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   1994| September  | Volume 28 | Issue 3  
    Online since September 16, 2010

 
 
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The Cincinnati Incision In Surgical Correction Of Congenital Foot And Ankle Disorders
A. K Gupta, S Srivastava, R Kumar, A. K Mehtani, L. K Sood
September 1994, 28(3):22-26
Surgical correction of most congenital foot and ankle deformities requires soft tissue release of medial, posterior and lateral structures around the foot and ankle. Various incisions have been described in the past. Fifty three feet in 45 children were operated for various congenital foot and ankle problems, using a comprehensive transverse incision (the Cincinnati incision). The incision gave excellent exposure of the involved structures. Forty two of the 53 operations performed were extensive, single-stage soft tissue release procedures. Satisfactory results were seen in 75.4% cases. Deep wound problems were seen in 9.43% feet. Cosmetically the scars were acceptable and the children had no shoe wear problems.
[ABSTRACT]   Full text not available  [PDF]
  529 19 -
Outbreak Of Serratia Marcescens Infection In Incisional Orthopaedic Wounds
P Sharma, V Talwar, S. M Tuli
September 1994, 28(3):74-77
An outbreak of Serratia marcescens infection involving incisional wounds in six orthopaedic patients occurred during March and April, 1994. All these patients were receiving postoperative antibiotic combination of gentamicin and cloxacillin. Epidemiological search for the source of infection revealed isolation of S. marcescens from the floor of the sideroom of the orthopaedic ward where the two index cases were housed and in the urine of one of the index cases. The patients’ isolates and the floor isolate were similar in nonpigmentation, biochemical profile and multiple antibiotic resistance. The wound infections responded to change of antibiotic and disinfections of side room and ward. S. marcescens was not isolated in subsequent wound sampling form the same ward in the consecutive twenty admissions over the next eight weeks.
[ABSTRACT]   Full text not available  [PDF]
  414 6 -
Hemiarthroplasty Of Hip With Unipolar And Bipolar Femoral Head Prosthesis : A Prospective And Retrospective Evaluation
A. K Gupta, S. N Chaturvedi, Vinod Kumar, R Nath, S Rastogi, R. K Shukla, D Sundararajan
September 1994, 28(3):12-17
This study represents the authors' experience with Moore and Bipolar prostheses in 42 patients with displaced fracture neck femur. Thirty four patients with 35 hemiarthroplasties were available for follow up for more than one year. The average follow up was 2 years (range 1 to 8 years). Various pre-operative factors like hone quality, pre-operative delay, and secondary bony changes were evaluated in both groups. The mean hip scores of Bipolar and Moore prosthesis groups were correlated with various pre-operative factors, type of prosthesis, duration of follow-up and the post-operative complications. Out of 28 Moore prosthetic replacements, 23 had good to excellent results (excellent 15; good 8) in initial 3 months, which was reduced to 17 in 8 months and to 12 at the final follow up. In Bipolar hemiarfhroplasty 11 out of 12 cases had good to excellent score in initial 3 months, which was reduced to 10 and 9 at 6 months and 2 years respectively. Further follow up shows no more deterioration of the result in bipolar groups. The patients with minimal pre-operative delay (<10 days) had fewer complications than those with more delay. Moore group had greater incidence of complications which include infection, wound griping and hematoma in early postoperative period and stern loosening (21%), acetabular erosion (12.5%) and painful hip (58%) later. Bipolar group had few immediate complications and there was no evidence of stem loosening or acetabular erosion.
[ABSTRACT]   Full text not available  [PDF]
  354 58 -
Epidemiological Study Of Injured Patients Admitted In Medical College Hospital Kanpur
A. K Gupta, R Nath, S Rastogi, R. K Shukla, Vinod Kumar
September 1994, 28(3):61-64
This study was carried out in casualty department of LLR Hospital, G.S.V. M. Medical College, Kanpur to study the epidemiology of accidents in form of road traffic accidents,fall from hieght, agricultural accidents and violence. Studies of mode of transport from site of injury to hospital and time lag between accident and hospitalsation were also done. These all factors i.e mechanism of injury, mode of transport and time lag were studied in relation to different age group of patients, their incidence, morbidity, permanent disability and mortality. Total 1914 patients which could be adequately followed were included in this study. It was inferred that maximum number of accidents found were due to road traffic accidents. Accidents due to fall from height were common in extremes of age. Maximum number of mortality and disability were found in patients who reached the hospital after six hours of the injury. These datas are of importance, in planning the preventive measures to prevent such accidents, for better management of such accidents by reducing the time lag between accidents and hospitalsation, by quick and safe transportation and to emphasize upon the need of developing trauma centers.
