Sunny Chaudhary

All India Institute of Medical Sciences Rishikesh

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Vivek Singh

All India Institute of Medical Sciences Rishikesh

Sitanshu Barik

All India Institute of Medical Sciences, Nagpur

Varun Garg

Chacha Nehru Bal Chikitsalaya

Pankaj Kandwal

All India Institute of Medical Sciences Rishikesh

Vicky Bakshi

Sourabh Kumar Sinha

All India Institute of Medical Sciences Rishikesh

Hawaibam Nongdamba

All India Institute of Medical Sciences Rishikesh

Rama Priya Yasam

All India Institute of Medical Sciences Rishikesh

R K Siddharth

All India Institute of Medical Sciences Rishikesh

Nitin Kumar Uniyal

Cooperative Institutions

All India Institute of Medical Sciences Rishikesh

All India Institute of Medical Sciences Raipur

All India Institute of Medical Sciences Bhopal

All India Institute of Medical Sciences

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Aligarh Muslim University

Sanjay Gandhi Post Graduate Institute of Medical Sciences

Jawaharlal Nehru Medical College Hospital

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Ganesh Shankar Vidyarthi Memorial Medical College

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Imaging Parameters of Hip Dysplasia in Cerebral Palsy: A Systematic Review

Indian Journal of Orthopaedics (2022)

Sitanshu Barik Akash Jain Hawaibam Nongdamba Sunny Chaudhary Rama Priya Yasam

Hip Dysplasia

Gold standard (test)

10.1007/s43465-022-00610-x

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Citations (1)

Angulation osteotomy of ulna for management of missed monteggia fractures and risk factors associated with poor outcomes

Journal of Orthopaedic Reports (2023)

Varun Garg Aditya K.S. Gowda Anil Regmi Sunny Chaudhary Surabhi Das

the purpose of this study is to examine the clinical and radiological outcomes, complications and risk factors associated with poor outcomes. We performed a retrospective chart evaluation in 12 patients (between march 2017–march 2020) who underwent angulation osteotomy of the ulna. Patients were evaluated in terms of demographic data, injury to surgery time interval, instability and radiologic classification given by Bado. The elbows were clinically evaluated using Mayo elbow performance score. Patients were evaluated for complications at last follow-up. There were 12 patients (3 females and 9 males) with mean age at presentation as 8.58 ± 1.93years. According to Bado classification, 9 were type I and 2 were type III and one was type II. In 5 cases additionally radio-capitellar joint was exposed to remove any intervening soft tissue. The mean follow-up was 16.25 ± 1.71 months. At the last follow-up, the mean flexion-extension arc was 114.17° ± 14.43°, mean pronation arc was 64.58°± 9.40°, and supination arc was 69.58°±8.10°. The mean preoperative MEPI score at the last follow-up was 90.83 ± 13.79. Complications such as ulnar prominence at the site of angulation in 2 patients, hypertrophic scar in 2 patients, superficial infection at the surgical site were observed in one patient and re-dislocation in one patient. Ulnar osteotomy is effective procedure for the treatment of missed monteggia fracture. The radio-capitellar joint must be opened to remove any fibrous tissue which may prevent radial head dislocation. Patients age, fracture type, duration of injury and addition of radio-capitellar k-wire is not linked to poor outcomes. III.

10.1016/j.jorep.2023.100296

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Quantification of volume mismatch of acetabulum and femoral head in Developmental Dysplasia of Hip

SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital (2022)

Sitanshu Barik Vivek Singh Udit Chauhan Souvik Paul Kshitij Gupta

The sustained subluxation or dislocation of the femoral head over time does not permit normal development of acetabulum and results in predictable pattern of acetabular growth disturbance that is termed hip dysplasia. The primary aim of this study is to analyze and quantify the volume mismatch between acetabulum and femoral head of affected side as compared to normal hip.A prospective observational study was conducted by including isolated untreated unilateral idiopathic developmental dysplasia of hip (DDH). After routine clinical and radiographic examination, computed tomography (CT) of both hips was done with pre-determined radiation dosage within safe limits for the pediatric age group in 18 patients of median age 2 years (range 1-5 years).A significant difference was noted between acetabular index (p<0.001), acetabular volume (p<0.001), femoral head volume (p<0.001), and acetabular anterior sectoral angle (p=0.002) of the affected and the normal hips. As compared to the normal side, the acetabulum is 2.6 times smaller than the normal side and femoral epiphysis volume by 3.8 times. A significant negative correlation (r=-0.66, p=0.04) was noted between posterior acetabular sectoral angle and acetabular volume of affected hip.CT is an important investigation in evaluation of late-presenting DDH. The absence of femoral head in its orthotopic location affects the volume of acetabulum as well as that of femoral head. The abnormality of the volume of acetabulum which is seen as related to the dysplasia should be studied and assessed in detail in a child of late-presenting DDH. This would guide us toward the coverage defect and type of osteotomy to be performed.

