Indian Journal of Orthopaedics

BACKGROUND: Volar locking plate fixation (VLPF) is the most common method for operative fixation of distal radius fractures (DRF). The dorsal ulnar corner (DUC) can be difficult to stabilize as the fragment is small and not exposed when using the volar approach. The purpose of this study was to study fracture fragment migration after VLPF of AO type C DRF, using a volume registration technique of paired CT scans with special focus on the DUC fragment. MATERIALS AND METHODS: This pilot study included ten patients with AO type C DRF, all operated with VLPF...

PURPOSE OF THE STUDY: Femoral neck fracture osteosynthesis is usually performed by using dynamic hip screw (DHS) or multiple parallel cannulated screws (MCS). In orthopedic surgery training, certain hip fractures are one of the most common operations performed by residents. It has been questioned, whether residents can provide as safe treatment and patient outcomes as those of more experienced surgeons. The aim of this study was to evaluate the effect of surgical experience on risk of complications by comparing the surgical performance and clinical outcomes in femoral neck osteosyntheses between surgical residents and orthopaedic surgeons...

BACKGROUND: Orthopedic surgeons favor an intramedullary guiding system on the femoral component during total knee arthroplasty (TKA); nevertheless, improper positioning of the entry point affects the final alignment. We have designed a new femoral cutting system for TKA that uses the distal and posterior femoral condyles as reference points for the setting of the cutting system regardless of the femoral canal. This study aims to evaluate the outcomes of this new guiding system. METHODS: We enrolled a series of 75 consecutive knees undergoing TKA...

INTRODUCTION: Negative Pressure Wound Therapy (NPWT) is a well-established method to promote wound healing by delivering negative pressure (a vacuum) at the wound site. Enhancement of NPWT techniques may allow an innovative way of treating trauma and orthopaedic wounds which provide unique challenges. We explore the role of negative pressure wound therapy with instillation and dwell time (NPWTi-d-) in the management of trauma and orthopaedic wounds. MATERIALS AND METHODS: A comprehensive search strategy was conducted using databases of PubMed, Web of Science, Google Scholar, and Cochrane Library with the search words of 'NPWTid' or 'NPWTi-d-' or 'NPWT with instillation' or 'Negative pressure wound treatment with instillation' to generate this narrative review...

INTRODUCTION: With the increasing number of Arthroscopic surgeries, comes with it, the undesirable problem of litigation associated with it. Arthroscopy does possess certain unique aspects which need to be understood from the legal point of view as well. MATERIALS AND METHODS: We obtained information on specific medico-legal cases involving arthroscopy from books and websites containing collections of medico-legal judgments in Indian legal courts, consumer dispute redressal forums at the state and national levels, and state medical councils...

BACKGROUND: Wound closure in joint replacement surgeries is crucial for postoperative rehabilitation. Despite substantial advances in total knee arthroplasty (TKA), no guidelines/recommendation or consensus practice statement available internationally or nationally around the optimal method of wound closure. The study aimed to develop evidence-based consensus on current practices, and proposed adoption of advanced wound closure initiatives. METHODS: From Nov 2020 to Jan 2021, a group of 12 leading orthopedic surgeons from India met virtually under the Success in Total joint replacement through Recommendation In wounD closure (STRIDE) initiative...

BACKGROUND: Currently, two classification systems, namely Stephens and Sanders, based on axial CT images, and Zwipp and Rammelt, which consider deformities, are used for calcaneus malunions. Existing classifications have limitations due to their pure anatomical basis, and the complexity of the problem, involving both bone and soft tissues. As a solution, the senior author proposed a novel ADIENS classification system for calcaneal malunion, based on pain generators. This study aimed to introduce and evaluate the inter- and intra-observer reliability of a new classification system for calcaneal malunions...

PURPOSE: Extraforaminal lumbar interbody fusion as with other methods that involve the mechanism of indirect decompression, the discussion not only focuses on the benefit of minimizing the risk of thecal sac injury and postoperative scarring, but also on the risk of insufficient decompression in the affected neural structures during the reduction of the affected segment. METHODS: Eighty-two patients presenting with degenerative lumbar disease with segmental instability underwent ELIF combined with transpedicular fixation and circumferential fusion...

PURPOSE: Tension band wiring is the standard treatment for olecranon fractures, but it is associated with high rate of implant-related complication. To reduce this high complication rate, we developed a modified technique, locked tension band wiring (LTBW). The aim of this study was to investigate whether LTBW reduces complication and reoperation rates compared to conventional methods (CTBW). METHODS: We identified 213 olecranon fractures treated with tension band wiring: 183 were treated with CTBW, and 30 were treated with LTBW, and patients in each group were selected using propensity score matching...