[ABSTRACT]   Full text not available  [PDF]
  365 38 -
Volar Barton's Fracture Dislocation - Long Term Follow Up
S Rastogi, R. K Arya, S Bhan
September 1994, 28(3):39-44
Fracture of the lower end of radius are supposed to be the most easy fracture to treat, yet are maximally mismanaged. One of the important intra-articular fractures at the distal end of radius are the Barton’s fracture-disolaction. In this study, out of total 1350 patients with fracture of lower-end of radius, 174 were Barton’s fracture-dislocation with an incidence of 12 per cent, mainly in the age group of 20-50 years. These fractures were classified into four types for appropriate treatment & planning. Total number of cases studied were 92, with a follow up of 24-60 months (average of 36 months.) All the cases in type I and II were managed mainly by closed manipulation and plaster immobilization, type III and IV by open reduction and internal fixation or by external fixators. Proper early planning of adequate treatment. This is essential to obviate pain and degeneration of this very important joint in the later years.
[ABSTRACT]   Full text not available  [PDF]
  353 42 -
Bipolar Arthroplasty In Young Adults
A. K Singh, K. D Tripathi, M. M Sahoo
September 1994, 28(3):8-11
Bipolar Arthroplasty was performed in the 25 relatively young adults in the age group of 25-70 years. Most of the cases were of avascular necrosis of femoral head with normal acetabulum. Few were cases of non-infective arthritis and osteoarthritis with minimal acetabular involvement. We belive that this type of bipolar endoprosthesis is easy to implant and can be done in the above age group instead of conventional hemiarthroplasty and more extensive surgery like total hip arthroplasty. Due to double mobility it protects the acetabular cartilage for a quite long time with the increased range of motion in the hip joint. Most of the patients are sitting cross leg and squatting
[ABSTRACT]   Full text not available  [PDF]
  316 21 -
A Clinical Evaluation Of Bone Plates In Mandibular Fracture
S. C Sahu, S. K Katharia, V. P Agarwal
September 1994, 28(3):78-81
The principal factors, in successful treatment of the mandihular fracture, are the segmental stability with normal physiological functions. In present study 45 patients of mandible fracture were treated by various methods like eyelet wiring, intraosseous wring, arch bar, bone plating, acrylic splint and external pin fixation. Patients were properly evaluated on the basis of clinical and roentagenographic interpretation. Bone plates facilitate anatomical reduction, functional stability and do not require intermaxillary fixation during bone healing in comparison with other treatment methods. There was no temporomandibular joint disturbances and pretrauma occlusion of teeth was achieved with bone plates.
[ABSTRACT]   Full text not available  [PDF]
  312 19 -
Supraclavicular Excision With Scalenectomy For Symptomatic Cervical Ribs
A. K Mishra, A. K Sahu, K. M Pathi
September 1994, 28(3):55-57
A total number of 50 cases of symptomatic cervical rib have been treated during the period 1988 to 1993 for an average duration of 3 years. Only 7 (14%) cases needed surgical intervention. The age of the patients ranged between 11 to 45 years with a mean age of 28 years. Vascular signs and symptoms were more common than the true compression of brachial plexus. In addition to extra periosteal excision of cervical rib, partial resection of scalenus anticus and medius muscle through a supraclavicular approach gives more satisfactory results. This procedure is simple, effective with least complications.
