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   2004| July-September  | Volume 38 | Issue 3  
    Online since May 23, 2008

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Principles and practice of deformity correction
GS Kulkarni
July-September 2004, 38(3):191-198
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Short and long term results of arthroscopic partial meniscectomy
P Sripathi Rao, Sharath K Rao, Shyamasunder N Bhat
July-September 2004, 38(3):158-161
Background: Arthroscopic partial meniscectomy is the treatment of choice for meniscal tears. The ultimate effect of meniscectomy on the joint has been controversial. Methods: This study was done to determine the short and longterm end results of arthroscopic partial meniscectomy. The results were assessed on the basis of Lysholm scoring and Tapper and Hoover scoring systems. Detailed questionnaires including different criteria like pain, swelling, locking etc. were sent to 323 patients with meniscal injuries. One hundred and sixty five patients responded to the questionnaire. The patients were categorized as long term for more than 2 years and short term for 2 years or less of follow up. Patients who underwent reconstruction of anterior cruciate ligament were excluded from the study. Results: The best clinical results were observed in patients who were operated within 3 months after injury (81.25% excellent & good results). Patients below the age of 40 showed consistently better results than those above the age of 40 years. Associated cartilage defects and anterior cruciate ligament rupture vitiated the results. Results were similar for short-term and long-term. The overall scoring showed 76.06% excellent and good results in the Lysholm scoring method and 69.72% excellent and good results in Tapper and Hoover scoring system. Conclusion: Arthroscopic partial meniscectomy gives good shortand long-term clinical results when performed early and in patients below the age of 40 years for meniscal injuries. Cartilage damage and anterior cruciate ligament injury vitiated clinical end results.
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Hip arthroplasty following failed dynamic hip screw fixation for per-trochanteric femoral fractures
SKS Marya, R Thukral, R Bawari, R Gupta
July-September 2004, 38(3):147-150
Background: Unstable trochanteric fractures have a poor outcome in patients in whom fixation fails and revision to a total hip arthroplasty is required. The primary indication for secondary surgery is relief of pain. Method: A retrospective review was performed on 17 patients with hip arthroplasty following failure of dynamic hip screw fixation done for per-trochanteric femoral fractures. Three patients underwent bipolar hip arthroplasty and total hip replacement in the remaining fourteen. Results: Clinical and radiological results at final follow up were equally good following bipolar or total hip arthroplasty conversions. Extreme care needs to be taken to avoid fracture and penetration of the femoral shaft. Auto graft, allograft or head and neck replacement components should be made available for reconstruction of difficult cases. Conclusion: The principles of a successful outcome include preservation of the functional continuity of the abduction apparatus during surgery, and early supervised weight bearing.
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Deep venous thrombosis prophylaxis- A multicentric study
S Bhan, BK Dhaon, Yash Gulati, Shekhar Aggarwal
July-September 2004, 38(3):178-182
Background : Deep vein thrombosis is a common complication after hip and knee surgery. Ideal prophylaxis is still not available. Methods : In a controlled trial, 30 patients in group I were not given any thromboprophylaxis while 100 patients in group II were put on mechanical prophylaxis. Results: Seven patients in group I developed DVT while no patient in group II had this complications. Conclusion : Mechanical prophylaxis may be a safe tool in preventing DVT.
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Estimation of femoral neck anteversion in adults - A comparison between peroperative, clinical and biplane X-rays methods
AV Maheshwari, AK Jain, MP Singh, SK Bhargava
July-September 2004, 38(3):151-157
Background: The accurate estimation of femoral neck anteversion in living subjects has always been difficult with lots of inter- and intra-method variations. The present study was undertaken to define the range of normal femoral neck anteversion in our adult population and to draw the relationship between the peroperative, biplane X-rays and clinical methods. Methods: Femoral neck anteversion was evaluated by the peroperative, biplane X-rays and clinical methods on 31 otherwise healthy and normal adults who underwent closed reduction / open reduction and internal fixation for post traumatic fresh intracapsular fracture of the neck of femur. Results: The mean value obtained by peroperative, biplane Xrays and clinical methods were 10.6 (n=31 hips), 11.7 (n=62 hips) and 13.0 (n=62 hips) respectively. No statistically significant difference was found between the sides and the sexes. The clinical method correlated better with the peroperative method than the X-rays method. Conclusion: The average femoral neck anteversion in our subjects was estimated to be 10.6 (SD 2.2) by the per-operative method, with 83.6% subjects having anteversion between 8.612.6. This is less than most of the western data. Statistical relations have also been drawn between the peroperative, X-ray and the clinical methods.