PURPOSE: The purpose of this study was to measure anterior cruciate ligament (ACL) volume in a newly reported multi-truncated pyramid shape simulation using axial magnetic resonance imaging (MRI) for the detailed knowledge of the ACL anatomy. METHODS: Fifty subjects (27 female and 23 male, average age: 23 ± 7.8) visiting our clinic with knee pain and in whom MRI showed no structural injury were included in this study. Using the axial image of the MRI, four deferent levels of the cross-sectional area of the ACL were measured...

BACKGROUND: Amputation of a limb is equivalent to loss of a person's life. Psychological aspects are essential factors in dealing with the disability and functional outcome is a significant concern. Longitudinal studies have not examined the experience and determinants of common mental health problems and functional outcome in lower limb amputees. MATERIALS AND METHODOLOGY: A total of 103 lower limb amputees were recruited and followed up for 6  months. Patients were assessed on Hospital Anxiety and Depression Scale (HADS) and Social Functioning (SF-36) Quality of life, semi-structured clinical interview for psychiatric disorders and phantom limb at baseline (in hospital), at 2 weeks, 3 months and 6 months, respectively after discharge...

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PURPOSE: Our study aims to find the role of lateral retinacular release (LRR) on realigning the patella in knees with maltracking during primary total knee arthroplasty. We also compared the patellar morphological factors between the varus and valgus knees on predicting the need for LRR. METHODS: We have retrospectively analyzed the incidence of LRR in consecutive 152 primary TKA (124 patients) from May 2018 to December 2018. We have evaluated the preoperative radiological parameters like Wiberg's patellar morphological type, patellar angle, sulcus angle, patellar width and thickness, preoperative patellar tilt and patellar shift, lateral patellofemoral angle and congruent angle...

BACKGROUND AND OBJECTIVE: Crouch gait is the most common pathological gait pattern in cerebral palsy and is commonly seen in patients with spastic diplegia. It is characterized by excessive knee flexion throughout the stance phase of gait cycle. The aim of this review is to discuss the current literature about CG for a more comprehensive understanding. METHODS: A literature review about various aspects of crouch gait in cerebral palsy was undertaken. This included its etiology and pathophysiology, biomechanics in crouch gait, natural history of untreated crouch gait, clinical and radiological evaluation and different modalities of available treatment...

BACKGROUND: The aim of this study is to evaluate comparative biomechanical fixation provided with the BDSF method with the conventional CC screw fixation for treatment of femoral neck fractures with three parallel cannulated screws. METHODS: This is a prospective cohort study. There were two teams of surgeons out of which one team operated the patients with BDSF technique and second with conventional CC screw fixation technique; thus, the patients were randomly distributed into two groups...

PURPOSE: 3D bioprinting is capable of rapidly producing small-scale human-based tissue models, or organoids, for pathology modeling, diagnostics, and drug development. With the use of 3D bioprinting technology, 3D functional complex tissue can be created by combining biocompatible materials, cells, and growth factor. In today's world, 3D bioprinting may be the best solution for meeting the demand for organ transplantation. It is essential to examine the existing literature with the objective to identify the future trend in terms of application of 3D bioprinting, different bioprinting techniques, and selected tissues by the researchers, it is very important to examine the existing literature...

BACKGROUND: It is not clearly defined in the literature how the lowest instrumented vertebra (LIV) selection effects the rotation of lumbar vertebrae at fused and unfused levels in thoracolumbar/lumbar (TL/L) curves. The aim of this study was to evaluate the rotational profile of structural TL/L curves, corrected with rod derotation manoeuvre, according to LIV level. METHODS: 82 consecutive AIS patients with structural TL/L curves who were treated with long segment posterior instrumentation and fusion were retrospectively evaluated...

IMPORTANCE: Recently, peroneus longus (PL) autograft as a graft choice for ligament surgeries have attracted interest due to studies showing good clinical outcomes and minimal donor site morbidity. There remain concerns related to these grafts, especially the potential impact on ankle functions. AIMS/OBJECTIVE: The purpose of this review and meta-analysis is to summarize the available evidence for ankle functional outcomes after PL harvest. This will provide objective clinical evidence for surgical decision making...

BACKGROUND: Limb salvage surgery in osteosarcoma requires a multidisciplinary team of experts, due to which research interest has remained limited globally. This article analyzes research trends over 15 years from 2007 to 2022. MATERIALS AND METHODS: Publications on limb salvage surgery in osteosarcoma were retrieved using the Web of Science. Bibliometric analysis of the publication metadata was done using R software. VOS viewer software was used to analyze the bibliographic coupling, co-citation, co-authorship, and co-occurrence to report the current trends in global research on limb salvage surgery in osteosarcoma...

BACKGROUND: There is paucity of data on incidence and pattern of drug resistance in spinal TB. This prospective observational study was conducted to document the incidence and drug-resistance pattern among primary and presumptive resistant cases. METHODS: 59 consecutive cases diagnosed clinico-radiologically (imaging) were grouped into Group A ( n  = 51, primary cases) and Group B ( n  = 8, presumptive resistant cases) based on pre-defined criteria (INDEX-TB guidelines)...