[ABSTRACT]   Full text not available  [PDF]
  302 12 -
A Biomedical Study Of Articular Cartilage And Its Clinical Significance
R. K Saxena, K. B Sahay, S. K Guha, P. K Dave
September 1994, 28(3):68-73
The roles of mechanical stresses in the genesis of osteoarthritis in animal model have been studied. Morphological, biochemical and biomechanical study were done on a freshly amputated bovine knee joint immediately after cyclic mechanical load testing on a specially designed knee joint articulating machine. Results showed that cyclic mechanical loading of joints at 150 Kg (moderate loading) produced no qualitative difference between the histologic properties of the cartilage obtained from the moderately loaded and the unloaded control specimens: in both the groups, the articular surface appeared smooth, regular and intact in the matrix. Proteoglycan content and water ratio in the moderately loaded cartilage showed significant increases along with improvement in the shear properties of the tissue. However, the articular cartilage form the joint tested at high loading (300 kg) showed early osteoarthrotic changes in the cartilage structure such as fibrillation and beginning of early osteoarthortic exposure of collagen bundles: decrease in proteoglycan content and water ratio and also in shear moduli of the cartilage tissues. These findings appear to support the hypothesis that physical stresses on the weight bearing joints are responsible for the early onset of osteoarthritis. This study may have clinical relevance in designing appropriate physiotherapeutic protocol of osteoarthritic patients management.
[ABSTRACT]   Full text not available  [PDF]
  298 14 -
Bipolar Prosthesis - The Viable Alternative To THR In Patients With Ankylosing Spondylitis
R Malhotra, S Bhan
September 1994, 28(3):3-7
Bipolar prosthesis was used to manage twenty three arthritic hips in fifteen patients with ankylosing spondylitis. Additional procedures used were adductor tenotomy in nine, iliopoas release in five, anterior capsulectomyin thirteen, knee flexion contracture release in nine, supracondylar osteotomy of femur in one had tendo-Achilles lengthening in one patient. All the patients showed remarkable improvement in terms of ambulation, function, pain relief and sum total range of movements. Heterotopic ossification did not occur in any case. Two third patients returned to their original occupation. Aseptic loosening led to revision to cemented THR in one case. Bipolar prosthesis is safe, reliable, technically easy and less complicated alternative to THR in arthritic hip in patients with ankylosing spondylitis. When need arises in future, it can be easily revised to THR.
[ABSTRACT]   Full text not available  [PDF]
  285 23 -
Long Term Results Of Prosthetic Reconstruction Of The Anterior Cruciate Ligament
P Sripathi Rao, Sharathi K Rao, Syed Nizamuddin
September 1994, 28(3):27-29
35 patients with ACL deficient knee underwent ACL reconstruction with the Leeds Keio prosthetic ligament. Patients ranged in aged from 22 to 34 years, 57.1 percent has associated meniscal injuries and the average injury reconstruction interval was 2.1 years. All patients had open, combined intra and extra articular reconstruction. Followup ranged from 10 months to 4 years. Good results were seen in 29, fair results in 3 and poor in 3. Poor results were due to rerupture (2 cases) and patellofemoral arthritis (1) A relook arthroscopy of a knee with ruptured ligament, confirmed collagen ingrowth.
[ABSTRACT]   Full text not available  [PDF]
  270 21 -
Evaluation Of Various Flap Procedures Used In Orthopaedic Surgery
Sanjai Rastogi, A. K Gupta, R Nath, R. K Shukla, Niraj K Agarwal
September 1994, 28(3):35-38
In this study 38 flap procedures have been done in 27 patients to cover various skin defects caused by trauma, pressure sores and non-healing ulcers. It was observed that maximum numbers of defects were caused by compound fractures. Fasciocutanous flaps were commonly used in this study. Most of the flaps healed within 4 weeks. It is concluded that various flap procedures are essential for better biological environment for future surgery and to cover defects which can not be treated with other procedures.
