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Acta Scientific Orthopaedics

Journal Papers (16) Details Call for Paper Manuscript submission Publication Ethics Contact Authors' Guide Line
1 New Study: Spine Surgeons Take Care of Your Necks! , Ken Hansraj
Indian spine surgeons J Naresh-Babu, Viswanadha Arun-Kumar and DGS Ragu of the Mallika Spine Centre, Andhra Pradesh per-formed an observational study whose purpose was to analyze the surgeon's neck postures while performing lumbar spinal surger-ies.
2 Acute Median Nerve Compression by a Fragment of Hamate Bone , Martín Ulloa Cerezales and Uxía Blanco Sampedro
Acute median nerve symptoms are not commonly seen. Less frequent is the association with hamate fractures, which usually produce ulnar nerve symptoms. We report a case of a patient with an hamate fracture and acute median nerve injury. On surgical intervention, a bone fragment, directly responsible for the symptoms, was found inside the carpal tunnel
3 Gradual Correction of Proximal Tibial Biplanar Deformities Using Truelok Hexapod System , Saleh Alsaifi, Ahmed Abdelaziz, Sameeh Elashry and Mohamed Mosad
At thirteen-years-old boy who sustained an open physeal injury of the left proximal tibia at four year of age presented to our lower limb deformity clinic complaining from deformity of the left knee and limb length discrepancy. Clinical and radiographic assessment revealed apparent shortening of the left lower limb due to a biplanar deformity of left proximal tibia. The deformity was quantified as a 25° varus and 20° procurvatum deformity. The patient underwent treatment in the form of gradual deformity correction and 20 mm over-lengthening with a TL-Hex circular external fixator, along with complete epiphysiodesis of the proximal tibial and fibular physis. Treatment was completed over-six months including correction and consolidation and he returned to full activity one month after frame removal with 20 mm shoe raise to right lower limb. Normal clinical and radiological alignment of the left lower limb was achieved with good knee and ankle range of motion.
4 Perioperative Medication Management for Spinal Surgery , Nicholas S Venuti, Sangili Chandran, Connor Willis-Hong and Vivek Mohan
Background: Perioperative medication management of spinal surgery patients is essential to minimize risk of complications and expedite patient recovery. Commonly prescribed medication regimens such as anticoagulants (e.g. aspirin, clopidogrel), nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen) and immunosuppressants (e.g. methotrexate, cyclosporine) may predispose patients to excessive hemorrhaging, wound dehiscence, and surgical infections among other intra-operative and post-operative complications. Through an understanding of medication mechanisms, recommended use and disuse protocol, and how these medications pertain to individual circumstances, physicians are optimally informed to prepare patients for elective spinal surgery. Study Design: Review of literature.Methods: Numerous searches were conducted utilizing PubMed. The searches were filtered to be written in English and within twenty years.Results: After review of relevant literature, different precautions must be taken depending on the type of medication (anti-coagulant, anti-platelet, non-steroidal anti- inflammatory drugs, immunosuppressants) and the individual perioperative health conditions. Patients on blood thinning regimens may need to discontinue use of prescribed medication as early as 10 days to 12 hours pre-operatively and may resume consumption as early as 12 hours post-operatively depending on the medication and perioperative health condition of the patient. Patients on nonsteroidal anti-inflammatory drugs (NSAIDs) may need to discontinue use as early as eight days to 12 hours pre-operatively and may not resume consumption of NSAIDs for up to three months post-operatively depending on medication and the patient’s perioperative health condition. Patients on immunosuppressant regimens may need to discontinue use as early as two months to eight hours pre-operatively and may resume post-operative consumption as early as one week or when the operative wounds have completely healed depending on the medication and the patient’s perioperative health condition.Conclusion: Due to the invasive nature of spinal surgery, and the potential effect of various medications that can affect surgical outcomes, it is imperative that providers review patient medications for proper management during the perioperative period. In the future, additional research for new classes of drugs and medications where literature is currently scarce will help to reduce hospital admission lengths, complications post-operation and even death
