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  Citation statistics : Table of Contents
   1981| October-December  | Volume 15 | Issue 2  
    Online since March 27, 2010

 
 
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Morbid Anatomy Of Congenital Club-Foot
R. L Mittal, S. S Makhani, G. S Sidhu
October-December 1981, 15(2):129-135
Orthopaedic surgeous are too familiar with congenital club-foot cases which are difficult or impossible to correct fully. About 50 per cent require further treatment after the primary treatment. An important cause of recurrence or failure to achieve correction of the deformity is an incomplete understating of the pathological anatomy of the deformed foot, which could be studied best by dissecting feet of still born infants having club foot deformities. From a review of English literature, only about 80 dissections of club-feet have been reported in the literature and too with conflicting views. The exact aetiology of the congenital club foot is still a subject of debate. However, one school of thought has put the primary blame on the muscles and soft tissues based on their dissection (Stewart 1951, Flinchum 1953, Fried 1959) while the other school believes bones to be primarily responsible (Bissell 1888, Irani and Sherman 1963, Settle 1963, Waisbord 1973) and still others consider it to be a composite abnormality of muscles as well as bones (Bechtol and Mosman 1950, Wiley 1959). The purpose of this study is to obtain a clear understanding of the morbid anatomy of club and factors responsible for recurrence.
[ABSTRACT]   Full text not available  [PDF]
  - 355 57
Radiology In Club-Foot
Benjamin Joseph, Verghese Chacko
October-December 1981, 15(2):136-149
In spite of adhering to universally accepted principles in the treatment of club-foot, one is often with feet which go back in to the equinovarus deformity within months or years after completion of treatment. Such feet have been termed “recurrent” or “relapsed” club-feet. There appears to be increasing support to the view that the so-called “relapsed” clubfoot is nothing more than an incompletely corrected clubfoot (Beatson and Pearson 1966, Evans 1961, Fripp and Shaw 1967, Kite 1972, Turco 1971). If this is true it is obvious that some feet appear adequately corrected initially, when in fact, covert residual deformity persists. Such spurious correction later manifests itself as a “relapse”. Attenborough (1972) divided the feet into the “easy” and “resistant” types, the latter being difficult to treat. Some feet may show evidence of “resistance” at the outset, while others fail to respond to conservative measures later on. This study was, therefore, undertaken to evaluate the role of radiology in detecting spurious correction, thereby avoiding relapse, and elucidate the cause of “resistance”. The efficacy of plain radiography in assessing the completeness of correction in treated feet was also studied.
[ABSTRACT]   Full text not available  [PDF]
  - 530 89
Role Of Radiography In Congenital Talipes Equinovarus
B Das, J. P Jain
October-December 1981, 15(2):150-152
Though congenital talipes equinovarus is one of the commonest congenital anomalies to be detected at the time of birth, the results of treatment however, are not equally successful in every case. Radiography was therefore, considered as one of the investigating procedures in the present study in order to evaluate the causes of success and failure.
[ABSTRACT]   Full text not available  [PDF]
  - 316 23
Serum And Synovial Fluid Alpha-I-Antitrypsin Levels In Cases Of Rheumatoid Arthritis
N Kishore, K. P Srivastava, R. K Goyal, V Agarwal
October-December 1981, 15(2):153-156
Various protease inhibitors found in serum are alpha-I-antitrypsin, alpha-2-macroglobulin, inter-alpha-I trypsin inhibitor and alpha-I-antichymotrypsin (Schwick et al. 1966); alpha-I-antitrypsin (alpha-I-AT) is the main trypsin inhibitor. Its 90 per cent inhibiting capacity remains in alpha-I-globulin and rest in alpha-2 band. It not only inhibits trypsin but many other proteolytic enzymes like thrombin, plasmin, collagenase, leucocytase etc. (Lieberman 1973). Cochrane (1968) first suggested that synovial cells and leucocytes liberate Iysosomal enzymes, which cause damage of the joint in rheumatoid arthritis. Swedlund et al. (1974) found increased level of alpha-I-AT in cases of rheumatoid arthritis, while Walsh and McConkey (1977) observed deficient levels of antitrypsin in cases of rheumatoid arthritis. This study was undertaken to measure serum and synovial fluid alpha-I-AT in cases of rheumatoid arthritis.
[ABSTRACT]   Full text not available  [PDF]
  - 367 32
Synovial Fluid Analysis And Synovial Biopsy In Various Types Of Arthritides
A. C Sakhuja, S. N Singh, S. N Chaturvedi, J Bajpai, R. K Shukla
October-December 1981, 15(2):157-161
Synovial fluid has been described as a protein containing dialysate of blood plasma to which mucin is added by the synovial cells (Ropes and Bauer 1953). It reflects the pathology of a joint in the same manner as urine reflects the process taking place in the kidney (Schmid and Ogata 1965). Singh and Lal (1978) recently reviewed the usefulness of synovial analysis in diseases of the joints. The present study was undertaken to correlate the clinical presentation and results of synovial fluid analysis, serum biochemistry and histological examination of synovial membrane in arthritic conditions commonly encountered in this part of the country.