[ABSTRACT]   Full text not available  [PDF]
  266 21 -
Role Of Internal Fixation In Seqmental Fractures Of Forearm Bones
Sajeeva Kumar, Krishnan Nair, B. K Behera, K. M Pathi
September 1994, 28(3):45-47
16 cases of segmental fractures of radius and ulna were managed by early open reduction. Under sized nails were used for fixation with minimum exposure and soft tissue stripping. Unstable fragment was not raised from its vascular bed and normal radial bow was maintained. Bone grafting was not undertaken as a primary procedure. We have 82% excellent to satisfactory results in terms of rotational movements, grip strength and radiological union. Mean union time in our series was 13.2 week
[ABSTRACT]   Full text not available  [PDF]
  269 16 -
Lumbar Spinal Osteotomy In Ankylosing Spondylitis Without Internal Or External Fixation
B. K Dhaon
September 1994, 28(3):51-54
Eleven patients with ankylosing spondylitis had a vertebral osteotomy for the fixed-flexion deformity of the spine. The Smith-Peterson technique of lumbar osteotomy was used and slow, controlled, correction achieved without using internal or external fixation. There were no serious complications. All the patients but one had improved, could see ahead and had solid fusion at six months.
[ABSTRACT]   Full text not available  [PDF]
  271 13 -
Parameter Of Safety Of Carriage And Transfer Of Spinal Cord Injury Patietns
Dilip Kumar Sinha
September 1994, 28(3):58-60
Incomplete versus complete transaction ratio of spinal cord, the ‘Safety Index’, is very low in eastern rural India where the ignorant attendants carry the victims in flexion attitude in a ‘Khatauli’ thus possibly aggravating further the level of spinal cord injury. It suggests the importance of maintenance of proper posture and careful handling of the patients during the journey form the site of injury to the hospital.
[ABSTRACT]   Full text not available  [PDF]
  272 8 -
Repair Of Neglected Repture Of The Calcaneal Tendon
M. K Mam, T. S Sethi
September 1994, 28(3):30-34
Twenty one patients with neglected rupture of calcaneal tendon resenting at an interval of four to twenty four weeks after injury, were repaired following excision of the intervening fibrous tissue. VY plasty was done in 14 cases, as approximation of the ends could not be achieved. Two Kirschner wires, introduced transversly, one each in proximal and distal part of the ruptured tendon were incorporated in the cast. Results were assessed at a follow up, ranging from one to fifteen years. None of the patients, had re-rupture. Three of our patients developed wound infection while skin necrosis was noticed in three. Most of our patients returned to their activity which they had enjoyed prior to rupture.
[ABSTRACT]   Full text not available  [PDF]
  256 14 -
Kuntscher Nailing In Fracture Shaft Humerus
Dinesh Dhar, M. N Gupta, V. K Pachnanda
September 1994, 28(3):48-50
In this study, we report the results of lntramedullary osteosynthesis in treatment of fracture shaft humerus. Extremely favourable results emerged in the treatment of fractures of humerus with Kuntscher nailing as is seen in a critical review of 30 cases observed over a period of three years at our centre.
[ABSTRACT]   Full text not available  [PDF]
  242 16 -
Bizzare Parosteal Osteochondromatosis Of Foot And Ankle
R Malhotra, V. K Sinha, Amit K Dinda
September 1994, 28(3):83-84
A case of Bizzare parosteal osteochondromatosis involving multiple foot bones is presented.
[ABSTRACT]   Full text not available  [PDF]
  244 4 -
Disengaged Steinmann's Pin Presenting As Parietal wall Swelling
Nisar Ahmad Wani, Mumtaz-Din Wani, Hassan Bhat, Mohd Shafi Malik
September 1994, 28(3):82-82
Full text not available  [PDF]
  231 6 -
Calcified Leiomyoma Of The Diaphragm – A Case Report
M Farooque, Balram Airon, P. P Kotwal, R. K Sharma, U. N Bhuyan
September 1994, 28(3):65-67
Full text not available  [PDF]
  182 6 -
Management Of Broken Femoral Endoprostheses
M Farooque, A Diwan, H. A Raju, K Farooque
September 1994, 28(3):18-21
Full text not available  [PDF]
  162 5 -
61st Meeting Of American Academy Of Orthopaedic Surgeon 28th Feb. To March, 1994 At Neworleans U. S. A.
D. K Taneja
September 1994, 28(3):85-85
Full text not available  [PDF]
  147 4 -
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