5 Metastatic Follicular Thyroid Carcinoma to the Dorsal Spine Presenting as Early Manifestation: Case Report , Romit Agrawal, Ayush Sharma, Vijay Singh, Nilesh Mangale and Ajay Jaiswal
Follicular thyroid carcinoma (FTC) patients are rarely present with spinal metastasis as an early manifestation. Here we present a 56 year old non ambulatory female with paraparesis of both lower limbs which was progressed over last 3 months. Spinal MRI and CT scan revealed D7 thoracic spine intramedullary lesion probably of thyroid origin which was confirmed on USG and FNAC later on. The aim of surgery was decompression of spinal cord and histological evaluation of the tumour. Surgery in the form of spinal mass excision and posterior spinal decompression and fixation two levels above and below was done and then adjuvant chemotherapy was given. Hence patients presenting with spinal tumour must always be screened for thyroid carcinoma as a differential diagnosis. Prognosis is quite well in such patients post decompression
6 Revisiting Characters of Human Immune Orchestra in Light of Immuno-Suppression by Corona Virus , SS Jha
Basic understanding of immunology is relevant today in the light of consciousness raised by the worldwide pandemic of SARS-COV-2 responsible for Novel COVID-19.Immune system is evolved to protect from universe of foreign pathogens. During the course of evolution, depending on species, there has been diversification and high sophistication to permit the organism to adapt to its environment. The human immunity has two interdependent arms, “innate” and “adaptive” immune systems
7 Rehabilitation Program after Post-Traumatic Reconstruction of the Anterior Cruciate Ligament (With a Clinical Case Report) , Ivet Koleva and Borislav Yoshinov
The Anterior Cruciate Ligament (ACL) is an important stabilizer of the knee, providing almost 85% of the joint stability to forward force (especially in some aggressive twisting and jumping sports, as skiing and basketball). The common orthopedic surgical intervention is the reconstruction, performed as soon as possible after the traumatic injury.After the orthopedic surgery, a period of rehabilitation must begin and the consultation with a medical doctor - specialist in Physical and Rehabilitation Medicine (PRM) is required. The goal of current article is to suggest a complex PRM-algorithm of care of these patients, based on detailed literature review and on our own clinical practice
8 Percutaneous or Open Release is the Most Effective Surgical Technique in Diabetic Recurrent Trigger Finger in Short and Long Term Outcomes? A Clinical Review , Grigorios Kastanis, Pantouvaki A, Spyrantis M, Christoforidis C and Velivasakis G
Introduction: Stenosing Tenosynovitis is a common disorder among patients with diabetes mellitus. The definitive treatment is release of the A1 pulley (open or percutaneous). The aim of this study is to compare functional outcomes and complication rates of these two methods (open versus percutaneous release) for recurrent trigger finger in patients with diabetes mellitus.Materials and Methods: 114 patients with diabetes mellitus and an average age of 48 years (range 28 - 64 yrs old) were treated for recurrent trigger finger. The modified Quinnell grading system was used as a selection criterion for the classification of trigger digit. The patients were divided in two groups randomly. Group A included 52 patients who were treated with open release of A1 pulley and group B included 62 patients who were treated with percutaneous release using the tip of an 18-gauge or knife (Ophthalmic Corneal/Scleral knife 19 Gauge).Results: The median follow-up was 12 months (range from 10 - 14 months). The results were based on the Visual Analogue Scale (VAS), Quick Dash and Gilberts and Wereldasma Questionnaire. At 3 months, the results seemed to be better in group B, while there was no statistical difference at six months and at one year postoperatively. Conclusion: Both surgical methods (open and percutaneous release) in long-term follow-up postoperatively, resulted in similar therapeutic efficacy. The advantages of percutaneous release over the classic open method in short-term outcomes are: 1) low cost, 2) less complication rates and 3) immediate functional recovery.