Hip Dysplasia

Subluxation

10.14744/semb.2022.40221

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Isolated multidrug-resistant tubercular tenosynovitis of the flexor tendon of the little finger

BMJ Case Reports (2021)

Sunny Chaudhary Subhajit Maji Varun Garg Vivek Singh

Isolated multidrug-resistant (MDR) tubercular tenosynovitis of the flexor tendons of finger without involvement of wrist is a rare presentation. Tenosynovitis of hand is an uncommon manifestation of extrapulmonary tuberculosis. Pyogenic flexor tenosynovitis of hand is frequently seen and is the closest differential. Non-specific clinical signs may lead to delay in diagnosis, which is often made after biopsy. Management includes surgical excision of necrotic tissue and infected synovium along with antitubercular therapy after histopathological diagnosis. MDR tuberculosis of hand is extremely rare and, to the best of our knowledge, has not been reported in the literature so far. We report an interesting case of MDR tubercular flexor tendon tenosynovitis of the little finger without any pulmonary involvement in an immunocompetent patient. The case was managed by complete synovectomy and second-line antitubercular therapy with complete resolution of disease and had no functional limitation.

Tenosynovitis

Tendon sheath

Synovectomy

Trigger finger

10.1136/bcr-2020-238339

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Impact of Transverse Ultrasound Images on the Classification and Treatment of Pediatric Lateral Humeral Condyle Fractures

Journal of Pediatric Orthopaedics (2020)

Sunny Chaudhary Hawaibam Nongdamba Vivek Singh

Chaudhary, Sunny MBBS, DNB, MCh; Nongdamba, Hawaibam MBBS, MS; Singh, Vivek MBBS, MS Author Information

10.1097/bpo.0000000000001674

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Risk Factors for Avascular Necrosis of the Femoral Head in Pediatric Femoral Neck Fractures

Cureus (2021)

Sunny Chaudhary Varun Garg Dipun Mishra Rama Priya Yasam Sitanshu Barik

Introduction A neck of femur fracture is a rare injury in the pediatric population and is of foremost importance, as it is associated with a high rate of complications. It usually occurs due to high-velocity trauma or a fall from a height. There is a scarcity of data on risk factors and their role in the prognostication of avascular necrosis. The purpose of the study was to retrospectively analyze the association of various risk factors with avascular necrosis (AVN) of the femoral head in patients with a neck of femur fracture in the pediatric age group. Material and methods The study included 21 (13 males and 8 females) pediatric patients with a neck of femur fracture treated at a university-level hospital. The patients were followed for a minimum of one year and the clinico-radiological outcome was analyzed using Ratliff criteria. The association of AVN with age, gender, side, fracture type, and injury with treatment delay, type of reduction, and type of internal fixation used was studied. Results The mean age of the treated patients was 11 (±3.178) years (range=5-16 years). Avascular necrosis was seen in four patients and coxa vara occurred in two of them. A statistically significant association was seen between the Delbet fracture type and avascular necrosis, and three out of four cases of AVN were a Type I fracture (p-value=0.006). Three out of six patients having concomitant skeletal or other organ injuries developed AVN (p-value=0.022). The rate of AVN was higher in patients who were managed after 48 hours of initial injury but no statistically significant correlation was found (p-value=0.314). No statistically significant association with AVN was found between gender, age, type of reduction (closed/open), or the implant used (cannulated screws/k-wires). Conclusions Multiple independent factors may have a role in the development of AVN of the femoral head in children. Prognostication should not be based on a single factor. Statistically significant results in this study have shown that the type of fracture and concomitant skeletal or other organ injuries are important risk factors and should be kept in mind. All independent risk factors must be noted and should be considered while prognosticating the outcome of a child with a neck of femur fracture.

