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   Table of Contents - Current issue
January-June 2021
Volume 29 | Issue 1
Page Nos. 1-33

Online since Saturday, August 21, 2021

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Orthopedic clinics under the coronavirus disease-2019 (COVID-19) pandemic: Time to revisit the safety measures p. 1
Sanjay Keshkar, Dilip Kumar Mazumder
Coronavirus disease-2019 (COVID-19) pandemic has changed the seen in each and every field of the globe and is true for orthopedic clinics as well. As the second surge of COVID-19 pandemic is fading away, number of patients in orthopedic clinics of hospitals, nursing homes, and even private chambers is increasing day by day. Very soon we will see a sudden surge of patients in orthopedic OPD (outpatient department) as the cold cases have been differed for the last one and half years. Visiting/handling the increasing number of patients in the same space of consulting and waiting area will be a challenge and it is quite possible that we may commit a mistake by compromising the protective guidelines, as we did during the beginning of this year. However, the first surge was fading away, which resulted into the entry of second surge of COVID pandemic. Therefore, it is time to revisit the situation in terms of safety measures while attending the patients in orthopedic clinic.
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Outcome analysis of surgeries around craniovertebral junction p. 3
Abdul Naim Ostagar, Rajan Kumar, Nasim Akhtar, Sisir Das, Arkadeb Kar
Background: The craniovertebral junction (CVJ) is mainly affected by various bony developmental anomalies. Other causes of compression include trauma, tumors, atlantoaxial instability, and infection (tubercular/pyogenic). We have surgically treated 38 patients of CVJ utilizing different procedures over a span of 4 years and done retrospective study. The purpose of this paper is to analyze the outcome of surgeries around CVJ. Materials and Methods: In our institution, from September 2015 to August 2019, 38 patients underwent surgeries by different methods around CVJ and a retrospective analysis was done. Clinico-radiological evaluation was done to assess the results. The neurologic recovery rate was calculated by Japanese Orthopaedic Association (JOA) score. Results: There were 31 male and 7 female patients in our study with a mean age of 49.8 years (2–86 years). Three (3) anterior surgeries, one (1) combined anterior-posterior 360º fusion, and 34 posterior surgeries including 22 atlantoaxial fixations were done. Average JOA pre-op was 11.6 (range 4–16), at last follow-up average JOA is 14.1 (range 6–16). Radiologically, fusion was achieved in all except two cases. Conclusion: We conclude that CVJ procedures are safe and effective, posterior-only surgery gives promising results with high fusion rate and neurological improvement in most of the patients.
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Anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft through transtibial tunnel: Functional results after 7 years of follow-up p. 9
Riddhideb Barman, Sarkar Pushpal Pijush, Lawrence Kisku, Mohammad Nasim Akhtar, Sanjay Keshkar
Background: The anterior cruciate ligament (ACL) reconstruction is conducted to improve the stability and function of the knee. Bone-patellar tendon-bone (BPTB) graft is still considered as one of the best grafts for ACL reconstruction. The purpose of this paper was to assess outcomes of BPTB ACL reconstruction at 7 years of follow-up. Materials and Methods: This was a retrospective study in which records of 26 patients, who had ACL reconstruction using BPTB graft from 2013 to 2015, were done and the outcomes of results were analyzed by clinical Tegner activity levels and Lysholm score at 6–8 years of follow-up. Results: The follow-up study has revealed excellent long-term results. Approximately 87% of 26 patients had negative pivot shift examination with the remaining 13% having grade 1 ligament laxity. Tegner activity levels were similar to preinjury levels and Lysholm score was 91. All patients were satisfied with the procedure. Conclusion: BPTB ACL reconstruction using transtibial tunnel provides a satisfactory mid-term follow-up outcome.