9 Effectiveness of 6 Weeks Plyometric Training Protocol on Vertical Jump Ability among High School Amateur Male Volleyball Players-A Randomized Control Trial , Chaitanya D Sahasrabudhe, Siddhi Tendulkar and Sucheta Golhar
Volleyball is one of the most played games in Indian School going population. Vertical jump height is an essential part in volleyball which can be achieved by strengthening the lower leg musculature. Thus the 6 weeks plyometric training protocol is added to see its results on the strength of lower leg musculature among high school amateur male volleyball players. The subjects (n = 40; age = 10 - 16 years; mean = 12 ± 1.00 years) jumping reach Height (mean) = 169.00 ± 1.00 cm) were divided equally into 2 groups called as group A (Experimental) and group B (Control) respectively by simple random sampling method. Group A received the 6 weeks plyometric training protocol and conventional training while group B received only conventional training. Sargent jump test was used to assess the jump heights pre and post at the end of 6 weeks. Unpaired t-test was used to compare the results between the groups. Group A showed significant increase in the difference between the jumping and standing reach heights at the end of 6 weeks (mean difference in the height = 34.25 cm; p-value < 0.05) than in Group B (mean difference in the height = 25.15 cm; p-value < 0.05) at the end of 6 weeks. Also, there is significant improvement in Jumping reach height in Group A (pre = 188.05 cm; post = 203.00 cm) than in Group B (pre = 187.20 cm; post = 195.15 cm). Group A showed 43.65% (mean = 34.25 cm; SD = 7.59) increase while Group B achieved 31.61% (mean = 25.15 cm; SD = 3.73) increase with their initial vertical jump height Both the training protocols are effective in improving vertical jump height but the 6 weeks plyometric training protocol is more effective in improving vertical jump than the conventional training among high school amateur male volleyball players
10 Re-Igniting Our Body and Mind to Surpass Future Challenges , Julie Rammal
The human body and mind is incredibly intelligent and pow-erful. Our body, mind, organs and everything within us speaks its own language, records its own data, and to boost health, energy, and positive emotion one must unblock stagnant energy in body, mind or soul or the system may fail, collapse or become diseased
11 Outcomes of Outpatient Percutaneous Release of Trigger Finger , Jayesh Vaza, Pathik Vala, Rutvik Shah and Kuldeep Parmar.
Introduction: Trigger finger is caused by stenosing tenosynovitis, resulting in painful catching of the involved flexor tendon as the patient flexes and extends the digit. Treatments include Nonsteroidal anti-inflammatory drugs (NSAIDs), splinting, corticosteroid injection, open and percutaneous release. Aim of the Study: The aim of this study was to evaluate the results of percutaneous trigger finger release using 18G hypodermic needle. Materials and Methods: A prospective study of 80 patients for treatment of trigger finger by percutaneous release by 18G needle was conducted at L.G Medical college and hospital, Ahmedabad, Gujarat between 1st January 2019 to 31st December 2019. Written Consent was obtained for Surgery. Patients were followed up in opd on 1st week, 1 month, 3rd month, 6th month, 12th month and evaluated for complications and re-occurrence of symptoms. Results: A total of 80 patients with trigger fingers were included in this study, out of which 10 patients did not follow up on time. Successful release was achieved in 68/70 (97.14%) patients. There was no patient who experienced any issues like nerve injury, wound complications, decreased sensation and tendon bowstringing. Conclusion: Our review showed that this technique for release of trigger finger is less costly technique with more patient oriented, less complications and better recovery rate. This is a day care procedure
12 Objective Assessment of Tendinopathy by Ultrasound Elastography , Rajul Rastogi, Neha, Vijai Pratap and GL Meena.
Tendinopathy refers to an inflammatory condition of tendon usually secondary to overuse. In the tendons, edema leads to internal softening with consequent decrease in echogenicity and elasticity hence the tendon will appear hypoechoic on B-mode, gray-scale ultrasonography while appearing brighter on ultrasound elastography than its normal counterpart tendon.Ultrasound Elastography is a recent noninvasive technique that allows evaluation of the elasticity of human tissues. Acoustic radiation forced impulse is a special form of ultrasound elastography wherein an acoustic radiation impulse is sent to the human tissues and the strength of returning echo indicates the elasticity of tissues. The latter can be depicted in shades of gray or different colors. If the image is coded with shades of gray, harder tissues will appear black while softer tissues will show varying shades of gray. However, in color-coded maps red or blue is indicated for hard tissue and blue or red respectively indicating soft tissue. Majority of the studies in the recent literature focusses on ultrasound elastography of evaluation of larger tendons especially the Achilles tendon, rotator cuff, quadriceps tendon, etc. while very few studies have focused on smaller tendons of the human body. Hence, this study primarily focusses on objectively evaluating the role of ultrasound elastography in assessment of tendinopathy at wrist joint.
13 Re-Igniting Our Body and Mind to Surpass Future Challenges , Julie Rammal
The human body and mind is incredibly intelligent and pow-erful. Our body, mind, organs and everything within us speaks its own language, records its own data, and to boost health, energy, and positive emotion one must unblock stagnant energy in body, mind or soul or the system may fail, collapse or become diseased.
