<p class="abstract">Plasma cell osteomyelitis is an uncommon type of localized chronic osteomyelitis which is characterized by the absence of typical clinical features of infection. It usually affects the metaphysis of long bones and presents as dense thickening of bone without sequestrum formation. We present an atypical case of plasma cell osteomyelitis with a lesion in the diaphysis of long bone and sequestrum formation<em>.</em> A 23 year old male patient came to our OPD with complaint of pain in mid-thigh radiating to the left knee since 2 months. X-ray showed radiolucencies in the medulla of middle third of shaft of femur along with a linear sequestrum suggestive of chronic osteomyelitis. An open biopsy was performed and surgical curettage was done. Histopathological examination was consistent with plasma cell osteomyelitis. Chronic plasma cell osteomyelitis is a rare condition with nonspecific findings and an unclear cause. Histopathology is the definitive tool for obtaining a diagnosis. Knowledge of this condition and proper management can give a better outcome, at the same time avoiding unnecessary investigations and procedures.</p>
Introduction: Treatment of distal tibial fracture with or without intra-articular involvement is challenging, for reasons like poor healing due to precarious blood supply. Various modality of surgical treatment such as closed intramedullary nailing, Open Reduction and internal fixation with conventional plate osteosynthesis and external fixation has been tried so far. But none of them have good functional outcome but had high complication rate. The newer technique of distal tibia fractures fixation using MIPPO (minimally invasive percutaneous plate osteosynthesis), involves less soft tissue handling and minimal periosteal stripping resulting in low infection rate and faster healing. Aim of the Study:To study the functional and radiological outcome of distal tibial fractures managed with MIPPO (minimally invasive percutaneous plate osteosynthesis), using locking plates and to look for complications in MIPPO. Materials and Methods: In this study, 55 patients with distal third tibial extra articular Metaphyseodiaphyseal fractures with or without associated fibula fractures were treated with MIPPO. The present prospective study was conducted in the department of Orthopaedics at a tertiary care hospital, between September 2014 to September 2018, followed up for a period of 1 year. Results: All fractures had a good clinical and radiological union. The fractures were stabilized with MIPPO, at an average of 4.27 days post-trauma, with an average operative time of 76.5 minutes. Functional outcome evaluation was done using Olerud-Molander ankle score, at the end of 1 year. Average radiological union time of 19.6 weeks and there were one delayed union and one nonunion. None of the cases had implant failure or any significant deformity with good to excellent results in 88.5 % cases. Conclusion:From this study, it is concluded that Minimally invasive percutaneous plate osteosynthesis technique (MIPPO), using locking plate is the most effective procedure for closed extra-atricular distal tibial Dia-metaphyseal fractures.
Introduction: Plantar fasciitis is the most common overuse injury. Steroid injections are a popular shortterm method of treating it. However lack of an inflammatory process histologically in plantar fasciitis questions its mode of action. Recently, promising results were reported with the use of Platelet-rich plasma (PRP) injections for treating muscle and tendon injuries and degeneration. The rationale lies in reversing the blood ratio by decreasing RBCs (less useful in the healing process) to 5%, and increasing platelets to 94% to stimulate recovery. We conducted a study with an aim to assess the efficacy of PRP injections for treating chronic plantar fasciitis. Materials and Methods: Study was conducted in a private medical college in Andhra Pradesh, including 44 male and 16 females, attending orthopaedics OPD from November 2016 to October 2018, suffering with chronic plantar fasciitis. From each patient 10 cc of whole blood was drawn and PRP was prepared by differential centrifugation and injected locally. They were reviewed at 4 weeks 8 weeks 3 months and 6 months. Injection was repeated if no significant improvement seen at 4 th week. The result assessed using Base line Visual Analogue Score (VAS), Foot and Ankle Disability Index (FADI) score. Results: There was highly significant improvement in the VAS and FADI score on each successive visit, when compared with baseline scores. Conclusion: PRP injection has a beneficial effect in treatment of plantar fasciitis.
Introduction: Fractures of the mid-shaft clavicle are commonly encountered in clinical practice. These can be managed either by conservative method or operative by internal fixation. This study aims to compare the outcomes of conservative and operative management. Methods: Forty patients with displaced and comminuted mid-shaft clavicle fractures were included in the study, among which twenty-five patients were treated conservatively and 15 patients underwent surgery and were followed up for a period of 1 year. Time taken for union, functional outcome, complications, and patient satisfaction were compared. Results: In the non-operative group, 28% of the fractures took less than twelve weeks to unite, whereas in the operative group 60% of them took less than 12 weeks to unite. At the end of 1 year, there was no statistical difference in mean UCLA (University of California and Los Angeles) score and the mean DASH score of the non-operative group and operative group. There were more complications in the operative group. Re-operative rate in the operative group was 40%. Patient satisfaction was 80% in the non-operative group, whereas 48% of patients were satisfied in the operative group. Conclusion: Displaced and comminuted mid-shaft clavicle fractures treated conservatively have more advantages when compared to surgically treated fractures.
Introduction: Supracondylar femur fractures are fractures that involve the distal 15cm of the femur. Because of the proximity of these fractures to the knee joint, regaining full knee motion may be difficult. Earlier a nonsurgical approach was used. Later in 1970s to early 1990s open reduction and internal fixation by means of plate and screw osteosynthesis, has emerged. Later Flexible intramedullary nailing, modified antegrade nailing, allowed fracture fixation with minimal exposure of the fracture site. However, axial and rotational stability of these implants are inferior. To counter these problems, retrograde supracondylar nailing was developed for stable interlocked nailing. The advantages of the supracondylar nail include a reduction in operating time and blood loss with reduction of devascularization of fracture fragments. Aim of the Study:The present study is undertaken to evaluate and explore supracondylar nailing in supracondylar fractures of femur with emphasis on a stable fixation with minimal exposure, early mobilization, less complications and a better quality of life. Materials and Methods: The present study was conducted in the department of orthopaedics at Alluri Sitarama Raju academy of medical sciences Hospital, Eluru, September 2016 and January 2019 (over a period of 28 months). 33 adult patients with supracondylar Fracture Femur were selected for the present study. Results: All fractures had a good clinical and radiological union. The fractures were stabilized with retrograde nailing in this series, the majority of the patients with distal femur fractures were due to road or automobile accidents upto the extent of 54.6%. The operative time for 42.4% of cases is 1 to 1and1/2 hr. Functional evaluation was done using Sanders 40 point functional evaluation scale. At the end of study, 87.9% cases had good to excellent results and 12.1% cases had fair results and no patient had poor results. Conclusion:From this study, it is concluded that, supracondylar nail is the optimal tool for many supracondylar fractures of femur. It provides rigid fixation, with significantly less periosteal stripping and soft tissue exposure than that of lateral fixation devices.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.