Journal of clinical orthopaedics and trauma
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J Clin Orthop Trauma · Oct 2019
Circular external fixation as definitive treatment for open or comminuted femoral fractures: Radiologic and functional outcomes.
Ring external fixation can be a definitive treatment of high energy femoral fractures. A retrospective analysis of outcomes is presented. ⋯ Circular external fixation can achieve reliable rates of union and good to excellent functional outcome in open or comminuted femoral fractures. A strict rehabilitation protocol was effective in preserving knee joint function.
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J Clin Orthop Trauma · Sep 2019
Primary ilizarov external fixation in open grade III type C distal femur fractures: Our experience.
Open comminuted distal femur fractures are notorious for septic or aseptic non-union. The recommended fixed angle distal femur locking plate in such situations can lead to a septic non-union due to its extensive approach and further periosteal stripping. Supracondylar nails, though have a minimally invasive approach, are not suitable for type C2 and C3 (AO/ASIF) fractures. A monolateral fixator as damage control followed by plating may be recommended. But if wound healing is delayed it results in difficult articular reduction, poor alignment and a stiff knee. We therefore used ilizarov circular external fixators (ICEF) for such open fractures (type C1, C2 and C3) and analysed its radiological and functional outcomes. ⋯ With the encouraging results, the use of ICEF with minimal internal fixation in grade III open comminuted distal femur fractures as a primary definitive treatment is a valuable alternative.
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J Clin Orthop Trauma · Jul 2019
ReviewThe 'forgotten rubber band' syndrome - A systematic review of a uniquely 'desi' complication with a case illustration.
Once an exceedingly rare entity, multiple cases of forgotten rubber band syndrome or the so-called 'dhaaga' syndrome have now been reported in the literature. ⋯ A high index of suspicion must be maintained for this 'syndrome' in chronic osteomyelitis cases presenting with a linear, circumferential scar and discharging sinus in India. Soft tissue constriction sign on plain radiographs are pathognomonic.
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J Clin Orthop Trauma · Mar 2019
Variations of extensor pollicis brevis tendon in Indian population: A cadaveric study and review of literature.
Variations of the tendons of the first dorsal compartment of the wrist may be one of reasons of treatment failure and recurrence in De Quervain's tenosynovitis (DQT). The present cadaveric study was designed to look into the variations of the Extensor pollicis brevis (EPB) tendon in Indian population. ⋯ EPB in first extensor compartment of Indians is usually monotendinous. It mostly inserts into the distal part of dorsal surface of proximal phalanx of thumb and into the base of distal phalanx. In majority of the wrists, one may find an osseofibrous ridge separating EPB from APL. These anatomical variations may be helpful to guide proper treatment in de Quervain's tenosynovitis.
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J Clin Orthop Trauma · Mar 2019
Safe corridor for fibular transfixation wire in relation to common peroneal nerve: A cadaveric analysis.
Peroneal nerve impalement is a recognized complication of percutaneous placement of fibular transfixation wires by palpatory method after increase use of ilizarov technique in treatment of Tibial fractures, deformity correction and limb lengthening. The purpose of this study was to identify the relationship between the Common Peroneal Nerve (CPN) and the palpable landmark, fibular head for insertion of proximal fibular transfixation wire, safe zones in proximal tibia and percentage of fibula where nerve crosses the neck. ⋯ We recommend Proximal fibula transfixation wires are safer to pass with in 2 cm from the tip of the styloid process of the fibula, Anterior half of the head of fibula, <8% of total fibular length, Ventral half of the anterior compartment to avoid injury to peroneal fan. The palpable landmark of fibula is a misinterpretation; it is just the prominent subcutaneous portion of fibula and not the styloid process of fibula which on dissection was located much posterior. Better to take fluoroscopic guidance in difficult cases where palpation of head of fibula is difficult.