14 Popliteal Schwannoma Simulating Vascular Tumor: An Uncommon Case , Daoudi Samih, Affes Hassene,Bouaziz Anis, Kamoun Khaled Anis and Jenzri Mourad.
Schwannomas are benign tumors arising from the Schwann cells on the peripheral nerve sheath. This tumor affects specially adults between 20 and 50 years-old. Malignant transformation is rare and uncommon. The most common clinical presentation of sciatic nerve schwannoma is a painful palpable mass with paresthesia. We present the case of a 57 years old man with a schwannoma of the sciatic nerve. The imaging findings were suggestive of the diagnosis. The tumor was excised without neural damage and no neurological deficit was noted postoperatively.
15 Short-Term Functional Outcomes of Primary Total Hip Arthroplasty Using A Modified Minimally Invasive Antero Lateral Approach , F Maturana, G Hernández, I López and P Dobbs.
Background: Minimally invasive surgery (MIS) has had a progressive development in recent years, due to its advantages in terms of: reducing the rates of complications, infection, surgical time and bleeding. Total hip arthroplasty (THA) has not been exempt from this current. Since of the first descriptions in 90 ́, several different techniques has been described to achieve smaller incisions and better results in primary THA, however, there is not enough statistical evidence to widely recommend MIS-THA, defined as an incision < 8 cm. Materials and Methods: We retrospective reviewed a cohort of 173 THA, 55 men and 118 women, between January 2016 and October 2019, in an advanced trauma hospital, all performed by the same surgeon. An independent team, blinded to the primary diagnosis, performed a standardized clinical and radiological evaluation at 2, 6 and 12 weeks. Results: The average length of the incision was 71 mm (48 - 84 mm). The average surgical time was 68 minutes (42 - 175). Hematocrit decreased by an average of 3.8% (2.2 - 8.1%). Average blood loss was 335 ml (120 - 950 ml). Preoperative Harris Hip Score was 67 (45 - 76) and postoperatively at 12 weeks of 92 (82 - 97). Three cases of perioperative complications where reported: 1 case of calcar fracture with extended approach (84 mm) and cerclage fixation, 1 case of prosthetic dislocation and 1 postoperative periprosthetic fracture Vancouver B2. No cases of neurovascular injury, infection or misalignment of components were reported. Conclusion: These results with a locally developed technique, achieved satisfactory clinical and radiological outcomes, with minimum incisions up to 48 mm, with an average reduction of 50% to the standard approach (13 - 15 cm).
16 Effect of Subcutaneous Fat of Quadriceps Muscle on Q-Angle - A Cross-Sectional Study , Jagruti K Patel, Maldikar Pragna Satish, Patel Harsh Vinodbhai and Vaidya Nikita Rakeshkumar.
Background: Q-angle is an important indicator of the biomechanical function for the lower extremity. The increased value of Q-angle is suggestive of risk factors for many knee disorders. The fat is considered as basic compound of body which is necessary for certain anatomical and physiological functions. The accumulation of excess body fat affects the musculoskeletal system. Purpose: This study was conducted to determine the co-relation between the Q-angle and subcutaneous fat of the Quadriceps muscle and also determine the normal value of Q-angle and normal value of the Skinfold thickness of the Quadriceps Muscle. Procedure: A cross-sectional study was conducted among 109 individuals, having no history of knee injury or pain. There were 59 females and 50 males participated in the study. The Q-angle was measured in standing position with the help of universal goniometer and the Quadriceps muscle was kept relaxed. The measurement of the skinfold thickness was taken by normal plastic skin calliper. Results: The study showed that mean value of the Q-angle for females and males on the right side was 16.9 ± 1.85 and 13.87 ± 1.95 whereas on left side it was obtained 16.9 ± 1.85 and 13.96 ± 2.01. The study also obtained the mean value of the subcutaneous fat of quadriceps for females and males on right side 14.0 ± 5.16 and 11.22 ± 5.30 whereas on left side it was obtained 13.9 ± 5.15 and 11.54 ± 5.37. The study also obtained positive co-relation among the Q-angle and Quadriceps fat. (p = 0.001). Conclusion: The study concluded that there was a positive co-relation among the Q-angle and subcutaneous fat of the Quadriceps muscle.