., Nail patella syndrome: a review of 44 orthopaedic patients, J PediatrOrthop, 1991, 11(6):737–742.
16. BEGUIRISTÁIN J. L., DE RADA P. D., BARRIGA A., Nail-patella syndrome: long term evolution, J PediatrOrthop B, 2003, 12(1):13–16.
17. VARGHESE R. A., JOSEPH B., Congenital aplasia of the patella and the distal third of the quadriceps mechanism, J PediatrOrthop B, 2007, 16(5):323–326
18. DELLESTABLE F., PÉRÉ P., BLUM A., RÉGENT D., GAUCHER A., The ‘small patella’ syndrome. Hereditary osteodysplasia of the knee, pelvis and foot, J Bone Joint Surg Br, 1996, 78(1):63–65.
19. LETTS M., Hereditary onycho-osteodysplasia (nail-patella syndrome). A three-generation familial study, Orthop Rev, 1991, 20(3):267–272.
20. BANSKOTA A. K., MAYO-SMITH W., RAJBHANDARI S., ROSENTHAL D. I., Case report 548: Nail-patella syndrome (hereditary onycho-osteodysplasia) with congenital absence of the fibulae, Skeletal Radiol, 1989, 18(4):318–321.
21. TRINN C., SZÖKE B., MAGYARLAKI T., TURI S., ORMOS J., NAGY J., Nail-patella syndrome: clinico-pathological characteristics, Orv Hetil, 1996, 137(41):2253–2256.
22. DUNCAN J. G., SOUTER W. A., Hereditary onchyoosteodysplasia: The nail patella syndrome, J Bone Joint Surg [Br], 1963, 45:242.

How to Cite this Article: Das K C, Patra S R, Bamidi H K, Mohanty S S. | Small patella syndrome – A case report with review of literature. | Odisha Journal of Orthopaedics & Trauma | Jan-June 2020; 41(1): 38-40.

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