[ABSTRACT]   Full text not available  [PDF]
  - 379 57
Avascular Necrosis Of Femoral Head In Sickle Cell Haemoglobinopathies
S. S Babhulkar
October-December 1981, 15(2):162-165
Avascular necrosis of femoral head is a frequent and disabling manifestation in sickle cell haemoglobinopathies. Skeletal changes in sickle cell disease were observed as early as 1924 by Graham. Association of bone changes sickle cell disease was also observed by Golding (1959), Caffey (1937) and Diggs et al. (1965). The purpose of this article is to describe the clinical entity, laboratory investigations, and roentgenographic findings of sickle cell haemoglobinopathies in our cases of sickle cell anaemia and sickle cell trait causing avascular necrosis of femoral head.
[ABSTRACT]   Full text not available  [PDF]
  - 394 54
An Autosomal-Occulo-Auriculo-Skeletal Dysplasia
Samir Kumar Gupta
October-December 1981, 15(2):166-175
Full text not available  [PDF]
  - 234 13
Bilateral Lobster Claw Feet And Hand
A. A Khan, V. R Iyer
October-December 1981, 15(2):176-182
Congenital absence of the central rays of the hand and feet is commonly referred to as ‘lobster clawing’ or as cleft or split hands and feet. Jacob Hartsinck is credited with the first description of cleft hands and feet in a Negro in 1770. We are reported here 4 members in 2 generations of a family who had typical lobster claw feet in association with different types of congenital anamolies of both hands. The presence of typical and atypical deformities of the hands as described by Barsky (1964), in the same family is of particular interest.
[ABSTRACT]   Full text not available  [PDF]
  - 471 22
The Role Of Early Weight Bearing In A Patellar Tendon Bearing Below Knee Total Contact Plaster Cast In Fractures Of Tibia
R Bhargava, P. K Sethi
October-December 1981, 15(2):183-192
The conventional treatment for tibial fractures has been to achieve an accurate reduction, immobilize them in a plaster cast extending from the groin to toes and confine the patient to bed rest. Sarmiento (1967) described a below knee total contact cast for tibial fractures permitting early weight bearing on the fractured limb with free motion at the knee joint, and later, a plaster brace freeing both the knee and the ankle joints (Sarmiento 1970). Not all fractures are amenable to this type of treatment. An attempt has been made to evaluate the suitability of the below knee total contact plaster cast for early ambulation in the various types of fractures, at various sites in the tibia, and to find out if had any detrimental effect on the healing time and the stability of the various fractures within the cast. To achieve a near normal heel to toe gait during ambulation, a specially designed wooden clog was tried.
[ABSTRACT]   Full text not available  [PDF]
  - 398 22
Growth Disturbances After Diaphyseal Fractures Of Femur And Tibia In Children
P Tejeswar Rao, Brahmanand Sahu
October-December 1981, 15(2):193-198
The management of fractures in children is a separate entity from that of an adult, since, the growing bone possesses an immense power of growth and remodeling. That fractures in children could cause growth acceleration has been known since 1867. This has been established through different studies, but no clearcut principles to guide the management of these fractures have evolved to date. We have conducted a study on 75 children with fractures of the long bones of the lower limb and have tried to establish the relationship of growth disturbances with the age of the patient, nature of the fracture and the amount of displacement.
[ABSTRACT]   Full text not available  [PDF]
  - 311 11
Fracture Of The Shaft Femur In Children – A Clinical Review
V. P Bansal, Vinod Singhal, Dilip Malhotra
October-December 1981, 15(2):199-203
Fractures of the shaft of femur in children are relatively frequent. Though these should be considered serious injuries because of blood loss and potential shock, yet the management of these fractures is not difficult. The present clinical review is a retrospective analysis of 50 cases of fractures of shaft of femur in children with a total follow-up of one to 4 years. No innovations are claimed, but on analysis certain points emerged which were considered worth reporting.
[ABSTRACT]   Full text not available  [PDF]
  - 309 25
Tibial Osteotomy In Osteoarthrosis Of The Knee
L. S Kent, S. P Gupta, J Mayanger
October-December 1981, 15(2):204-210
In the west, total and hemi-arthroplasty for osteoarthrosis of the knee have become quite popular in the last decade, but in developing countries it will be a long time before the facilities for such operations will be generally available and the patients will be able to afford the high cost of prosthesis. However, until the long term results of arthroplasty are available, osteotomy will remain as one of the most reliable procedures for degenerative arthritis of the knee even in the west. Therefore in this study tibial osteotomy was done in patients with advanced osteoarthrosis who did not get relieved by the conservative line of treatment and had clinically obvious varus or valgus deformity.