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Sexual dimorphism of the scapula by morphometric analysis in south Indian population p. 12
Ashwini Kumar, Mansour A Alghamdi, Thittamaranahalli Muguregowda Honnegowda
Background: Forensic anthropology plays a key role in sexual dimorphism. It is possible to establish a profile and identification of the sex of an individual from the available parts of the skeleton. Several bones present dimorphism and have been studied to increase the approach for forensic identification. Objective: We morphometrically evaluated the human scapula and compared the measurements between scapula bone in cadavers of both sex to derive a logistical regression formula for sex determination of the south Indian population. Materials and Methods: Eighty adult scapulae were used in the study. Scapulae were measured in millimeters for 11 parameters with the help of the sliding caliper. Results: The most common shape of glenoid cavity recorded in this study in men and women was pear shape (54.92% and 51.02%) followed by inverted comma shape (31. 49% and 33.73%). The least common shape was oval (13.57% and 15.28). The mean (standard deviation [SD]) of parameters studies in men vs. women: MSH––143.3 ± 10.23 vs. 138.2 ± 11.89 mm; the MSB––105.3 ± 12.45 vs. 93.5 ± 9.23 mm; SpW––120.0 ± 0.81 vs. 104.0 ± 0.95 mm; ACW––87.0 ± 0.58 vs. 80.0 ± 0.53 mm; L2––44.7 ± 0.46 vs. 35.3 ± 0.39 mm; L4–50.5 ± 8.6 vs. 45.3 ± 9.51; L6–60.1 ± 7.71 vs. 56.8 ± 8.55 mm; SI glenoid diameter––37.63 ± 7.58 vs. 35.5 ± 4.75 mm; the anteroposterior glenoid diameter 1––24.50 ± 5.86 vs. 22.5 ± 6.93 mm and the anteroposterior glenoid diameter 2––16.30 ± 2.16 vs. 13.57 ± 5.58 mm; and mean glenoid cavity index was 65.10 ± 8.67% vs. 63.4 ± 9.23%. All parameters measured showed statistically significant values (P < 0.05) for the male scapula. Conclusion: The scapula can potentially be used in medicolegal investigations in terms of sexual dimorphism. Thus, the results of these studies can provide the baseline values increasing the range of options in the forensic investigation in sex determination.
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Cervical vertigo: A brief review p. 16
Kiran Kumar Mukhopadyay, Rajeev Raman
Vertigo is a perception of movement either of the environment or of one’s own body, which may be of rotation or swaying. Vertigo or nonvestibular dizziness is one of the most common complaints of the patients, but there are a number of causes for that. Very few literatures are available on vertigo. The purpose of this article was to provide an overview and literature review.
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Calcific myonecrosis of leg: A case report p. 18
Chaitanya Halder, Sabyasachi Santra, Sanjay Keshkar
Calcific myonecrosis is a rare entity characterised by a latent formation of dystrophic calcified mass occurring most commonly in the anterior compartment of the leg and is usually a posttraumatic condition. Diagnosis is based on the history of trauma and typical radiological features. Symptomatic patients require complete excision of the mass. We report such a case not only for its rarity but also for challenging diagnosis and treatment.
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Management of fibrous dysplasia of the femur neck in a child by PHILOS Stabilization, curettage, and bone grafting: A case report p. 21
Alok Chandra Agrawal, Ranjeet Choudary, Venishetty Nagaraju, Harshal Sakale
Fibrous dysplasia has a considerable risk of pathological fractures particularly in proximal femur in younger age group. These are challenging to treat, especially in pediatric population. Several treatment modalities have been proposed, each having its own pros and cons. Attention should be given in pediatric population in choosing technique and selection of implants to preserve growth of the limb and to prevent implant prominence and soft tissue irritation. We are reporting a case of pathological neck of femur fracture secondary to fibrous dysplasia, in an 11-year-old obese boy, managed with curettage, iliac crest bone grafting and osteosynthesis with PHILOS plate (a plate routinely used in adults for humerus neck fractures). At 6 months follow-up, he shows a good consolidation of iliac crest graft at fracture site with stable implant and an excellent functional outcome in terms of pain and range of motion, without any radiological sign of recurrence.
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A rare combination of acromion and coracoid base fracture: An unusual injury managed conservatively p. 26
Ganesh Singh Dharmshaktu, Navneet Adhikari, Pankaj Mourya
The acromion and coracoid process fractures are uncommon injuries and may be missed in cases of bad quality radiographs or inappropriate patient positioning during radiography. The complex shoulder region anatomy calls for careful observation and clinical suspicion to rule out these injuries. Concomitant coracoid and acromion process fracture is a rare pattern of injury. We report a case of minimally displaced acromion process fracture with undisplaced fracture of base of the coracoid process. Conservative management was done and a satisfactory outcome was noted in the mean follow-up of 9 months on using the DASH score.
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Effective editorial review system for improving impact factor of orthopedic journals p. 29
Ujjwal K Debnath, Sanjay Keshkar
The impact factor (IF) for peer-reviewed orthopaedic journals has increased in the recent years, so has the number of journals. The publication of high-level research in orthopaedics has considerable importance of citing good quality evidence for impact on day-to-day practice. Transparency and rigorous engagement of reviewers and authors in the peer review process may improve the quality of publication which may help developing practice guidelines. This article seeks to suggest simple ways to have effective peer review process which can maximize publication success and improve the IF.
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Our legends: Prof. ML Chatterjee p. 32
Sanjay Keshkar, Dilip Kumar Mazumder, Nirmal Dey, Tapan Kumar Maitra
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