<p class="abstract"><strong>Background:</strong> Pain management in orthopedic is very crucial matter to handle, which is many a times not managed properly and that leads to various medical complications to the patients. Trousseau sign of latent tetany is a medical sign observed in patients with low calcium. This is the first and one of a kind case series describing the development and pathogenesis of Trousseau sign in orthopedics.</p><p class="abstract"><strong>Methods:</strong> This is a case series of 5 patients with lower limb fractures who underwent surgery. All these patients developed Trousseau's sign in immediate postoperative period. All the patients were investigated and were diagnosed with respiratory alkalosis. They were managed with closed bag ventilation which relieved the symptoms.<strong></strong></p><p class="abstract"><strong>Results:</strong> Here we put forward a direct physiological and psychological relation between a low pain threshold and associated hyperventilation with lead to development of Trousseau's sign in our patients. So, next time in postoperative round, if we see patient hyperventilating and complaining about fixed hand’s position, do not start calcium gluconate drip immediately, it may be due to respiratory alkalosis, then closed bag ventilation would be suffice.</p><p class="abstract"><strong>Conclusions:</strong> Trousseau’s sign seen postoperatively in Orthopedics may be commonly due to inadequate pain management rather than altered calcium metabolism.</p><p class="abstract"> </p>
Introduction: Osteoarthritis (OA) is a chronic inflammatory condition affecting the joint. Knee is the most commonly involved joint of body in osteoarthritis. Osteoarthritis may occur primarily in knee joint or it may be due to some underlying condition of knee joint in which case it’s called secondary osteoarthritis. We have conducted this study to know the mechanism causing osteoarthritis knee relying on preponderance of side of involvement.
Materials and Methods: This is a cross sectional study of 400 patients presented to OPD of Department of Orthopaedics, Civil Hospital Ahmedabad during 1st of May, 2016 to 31st of May, 2016. Only patients with primary osteoarthritis of knee were enrolled in our study.
Results: Out of 400 patients enrolled, 180 (45%) patients had involvement of left knee joint, 170(42%) patients had involvement of right knee joint whereas 50 (13%) patients had bilateral knee joint involvement. There is no preponderance noted for specific side of OA knee in our study. Furthermore there was no correlation found between occupation and development of OA knee in your study.
Conclusion: There is no preponderance for specific side for OA knee as per our study further strengthening the claim that OA knee is not due to the wear and tear mechanism as if it would have been so bilateral involvement would be more common and in unilateral involvement, dominant extremity would have been commonly involved which is not consistent with the findings of our study.
Keywords: Knee, Osteoarthritis, Side
Introduction: Osteoarthritis of knee is a most common form of arthritis spread rampantly today. Platelet-rich plasma injections enhance cartilage repair and relieve osteoarthritis Symptoms. Thus it delays the need for joint replacement.
Objective: To investigate the effect of platelet-rich plasma (PRP) on progression of early stages of osteoarthritis knee.
Methodology: A case series study of 50 patients was carried out. Results were analyzed on the basis of following scores:
O WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index)
O KSS (Knee Society Score)
O VAS (Visual Analogue Scale)
Results: There were no significant adverse event observed. Statistically significant results in the Western Ontario and McMaster Universities Osteoarthritis Index and KSS and VAS scorings were recorded in patients who received PRP injections after a 3 and 6 months follow up.
Conclusions: Our study suggests that autologous PRP can be used as an effective and safe method in the treatment of the early stages of osteoarthritis. But further studies are needed to confirm these finding and to investigate the long term effects of autologous PRP.
Keywords: Autologous PRP, Osteoarthritis knee
Up to 20% of patients are not satisfied with the outcome following total knee replacement (TKR), because of many factors, an important one being patellofemoral joint. The aim of this study was to study and compare the outcomes of patella resurfacing and modified patelloplasty in controlled matched group of patients. 40 patients had staged bilateral total knee replace- ment surgery and kept blinded to which side patella resurfacing was done. Patella resurfacing was done always on side operated second. In followup, patients were examined for anterior knee pain, range of motion, Standard radiographs, KSS, VAS score, and Feller patellar scores were calculated. There was no significant difference between both groups in terms of scores, function and radiographic alignment. The results of patelloplasty were as good as resurfacing & in case of persistent anterior knee pain it offers option of secondary resurfacing, also avoiding complications associated with resurfacing. Joint replacement is the gold standard surgical treatment for patients with advanced osteoarthritis of the knee.TKR aims at addressing the tibiofemoral joint which the major weight bear- ing joint involved morecommonly in arthritis. However manage- ment of patellofemoral joint remains debatable issue.Up to 20% of patients are not satisfied with the outcome following total knee replacement (TKR). This can be related to multiple factors and the patellofemoral joint remains the important one among this.2
Background: Osteoarthritis of knee is one of the most common form of arthritis causing degeneration of articular cartilage and subchondral bone. Joint replacement is the gold standard treatment for patients with advanced osteoarthritis of the knee who despite appropriate medical management, have an unacceptable level of pain or physical function or both. There are mainly two types of implants used for total knee replacement nowadays. One is metal back type and other is all poly type.