[ABSTRACT]   Full text not available  [PDF]
  - 266 18
Treatment Of Chronic Osteomyelitis With Continuous Irrigation Suction Technique
A. S Bajaj, P. S Maini, D. R Arora, K. C Mudgil, B Arora
October-December 1981, 15(2):211-216
No other common process in orthopaedics has been so refractory to treatment as is chronic osteomyelitis. Its treatment has varied from the use of boiling water to various reconstructive operations of today. Recurrences occur in patients of chronic osteomyelitis after treatment because of the fact that bacteria are widespread in the necrotic tissue, haversian canals, or within the medullary cavity. Subperiosteal vessels and often the main nutrient artery are thrombosed and consequently the antibiotics fail to reach the organisms. Even after surgical removal of dead tissue, sequestra, excision of sinuses and saucerisation, the dead space left is filled up by a haematoma which is a potential site of infection. So a technique had to be thought of in which dead bone and scar tissue were excised, dead space eliminated and perfused with antibiotic solution locally. Wound irrigation in treatment of chronic osteomyelitis dates back to at least 1917 by Duman and Carrel. Closed continuous circulation of a solution containing antibiotic was first used by Goldmann et al. (1960). Mc Elvenny (1961) developed the detailes of the technique. This technique has subsequently been used by several other workers (Dombrowski and Dunn 1965, Kelly et al. 1970, Taylor et al. 1970, Michelinakis 1972, Clawson et al. 1973, Letts and Wong 1975, Kawashima 1975, Rao and Sahu 1978), however extensive clinical trials have not taken place. We report herewith results of the treatment of chronic osteomyelitis with the continuous irrigation technique in 30 cases.
[ABSTRACT]   Full text not available  [PDF]
  - 541 52
Prevention Of Wound Infection In Orthopaedics
S. K Gupta
October-December 1981, 15(2):217-220
Antibiotic therapy has expanded and altered the techniques in orthopaedics just as it has influenced most of the other fields in surgery and medicine. Slaney (1975) stated that despite more than 100 years experience of the factors influencing wound sepsis and innumerable attempts to control them, some 5 per cent of clear surgical incisions still become infected. Several recent studies have demonstrated a reduction in wound infection after introduction of “Clean air” in operation theatre. However, in places where there is neither the system of clean air nor a separate operation theatre for orthopaedic cases, chances of wound infection are greatly enhanced. Clean air theatres exist in our country in only a small percentage of hospitals. Reports available from various hospitals in our country reveal a wide range of infection rate. A study was carried out at 2 large Military Hospitals to establish the possible use of antibiotics to reduce wound infection after orthopadedic operations when it is not possible to have a very high standard of operating theatres like Charnley’s ‘Green House’ and the results of that study are reported here.
[ABSTRACT]   Full text not available  [PDF]
  - 405 42
Role Of Frozen Allogenic Cortical Bone Grafts In Monkeys-An Experimental Study
Shivinder Singh, O. N Nagi, R. N Chakravarty, V. P Bansal
October-December 1981, 15(2):221-227
Allogenic bone before transplantation, preferably has to be treated in such a way that it retained its bone inductive property and lost its antigenicity. Burwell (1963) concluded from his experimental work that marrow tissue of allogenic bone gave maximum reaction in the regional lymph nodes, whereas the bone free of marrow and periosteum incited minimal reaction. Burwell (1964), Melcher and Irving (1963), and Buring and Urist (1967), concluded that fresh autogenous bone was superior, but frozen and dried allogenic bone could also be used in clinical practice. Burwell (1970) stated that the frozen and freeze dried bone was a dead bone having no antigenicity, but it retained its inductive property leading to formation of new bone from the surrounding mesenchymal tissues. The present study was aimed to observe the role of allogenic cortical bone, free of periosteum and marrow stored at – 20 degrees Celsius for 4 weeks, in filling large bone defects.
[ABSTRACT]   Full text not available  [PDF]
  - 307 14
Changes In Electrical Resistance Of Bone After Fracture And During Healing
R. C Gupta, K. K Bhutani, K. K Mittal, B. S Khanka
October-December 1981, 15(2):228-233
Bones like all living tissues posses electric potentials and offer resistance to electric current flow. Polarity of intact bones and its variation after fracture have been well documented (Friedenberg 1966). But not much attention has been paid to electrical resistance of normal living bones and its variations after fracture and during healing. The electrical resistance of living bones has been stated to vary with wetness of surfaces, continuity of periosteum and internal circulation (Friedenberg and Kohanim, 1968). The present study was undertaken to assess the electrical resistance of canine tibia and its variations fracture healing.
