Background:
We undertook this study to evaluate the awareness of the Primary Caregivers of children with clubfoot aka Congenital Talipes Equino Varus (CTEV) and their familiarity with the disease, their beliefs, knowledge and compliance to treatment, and barriers encountered during the treatment process.
Settings and design:
Cross-sectional, analytical study.
Materials and methods:
A standard questionnaire in the local vernacular language was prepared, on which 108 respondents were interviewed. Data were analyzed by using Statistical Package for the Social Sciences (SPSS) software program, version 21.0. Chi-square test was applied wherever suitable as a parametric test.
Results:
Approximately 57.40% of participants had no prior knowledge of clubfoot at all, till they had a child born of the deformity in the family. Superstitions like lunar eclipse (37.96%), punishment from God (37.03%), solar eclipse (34.26%) and black magic (26.85%) were widely prevalent as the perceived cause of the deformity. Only 25% of the participants believed that any kind of treatment should be started immediately after birth and 20.37% of the study population felt the first line of treatment should be a visit to a spiritual healer or to a shrine of a saint. Approximately 68.52% of the study participants were satisfied with the explanation of the disease process and treatment plan offered by the treating doctor. Approximately 52.77% perceived social stigma as an obstacle to treatment, whereas 58.33% had difficulties adjusting to change of home or workplace routines.
Conclusion:
The awareness level regarding clubfoot in the primary caregivers in the Indian scenario is low and has an implication on successful treatment and compliance.
<p class="abstract"><strong>Background:</strong> Nonunion of long bone fractures is a common condition treated by an orthopaedic surgeon. Many nonunions can be treated effectively by internal fixation with or without bone grafting but, an infected nonunion can prove to be a tough challenge. The Ilizarov method is effective in managing infected nonunion of long bones. This study aims to assess the outcome of management of infected nonunions of long bones of lower limb with Ilizarov Ring fixator using bone and functional results as per Association for the Study and Application of Methods of Ilizarov (ASAMI) Scoring System.</p><p class="abstract"><strong>Methods:</strong> We retrospectively analysed 18 patients (16 Male: 2 Female; Mean age 43.2 years) managed with Ilizarov technique for an infected tibial or femoral nonunion between 01 January 2013 and 31 December 2014. They were followed up for an average of 25.4 months after removal of fixator. They were assessed for functional and Bone (radiological) outcomes using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 17 limbs were salvaged and union could be achieved. One limb required amputation due to severe persistent intractable infection. None required any additional skeletal stabilisation after removal of fixator frame except casting in a few patients for a period of 6 weeks. Mean time to union was 211.83 days (range 136 - 320days/median 184) or 7.01 months. As per the ASAMI score, Bone results were excellent in 10, good in 5, fair in 2 and poor in 1. Functionally 7 were graded as excellent, 6 as good, 3 as fair and 1 as poor and 1 patient underwent amputation.</p><p><strong>Conclusions:</strong> The Ilizarov’s method remains one of the most versatile and successful means of achieving bone healing in infected nonunions of long bones of lower limbs with additional benefits of correcting bone defects, deformities and limb length inequalities. </p>
Unicameral bone cyst (UBC) is a benign, expansile, non-neoplastic bony lesion characterized by spaces that are separated by fibrous septae. These sometimes may threaten the architectural strength of the proximal femoral trabaecular arrangement because of the destructive effect of the cyst on the bone and the propensity to develop into a pathological fracture, especially under the influence of weight-bearing. We report a case of a solitary bone cyst in the proximal femur in a 15 year old girl, which was treated with curettage, synthetic bone grafting and prophylactic internal fixation with a dynamic hip screw (DHS). At 2 years follow-up, the lesion had completely healed and patient was pain-free and without any deformity. We suggest this method of treatment to be ideal for UBCs at this site, especially in the skeletally immature.
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