Aim: To verify if transverse acetabular ligament (TAL) can be used as an anatomical landmark to reliably orient the cup in primary total hip arthroplasty and compare it to acetabular cups placed with the help of mechanical angle guide (MAG) device. Materials and methods: Thirty Five patients with primary total hip arthroplasty, all performed by the same surgeon were included in the study. All patients had undergone surgery by anterolateral approach and all were cementless total hip arthroplasty. TAL was used as a reference guide for positioning of the cup in one group while MAG device was used in the other. Post operatively CT was done to confirm the version and inclination of the acetabular cup and the femoral stem version. SPSS was used for statistical analysis. Results: 18 males and 17 females were included. The most common etiological cause for THR was secondary osteoarthritis due to AVN (40%). At 18 months follow up, there was just 1 case of dislocation in group in which angle guide device was used. The mean anteversion of the acetabular cup on CT findings was 23.82 by using TAL while 18.35 with help of MAG device (P < 0.05). All were within Leweniks safe zone. Conclusions: The TAL and MAG device both can be effectively used to align the acetabulum component. TAL is patient specific intraoperative landmark which is not affected by patient positioning while angle guide device can give false positive assessment of cup version.
A 30-year-old male presented to the outpatient clinic with pain and complete loss of movement at elbow since last three months. He gave history of fall three months back for which he took treatment from a quack. Clinically, there was bony deformity on the medial side of forearm. Patient held the elbow in 90 degree flexed and neutral position.Radial head was palpable anteriorly and no supination pronation was present. There was no flexion and extension at elbow. There was no neurovascular defect. On skiagrams [Table/ Fig-1], there was diaphyseal fracture of ulna with anterior angulation and radial head was dislocated anteriorly. Thus, it was labelled as Bado type I monteggia fracture dislocation.
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