[ABSTRACT]   Full text not available  [PDF]
  - 316 18
Simultaneous Fracture Separation Of Proximal And Distal Radial Epiphyses
A. N Verma
October-December 1981, 15(2):234-237
Fall on an outstretched hand, in addition to the innumerable classical fractures and dislocations, may produce unusual combinations of injury. The exact mechanism of these injuries is not always easy to discern. Aufrance et al. (1967) described a case of dislocation of the elbow associated with fractures of the proximal and radius. Agoropoulos et al. (1973) presented a series of case of unusual combination of simultaneous fracture of the carpal scaphoid and head of the radius. We had an opportunity to study an unusual combination of simultaneous fracture separation of the proximal and the distal radial epiphysis which is being reported.
[ABSTRACT]   Full text not available  [PDF]
  - 268 16
Concomitant Fracture Displacement Of Proximal And Distal Radial Epiphyses-A Case Report
S. C Goel, T. P Srivastava
October-December 1981, 15(2):238-240
Combined injuries of ipsilateral wrist and elbow region are uncommon as the brunt of the force acts on one site, but in cases of severe trauma caused by twisting force both regions can be simultaneously involved.
[ABSTRACT]   Full text not available  [PDF]
  - 251 11
Fracture Shaft Radius With Dislocation Head Radius-A Case Report
R. P Agarwal, M. C Gupta, R. K Garg
October-December 1981, 15(2):241-242
Fracture shaft of radius at junction of upper one third and middle third with anterior dislocation of head of radius is an exceptionally rare entity. The authors could not find any record of such a case in the available literature, and are therefore, reporting this case seen in L. L. R. M. Medical College, Meerut.
[ABSTRACT]   Full text not available  [PDF]
  - 255 8
Myositis Ossificans Progressiva In A Lady With Full Term Pregnancy
M. K Seth, J. K Khurana
October-December 1981, 15(2):243-246
Guy Patin (1662) first described “a women who turned in wood”. This rare congenital disorder was given the title myositis ossificans progressiva by Von Dusch (1868). Lutwak (1964) analysed 266 cases from medical literature. It was considered to be exclusively confined to white races till Grewal and Dass (1953) described an Indian child suffering from this malady. Nine additional cases were reported from India (Grewal and Dass 1953, Chatterjee 1955, Vyaghreshwarudu and Reddy 1960, Dikshit and Tandon 1967, Tuli and Sharma 1970, Sainaba and Mathai 1971, Sohi and Sohi 1973, Singh and Pachnanda 1976). A case of extensive myositis ossificans in a lady who could complete full term pregnancy and had normal delivery was considered worth reporting.
[ABSTRACT]   Full text not available  [PDF]
  - 269 21
An Unusual Spinal Intramedullary Epidermoid Cyst-Case Report
S Sharma, S. S Yadav, N Muthusamy, K. K Srivastava
October-December 1981, 15(2):247-250
Epidermoid tumour of the central nervous system are rare and represent less than one per cent of all brain tumours (Ross Fleming and Botterell 1959). The incidence of intraspinal epidermoid is even less, that too the intramedullary ones are extremely rare. MacCarty and associates (1959), found only 3 intraspinal epidermoids of spinal cord out 44 epidermoids of central nervous system. Manno et al. (1962) reviewed the literature, collected and classified 90 epidermoid tumours of the spine including 2 cases of his own. Higagi (1963) further put 2 more cases of intraspinal epidermoid on record making the total 92. Fager et al. (1966), Reeues (1967) and others have reported isolated cases. Gupta and Bhandari (1969), Ramamurthy and Sait (1973), each one of them had single case report to their credit. More recently, Page (1974) published an interesting report of intradural epidermoid cyst located in lumbar region and reviewed the literature. The purpose of this communication is to put on record one more case of intramedullary epidermoid because of its extreme rarity in the world literature and to the best of our knowledge this might be the third case to be reported from India.
[ABSTRACT]   Full text not available  [PDF]
  - 302 15
Malignant Haemangioendothelioma-A Case Report
K. M Pathi, S. K Jena
October-December 1981, 15(2):251-253
The term malignant haemangioendothelioma was suggested by Lichtenstein to describe malignant neoplasm of the intra-osseous vascular endothelium. The extreme rarity of this tumour is evident from several tumor surveys. Dahlin (1957) reviewed 2276 primary neoplasms of bone seen at Mayo clinic and found three such cases, showing an incidence of 0.13 per cent Recently we encountered one case of malignant haemangioendothelioma with unusual clinical course and presentation. Because of the rarity of the case it was thought worth while to report.
[ABSTRACT]   Full text not available  [PDF]
  - 244 9
Presidental Address
Prithi Pal Singh Maini
October-December 1981, 15(2):254-259
Full text not available  [PDF]
  - 234 15
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