Avascular Necrosis

Coxa vara

Femur fracture

Hip Fracture

Harris Hip Score

10.7759/cureus.16776

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Use of growth rod systems for management of early onset scoliosis in cerebral palsy: a systematic review

Turkish Neurosurgery (2022)

Kshitij Gupta Sitanshu Barik M SARKAR Sunny Chaudhary Sourabh Kumar Sinha

To review the literature for the role and outcome of growing rod surgeries in patients with cerebral palsy associated neuromuscular scoliosis.A systematic search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic literature search was conducted of PubMed and Embase databases. Patient demographics, type of growing rod used, lengthening and complications were analyzed from the included studies.A total of 11 studies with poor overall study quality (Level of evidence IV, V) were included in the study. A total of 181 patients with mean age 6.8 ± 1.3 (5-13 range) years at index surgery and mean follow-up of 3.02 ± 1.3 (2-5.8 range) years were included in the study, with a female preponderance. The most common curve and instrumentation was thoraco-lumbar and conventional dual growing rods respectively. All studies showed improvement in Cobb?s angle and pelvic obliquity. There was better improvement in pelvic obliquity if pelvis was included in instrumentation. Wound related complications (34.6%) were most commonly noted.Overall growing rod construct has shown questionable outcomes in cerebral palsy patients with scoliosis in terms of the complication rate observed although allowing growth of the spinal column with regular lengthenings. Magnetic controlled growth rods hold a bright promise for the future considering its ability to maintain correction as well as the lower rate of complications The benefits and risk of immediate fusion with respect to growth sparing surgeries should be considered before the decision.

Cobb angle

10.5137/1019-5149.jtn.41939-22.2

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Pig Bite Injury Mimicking as Battered Baby Syndrome Leading to Bilateral Foot Amputation in a Toddler: A Diagnostic Dilemma and a Rare Case Report.

PubMed (2020)

Sunny Chaudhary P. Venkata Sudhakar S. Banerjee Sonalika Mehta Vivek Singh

Animal bites are a less common cause of pediatric injury. They are rarely associated with fractures in toddlers. Child abuse is the most closely related differential diagnosis in a child presenting with animal bite and it is a serious threat to both mental health and physical well-being of pediatric population. In all such cases with diagnostic dilemma, battered child syndrome (BCS) needs to be ruled out and reported. To the best of our knowledge, there has been no case report of bilateral femur fracture after a pig bite injury in a toddler with gangrene of bilateral foot. Hence, we report this case to highlight the importance of differentiating animal bite injuries to BCS.We report a rare case of pig bite injury with bilateral femur fracture and bilateral foot gangrene in a case of an 11-month-old female child suffering from BCS.Apart from the medical and surgical management of pediatric injuries, it is essential to determine the cause of pediatric fractures and differentiate between abuse and accidental trauma. Identification of the etiology is significant to make sure that proper multidisciplinary intervention is initiated for the safety of the child.

Toddler

Etiology

10.13107/jocr.2020.v10.i04.1776

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Fifth toe Fillet Flap for Wound Coverage of Non-Healing Ulcer of the Foot: Surgical Technique and a Case Report

Asian Journal of Medical Research (2020)

Sunny Chaudhary Shiv Kumar Bali Arvind Singh R K Siddharth

Fillet flap is one of the options in the treatment of diabetic non-healing ulcers. The advantages of the fillet flap include the absence of donor site morbidity, excellent durability and preventing the need for more proximal amputation. A 56-year-old farmer presented to the out-patient department with complaints of a non-healing ulcer on the sole of the right foot for the past 7 months which was managed conservatively. A fifth ray partial amputation and a rotational flap of the redundant fifth finger for wound coverage were done. The wound healing was uneventful and the sutures were removed after two weeks. At the latest follow-up of 2 years, the patient was able to walk independently without pain and without any functional limitations. This case report describes the surgical technique of the lateral lesser toe fillet flap for wound closure on the plantar aspect of foot as an alternative to secondary healing or more proximal amputations.

Fillet (mechanics)

Wound Closure

Diabetic foot ulcer

Foot (prosody)

Wound care

10.47009/ajmr.2020.9.2.or2

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Posterior arthrodesis of atlantoaxial joint in congenital atlantoaxial instability under 5 years of age: A systematic review

Journal of Pediatric Neurosciences (2021)

Sitanshu Barik Nikhil Goyal Shivkumar Bali Kaustubh Ahuja Sunny Chaudhary

Atlantoaxial instability

10.4103/jpn.jpn_270_20

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Citations (2)