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Bone grafts and bone substitutes in clinical Orthopaedics
SM Tuli
July-September 2004, 38(3):199-202
  3,336 369 -
Crossed pin fixation in displaced supracondylar humerus fractures in children
UB Yadav, R Singhal, G Tonk, T Aggarwal, AN Verma
July-September 2004, 38(3):166-169
Background: Displaced supracondylar fractures of the humerus in children are common injuries treated by orthopedic surgeons. Amongst the various methods used for treating these fractures closed reduction and crossed pin fixation has shown improved results. Method: One hundred ninety seven cases with Gartland grade II and grade III supracondylar humeral fractures were treated with closed reduction and percutaneous crossed pin fixation with Kirschner wire and followed up for a minimum period of two years . Results: Patients were assessed on the basis of Flynn's criteria. There were 145 excellent and 41 good results. Conclusion: It is concluded that closed reduction and crossed pin fixation is a sound and effective treatment for displaced supracondylar fractures with several advantages but requires careful judgement on the part of surgeon to avoid complications
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Bone grafting for acetabular deficiencies in cases of total hip arthroplasty
BK Dhaon, Vineet Jain, Jainder Singla, Anuj Jaiswal, Vishal Nigam
July-September 2004, 38(3):143-146
Background: Bone-graft is among the most popular methods of providing bony support in cases of acetabular bony deficiencies during total hip arthroplasty. Controversy still exists on the best method for bony reconstruction. Methods: Twenty patients having acetabular deficiency were operated from 1998 to 2002 for total hip arthroplasty using bone cement, allograft or autograft. There were 14 males and 6 females in the study with an average age of 47 years. Average time of follow up was 3.2 years. Results: There was delayed union in one case each of allograft and autograft. Average Harris hip score pre-operatively was 39.5, which improved to an average of 80 post-operatively. Conclusion: Our study has shown that bone grafting both in form of autograft and allograft, provide excellent results in reconstruction of acetabular bony deficiencies. Graft should not support more than 50% of acetabular cup. Also, bone cement can be good option in cases of mild cavitatory lesion in old patients.
  2,844 153 -
Desmoplastic fibroma of lumber spine, an unusual localization of a rare primary bone tumor- A case report
MM Prabhakar, Tejas H Thakker
July-September 2004, 38(3):185-186
  2,867 76 -
Infected non-unions of tibia - management by simple fixator - compressor
ZS Kundu, SS Sangwan, Sanjeev Jain, Rajeev Mittal, RC Siwach, Gaurav Bhardwaj
July-September 2004, 38(3):162-165
Background : Management of open fractures of tibia complex problem. It requires stabilisation of fracture and soft tissue cover. Method: Seventeen patients of fractures both bones of leg, who suffered open fractures at the time of initial injury and were managed either by external fixator or pins incorporated in plaster cast with window, reported with non-union of either tibia or both bones of leg. These patients were managed by using simple external fixator-cum-compressor using Steinmann or Denham's pins and compressing the fracture site after doing the osteotomy of fibula and early weight bearing. Results : All fractures united well, however there was shortening of 3/4 to 1 inch in these cases which was compensated by shoe raise. Conclusion : Simple fixator compressor is a simple, economical and easy method of treatment of open tibial fractures.
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Coping mechanism and its correlation with quality of life in upper limb post traumatic joint stiffness patients
Aditya Aggarwal, Adarsh Kohli, ON Nagi, Arun Kumar
July-September 2004, 38(3):170-174
Background: Joint stiffness especially of upper limb joints following trauma may lead to psychological problems. Method: This study was carried out on twenty-six consecutive patients between 18-45 years of age, of post-traumatic joint stiffness (PTJS) in upper extremity, to determine the type of coping mechanism and its effect on their quality of life. Coping checklist1 and WHO QOL-Brief Version2 questionnaires were used to assess the coping strategies and quality of life of these patients. Results: Critical analysis of the data revealed that these patients commonly employed coping strategies like problem solving, positive cognition, avoidance, religious and magical thinking in that order. Conclusion: The correlation analysis between the scores of coping strategies and quality of life showed that patients, who were high on avoidance coping skills, had better psychological functioning where as those who were high on external attribution, had low physical health
  2,557 141 -
Psychological disturbance in Indian low back pain population
Ketan C Pande
July-September 2004, 38(3):175-177
Background: Psychologic disturbance is known to have an influence on the outcome of treatment of patients with low back pain. Method: The prevalence of anxiety and depression in 145 Indian low back pain patients was studied using the Hospital Anxiety and Depression Scale (HADS) Results: Significant correlation was found between the levels of self reported disability and anxiety and depression which were 71.7% and 64.8% respectively. Conclusion: The pain drawing was found to have a low sensitivity and positive predictive value in identifying patients with abnormal anxiety and depression.
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Tuberculosis of the patella - A case report
Roop Singh, Rakesh Gupta
July-September 2004, 38(3):189-190
  1,860 125 -
Massive discoid medial meniscus presenting as a meniscal cyst A case report
Sushil K Sabnis, Anish P Kadakia
July-September 2004, 38(3):187-188
  1,539 104 -
Osteoid osteoma- puzzling presentation & effective management a case report
S Agarwala, BS Rajput
July-September 2004, 38(3):183-184
  1,447 101 -
Evidence based medicine
VP Singh
July-September 2004, 38(3):139-142
  1,178 95 -
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