Journal of Clinical Orthopaedics and Trauma

Ankle osteoarthritis is primarily post traumatic and affects a younger population. It, therefore, not only has a negative effect on the quality of life but also impacts the working life of these patients. A thorough history, clinical examination followed by relevant investigations, radiological and hematological, can provide the necessary information to classify the severity and associated deformity of this condition. This will provide guidance to the necessary and appropriate commencement of treatment. Options include conservative or surgical which can be joint sparing or sacrificing procedures...

INTRODUCTION: Acetabular fractures, resulting from high-energy trauma, present significant orthopaedic challenges. Despite their rarity, the incidence of these fractures is rising, necessitating a comprehensive understanding of their epidemiological characteristics, especially in diverse populations like India. METHODS: This retrospective study analyzed data from 3643 patients across four level-1 trauma centers in India (North 1, North 2, West, and South) from January 2001 to December 2019...

INTRODUCTION: Total ankle replacements (TARs) is emerging as a successful alternate treatment option to arthrodesis for surgical treatment of end stage ankle arthritis. This has led to manufacturers producing a selection of implants. There is wide variations in post-operative rehab protocols being adopted for treatment following TAR surgery. This depends on choice of implants and manufacturer recommendations too. Following the author's investigation, a lack of standardisation between manufacturer post-operative protocols was identified...

BACKGROUND: Non-steroid anti-inflammatory drugs (NSAIDs) rank among the frequently prescribed medications for addressing pain and inflammation. Although they are powerful pain relievers, their side effects are indisputable. Serrapeptase, a serine protease, exhibits anti-inflammatory and anti-oedemic activity without the side effects of NSAIDs. We aim to assess the efficacy and safety of serrapeptase in the treatment of pain and edema in ankle sprains. METHODS: In a single-centre prospective comparative study, 76 patients aged 18-53 with Grade II ankle sprains were assigned to either a serrapeptase intervention group (n = 38) receiving 5 mg serrapeptase (two tablets, three times per day) for ten days, or a control group (n = 38) receiving 500 mg paracetamol (three times per day) for the same duration...

Intertrochanteric fracture management require effective management strategies for early return to function and minimise complications. Intramedullary devices like proximal femoral nail have an biomechanical advantage, particularly in unstable intertrochanteric fractures. Such unstable injury patterns not only require precise reduction technique, but also right implant design to minimise the complications. Novel concepts of reduction like medial cortical support classification and antero-posterior reduction (Subtype classification system) refine the reduction strategies...

Osteoarticular tuberculosis (TB), a form of extrapulmonary tuberculosis, refers to the involvement of Mycobacterium tuberculosis ( M.tb ) in the bones and joints. While pulmonary tuberculosis is the most common form, osteoarticular TB represents a relatively rare but significant manifestation, accounting for approximately 1-3% of all TB cases. Accurate and timely diagnosis plays a pivotal role in the management of osteoarticular TB. Conventional diagnostic methods for osteoarticular TB, such as acid-fast bacilli smear microscopy and culture, have limitations in terms of sensitivity, specificity, and turnaround time...

INTRODUCTION: Increasing the impingement-free Range Of Movement (ROM) is crucial for improving patient's functional outcome and reducing the rate of scapular notching. The purpose of this study was to compare, in a virtual model of Reverse Shoulder Arthroplasty with glenoid lateralization (L-RSA): 1) the impingement-free range of movement (ROM) between 155° Grammont-style inlay stem and 135° flushlay stem; 2) the effect of glenosphere size and type (centered vs eccentric) on impingement-free range of movement (ROM) using a 135° Neck Shaft Angle (NSA) flushlay stem...

BACKGROUND: Orthopedic device infections caused by Mycobacterium tuberculosis , including Periprosthetic joint infection (PJI), are rare and peculiar due to its poor adherence to implant surface and weak ability of biofilm formation. We present successful treatment of 2 cases of implant associated Mycobacterium tuberculosis infection (IMTI) by meticulous surgical debridement and long-term anti-tubercular chemotherapy with retention of implant. CASE DESCRIPTIONS: Case 1 : A case of Culture-Negative PJI, 4 years after left total hip replacement (THR) caused by M...

Evidence for management of shoulder periprosthetic joint infection (PJI) has traditionally originated from the hip and knee literature. The differing microbiome, anatomy and implants used in the shoulder mean this evidence is not always directly transferrable. The 2018 Philadelphia International Consensus Meeting for the first-time produced evidence-based guidelines and diagnostic criteria relating specifically to PJI of the shoulder. These guidelines and criteria recognize the pathogenicity of lower virulence organisms in the shoulder which often means clinical presentation is less obvious than other joints...

