The COVID-19 pandemic has presented with debilitating respiratory consequences especially more pronounced in high risk individuals. Individuals with underlying systemic diseases are more prone and vulnerable to suffer severe consequences of SARS-CoV-2 infectivity. The pathophysiological changes identified cytokine storm mechanism for out setting the series of adverse clinical conditions. Thereby, associating it with high mortality rates. This warrants urgent consideration of divergent modalities such as the cellular therapy. Cellular therapy (CT) is a new medical paradigm wherein cellular material is administered to patients for therapeutic purposes. In this regard, mesenchymal stem cells (MSCs) have yielded the most promising results among stromal vascular fraction (SVF); placental cells; natural killer (NK) cell and platelet lysate respectively. Following the administration of the CT as per preferred route, these play pivotal role in modifying the microenvironment of the lung tissue with their distinct sets of mechanism.Evidences have shown how their immunomodulatory action repairs and prevents lung injury which in turn improvise the compliance of lungs. In this review article we have discussed these emerging novel approaches and their target step serving as a ray of hope to combat severe form of COVID-19. Currently these aren't approved for preventing or treating COVID-19 cases, however clinical trials are afoot to dispense the utmost understanding in terms of efficacy and safety concerns.
Background: Fractures of proximal femur are amongst the most often encountered fractures by orthopedic surgeon. Intertrochanteric fractures were one of the most common fractures of the hip especially in the osteoporotic bones and high velocity trauma. Many treatment techniques are described in literature but internal fixation with Dynamic Hip Screw is the versatile treatment of choice. Objective: To analyze the clinico-radiological and functional outcome of intertrochanteric fractures by dynamic hip screw. Materials and Methods: A retrospective study with 64 adult patients with intertrochanteric fractures according to Boyd & Griffin classification were treated with dynamic hip screw (DHS) in School of Medical Sciences & Research from January 2014 and December 2018. All the cases were followed at regular intervals as per our study protocol. The functional outcome were assessed with Modified Harris Hip Score.Results: In the present study, 64 intertrochanteric fractures underwent surgical fixation with dynamic hip screw (DHS). The functional results assessed by Modified Harris Hip score showed excellent in 37 cases (57.81%), good in 13 cases (20.31%), fair in 9 cases (14.06%) and poor in 5 cases (7.81%).
Conclusion:We conclude that the dynamic hip screw (DHS) is an ideal and versatile implant of choice for intertrochanteric fractures, leading to high rate of bone union restoring the postero-medial wall, reducing the chances of implant failure and decreasing the post-operative morbidity by improving the functional quality of life.
Introduction: Atypical femoral fractures account for only 0.5% of femoral shaft fractures, but delayed union or non-union occurs in 50% of atypical femoral fractures accompanied by femoral lateral bowing. Such fractures are difficult to treat.
Case Report: The case was an 84-year-old woman. She was diagnosed post-operative non-union of atypical femoral fracture. We planned a revision surgery for post-operative non-union of the atypical proximal femoral fracture. A two-dimensional template was used to simulate the intramedullary nail (IMN). Due to the advanced femoral lateral bowing deformity, a mismatch with the nail was noted when the unaffected femur was used to construct the template. When the opposite side nail was used as a template, the nail was aligned with the medullary canal, and the tip of the nail coincided with the center of the medullary canal; hence, the opposite side nail was chosen. Radiographical assessments of healing of the fracture confirmed callus formation and complete bone union 3 months and 1 year after the operation, respectively.
Conclusion: We found that exchange nailing as revision surgery for post-operative non-union of atypical femoral fractures combined with an IMN on the opposite side was useful.
Keywords: Alendronate, femoral fracture, osteoporosis, revision surgery.
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