Materials and Methods: This is a retrospective multicentric study of 100 total knee replacements performed for comparison of metal back(50) versus all poly(50) total knee replacement on the basis of Clinical(KSS-knee society score, WOMAC-western Ontario & Macmaster university osteoarthritis index score, pain, deformity), radiological(alignment), complications and survival of that joint. All total knee arthroplasty are cruciate sacrificing and done through medial parapatellar approach.
Result:
· Average age of patients in our study was 58.4 years with a range of 52-80 years. We included 72 females and 28 males in our study.
· Knee society functional scores were improved from 36.4 to 75.1 for metal back component and 34.90 to 74.20 in all poly total knee replacement
· Womac score improved from 52.01 to 81 in metal back total knee replacement and improved from 54.07 to 82.39 93 in all poly total knee replacement.
· 97% patients of metal back and 98% of all poly tkr showed improvement in pain.
· Post operatively 82% patients from the metal back total knee replacement and 92% patients of all poly total knee replacement had alignment between 5 degree valgus to 5 degree varus.
· The mean fixed flexion deformity in metal back total knee replacement improved from 9 to 3 degrees in metal back total knee replacement and 11 to 1 in all poly total knee replacement.
· Crude survival rate of impl
Objective: To evaluate the result of core decompression and autologous PRP infusion over other treatment modalities of AVN HIP.
Introduction: Osteonecrosis is a disease of impaired blood flow affecting mainly young people in their third, fourth or fifth decades. Proposed risk factors include, chemotherapy, alcoholism, excessive steroid use, post trauma, sickle cell anaemia and Gaucher's Disease.
Materials and Methods: Retrospective study of 25 patient of Avascular necrosis of hip.25 patients were included in study. Autologous PRP was prepared a day before surgery. Decompression of the head of femur was done by using Michele trephine of size 8mm.
Outcome measures used during study were
· Anteroposterior and lateral radiographs
· MRI
· Harris hip score
· VAS for pain
Keywords: Core decompression, Autologous prp, Vas score, Harris hip score, Avn hip
Olecranon process is the proximal expansion of ulna bone which takes part in formation of elbow joint and is essential for elbow joint movements. Therefore, fractures of olecranon are to be treated by stable fixation and early mobilization. We have, in our study, tried to identify the best treatment option for the olecranon fracture. This is a prospective cohort study of 35 patients treated at Civil Hospital Ahmedabad for olecranon fracture between 1 st January, 2015 to 31 st December, 2015. Adult patients with traumatic closed isolated olecranon fractures were enrolled in our study. Post-operatively, all the patients were followed up to 6 months and their functional outcomes compared. Olecranon fractures are more common in elderly with male predilection. Post-operatively, range of movements ranged from full extension to full flexion in majority of patients but not in all. Complication like implant impingement, infection and restricted range of motion were noticed in our study. There was 100% union rate achieved at the end of 6 months. Treatment of choice for olecranon fracture depends on fracture type. Simple two-part transverse fracture is best treated with K-wiring and tension band wiring whereas oblique or comminuted fractures are best treated with olecranon plating. Keywords : Olecranon, TBW, K-wire, CCS, Plating, ROM
Introduction: Extra-articular promixal tibial fracture make up to around 10%(1) of all shaft tibia fractures which are most commonly due to high velocity injury. Both conservative and operative management options are available, but conservative management has resulted in many complications. Intramedullary nailing and minial invasive plating are the preferred techniques of the available modalities of operative management. There is not enough evidence regarding the superiority of one of the two techniques. The purpose of this study is to compare these different approaches based on hospital stay, blood loss, union rates, mal/non-union, post-operative range of motion of knee ,period of non-weight bearing , infection rates and implant removal rate. Material and Methods:This is a randomized prospective study conducted on 50 osteoporotic patients with extra-articular proximal tibia fractures treated with minimally invasive proximal tibial plating vs intramedullary nailing at Department of Orthopedics, BJ medical college, Civil hospital Ahmedabad between June 2016 and May 2017. Observation and Results:Patients with intramedullary nailing had lesser duration of stay, lower cost, less infection rate, less implamt removal rate but higher malunion and union rates compared to plating patients. Operative time, time to full weight bearing and range of motion was found to be similar in both. Conclusion:Intramedullary nailing is preferred operative modality over plating because of decreased hospital stay, faster union, decreased operative time and decreased infective rate. However there was no significant difference in range of motion of knee, rate of malunion and nonunion Keywords: Proximal tibia fracture, Intramedullary nailing, Plating
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