BACKGROUND: Majority of patients with Progressive Collapsing Foot Deformity(PCFD) have symptoms pertaining to the knee. Malalignment at the foot will have effects on the alignment of the knee. In this case control study, we compare the alignment of the knees between patients with PCFD and controls. MATERIALS: Sixty subjects, 30 PCFD and 30 controls, underwent radiographs in which the tibiofemoral angle and radiological parameters of PCFD were assessed. Parameters of PCFD were correlated with the tibiofemoral angle...

BACKGROUND/AIMS: Racial and ethnic minorities are under-represented in orthopaedic surgery despite efforts to promote diversity and inclusion in the specialty. The purpose of this study was to determine the proportion of international medical graduates (IMGs) in the surgical workforce and future residency pipeline. We further analyze IMG applicant qualifications relative to their US-based counterparts to assess the viability of recruiting IMG candidates as one strategy to advance diversity and inclusion in orthopaedic surgery...

BACKGROUND: Functional outcome following ankle fracture fixation is linked to the restoration of joint congruity, anatomic alignment and stability. If surgical fixation fails to achieve these goals, revision surgery may be indicated. This retrospective study aims to report a consecutive series of fourteen patients with a minimum of one year follow up after revision ankle fixation and describe CT scan based modified Pettrone score used to assess quality of primary fixation. METHODS: Between April 2019 and August 2021, fourteen patients underwent revision ankle fracture fixation...

BACKGROUND: Osteoarthritis (OA) stands as the most prevalent disability among the elderly population. Assessing functional outcomes after Total Knee Replacement (TKR) typically involves Gait analysis along with other evaluation methods. The objective of this study was to compare Gait results, including temporospatial parameters, joint angles, gait profile score (GPS), and movement analysis profiles (MAP), between conventional and iASSIST TKR techniques. METHOD: The study involved 21 participants (mean age 68...

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BACKGROUND: The most common upper limb fracture encountered in clinical practice is distal radius fracture (DRF). They frequently occur due to falls onto an outstretched hand or other traumatic incidents, resulting in a break in the radius near the wrist joint. DRFs often present a spectrum of injuries and are a common reason for emergency department visits, affecting approximately one out of every six patients seeking medical attention in this setting. METHODS: This systematic review was performed according to the guidelines of PRISMA, using the electronic database search of PubMed, Embase, Scopus, and Cochrane Library, and the protocol for the review was registered to PROSPERO...

BACKGROUND: The study aimed to assess functional and radiological outcomes of the suprapatellar approach (SPA) and infrapatellar approaches (IPA) of tibial nailing in patients with closed tibia shaft fractures. METHOD: After Institutional Ethical Committee (IEC) and Clinical Trials Registry- India (CTRI) approval, patients with Orthopaedic Trauma Association (OTA) fracture type 42 were enrolled from August 2021 and August 2022 at a level I trauma centre and randomized to SPA and IPA with informed consent...

BACKGROUND: Over the past 20 years, there has been an increase in demand for complete knee replacements, and this trend is predicted to continue. It has been shown that being overweight is a risk factor for knee osteoarthritis. There are only a few studies on this in India and none on South Indian patients, Therefore, our goal was to evaluate how BMI affected functional outcomes after primary total knee replacement. OBJECTIVES: To determine the impact of body mass index (BMI) on functional outcomes after primary total knee replacement...

BACKGROUND: The anterior cruciate ligament is commonly injured and multiple risk factors have been studied. But there is paucity of articles considering predictive risk factors of femoral condyle morphology in south Indian population. This study aims to assess distal femoral condyle sphericity as a risk factor in anterior cruciate ligament injury and to correlate it with proximal tibia morphological risk factors. MATERIALS AND METHODS: This is a case control study including 80 patients with knee MRI aged between 18 and 60...

INTRODUCTION: Following an index femoral fragility fracture, patients are at risk of a subsequent peri-implant fracture. Management of these injuries are further complicated by patient factors and multi-institutional care. This study quantifies such events and compare rate of identification between in-system and out-of-system patients. METHODS: A retrospective chart review of index operative femoral fragility fractures at a level I trauma center from January 1, 2005 to January 1, 2018 identified 840 patients with twenty-two subsequent peri-implant fractures...

Diabetic foot complications (DFC) such as ulcers and infection are the leading cause for non-traumatic non-oncologic amputations worldwide with a 5-year mortality reaching 70 %. Every attempt is warranted to preserve the limb for physical and psychological integrity of these patients. When possible to perform, conservative surgeries could save the foot and its function. This review will focus on those procedures that do not require in-depth surgical or microsurgical skills and that could be performed by general orthopedic surgeons...