The hip allows mobility of the entire extremity in 3 planes. Therefore any little derangement in the anatomy of the hip can affect it's functioning and can cripple & severely affect daily living of the person. The most common causes of disability are trauma and degenerative disease, and till date the most successful2 treatment for joints severely damaged has been replacement by artificial parts. Today replacement arthroplasties are very commonly performed by orthopedic surgeons the world over. In India too this procedure has gained wide acceptance among both surgeons and patients. The primary goal of this procedure is to restore normal anatomy of the hip joint so as to provide painless free mobility with a stable hip, and immediate functional outcomes of this procedure are very satisfactory. Technically there is little debate that the results of revision procedure are less satisfactory and the primary THR offers the best chances of success. Therefore it would be rational to assess and eliminate the human/iatrogenic factors that would-be influencing and jeopardizing the longevity of the implant since such surgeries in Indian patients are mostly once in a lifetime job. Also since the indications of arthroplasty have expanded and more surgeries are being done, so there is a statistic increase in the percentage of loose implants, which ever the reason. Although definite evidence and impact of loosing manifests late but the parameters reflecting the causative factors can be detected early in the form of altered anatomy and function. And repetitive cyclical loading of the implant in an unfavorable mechanical environment will over time, ultimately build up to a negative result.
To find out incidence, prevalence, various modes and pattern of cutthroat injury during COVID-19 pandemic and compare with prior non pandemic period. To find out the various factor influencing the suicidal cutthroat and establish the temporal association of suicidal cutthroat with COVID-19 pandemic. It is a retrospective study of cutthroat patients who were managed in ENT Dept. VIMSAR, Burla, Sambalur, Odisha, India from 1st September 2019 to 31st August 2020. Source of information are casualty, IPD and OT registers and online data. Total cases were divided into group-A (prior to COVID-19 pandemic) and group-B (during COVID-19 pandemic) and analysed. Total 24 cutthroat injury cases were treated over 1 year in department of ENT, VIMSAR, Burla, which was 0.054% of total cases attended at casualty and 2.371% of total IPD patients treated. In GROUP-A, total 10 cases with M:F = 9:1,suicidal 4 cases (40%), homicidal 6 cases (60%), and no accidental cases were recorded. While in GROUP-B, total 14 case with M:F = 14:0, suicidal 9 cases (64.28%), homicidal 3 cases (21.42%) and accidental 2 (14.28%) cases were recorded. In our study majority of cases were male with M:F = 23:1. Common age group belongs to 20–30 years with LSES and farmer by occupation. Zone II injury had incidence of 70.83%. Homicide cases proportionally high during non-COVID period while suicide cases high during COVID-19 pandemic. Association of COVID-19 pandemic with suicidal cut throat injury is seems to be significant. Among predisposing risk factors for suicidal, depression during COVID-19 pandemic had seen in 53.84% of total suicidal cases. Incidence and prevalence of Cut throat injury is comparatively high in western odisha which again increases during months of July and August parallel to COVID-19 pandemic. The common mode of cutthroat injury is homicidal, which suddenly changes to suicidal during COVID-19 pandemic. More vulnerable groups were young unemployed male, farmers and labours. Cutthroat injury cases definitely increases during COVID-19 pandemic with most common mode of injury being suicidal attempt, which may be due to economical and psychological imbalances, due to loss of job and fear and social stigma for COVID-19 diseases.
<p class="abstract"><strong>Background:</strong> Dislocation of carpo-metacarpal (CMC) joints especially involving the 2<sup>nd</sup> and 3<sup>rd</sup> or paired dislocations, presents a rare pattern of orthopaedics hand injuries. They are associated with high energy trauma usually involving motorbike accidents. Severe soft tissue inflammation over the affected hand and associated injuries often makes detection of these fractures difficult. They require prompt management at presentation. Failure to be diagnosed and treated at early stage leads to joint stiffness, restrictions of wrist movement, deformity and sometimes ruptures of tendons crossing the wrist. Most of them require open reduction and internal fixation for stabilization. The objective of the study was to clinically evaluate outcomes in management of carpometacarpal joint dislocations<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> We prospectively studied 6 cases of CMC dislocation presenting at average of 1week from the original injury. All were clinically and radiologically evaluated. 3 cases were managed with open reduction and internal fixation with K wire and 1with closed manipulation and percutaneous k wire fixation and 1 case by arthrodesis of CMC joint. Functional assessment was done with Quick DASH score at 6 weeks, 3 months, 6 months and 1 year.<strong></strong></p><p class="abstract"><strong>Results:</strong> All the patients went on to have good functional recovery. The average quick DASH score showed improvement from 77.39 to 4.07 over 1 year follow-up<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Careful and meticulous examinations of hands are necessary in high velocity trauma cases to avoid missing diagnosis of CMC dislocation. ORIF remains the gold standard treatment which can also be used for cases presenting late, followed by aggressive post-op physiotherapy can lead to excellent recovery of hand function<span lang="EN-IN">.</span></p>
Figure 1. Pre-operative fingers-in-palm deformity.Figure 2. Post-operative correction of deformity.
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