Background: Abnormal anatomy is a contributory factor to wrong-level surgery. Variations in the number of vertebrae in populations from different races and geographical regions have been described. A~10% prevalence of variations in number of thoracic and lumbar vertebrae in adolescent idiopathic scoliosis (AIS) patients has been previously reported. The objectives of present study were (i) to find out the prevalence of variations in the number of thoracic and lumbar vertebrae and the presence of lumbosacral transitional vertebrae (LSTV) in Indian AIS patients and (ii) to correlate these variations with gender and type of curve.Methods: Hospital records and imaging of 198 AIS patients were reviewed retrospectively. A standardized numbering strategy was used to identify the number of thoracic vertebrae, number of lumbar vertebrae, and presence of LSTV. Patients' gender and curve type were correlated with the presence of an abnormal number of thoracic or lumbar vertebrae. Radiology reports and operation notes were reviewed to find out instances when the radiologist or surgeon had identified an abnormal number of vertebrae.Results: Forty patients (20.2%) with abnormally numbered thoracic or lumbar vertebrae were identified. Twenty patients (10.1%) had abnormally numbered thoracic vertebrae, and 33 patients (16.7%) had abnormally numbered lumbar vertebrae. The prevalence of LSTV was 18.2%. Presence of variations did not correlate with gender or curve type. Radiology reports identified 2/40 patients with variations, whereas operation notes showed 4/40 patients had been correctly identified to have abnormally numbered vertebrae.Conclusions: There is high prevalence of variation in the number of thoracic or lumbar vertebrae in AIS patients, with most of those missed being identified by radiologists or surgeons. The patient's preoperative imaging must be scrutinized to identify these patients and take the variation into account to avoid wrong selection of fusion levels.Level of Evidence: 3. Clinical Relevance: Text. The study raises awareness about possibility of wrong selection in fusion levels due to anatomical variations in surgery for AIS.
Fractures of the capitellum, particularly coronal shear fractures, are difficult to manage. The challenges are adequate surgical exposure, proper anatomic reduction, and stable fixation of these fractures. Our study included 10 patients with a coronal shear fracture of the capitellum without any involvement of the posterior condyle. All patients underwent open reduction and Herbert screw fixation using the anterolateral approach, with good functional outcome. In our opinion, this is a good option for the treatment of coronal shear fractures of the capitellum.
Introduction: The WHO defines giant cell tumor as a benign locally aggressive neoplasm with metastasizing capacity and aggressive behavior. Very rarely, these tumors are seen fungating, mostly when neglected. But when they do, the treatment option commonly conferred is amputation of the limb which is disabling and traumatizing. Case Report: We report three cases of fungating limb masses (proximal tibia, distal fibula, and distal radius) diagnosed with giant cell tumor histologically, undergoing limb saving surgeries with various reconstruction techniques to endorse a good quality of life and functioning limb. Conclusion: Our study is one of the earliest to report medium-term follow-up after such limb salvage procedure. We recommend that salvage procedures should be considered in giant cell tumors even in the presence of fungation if there is no neurovascular encasement. Keywords: Giant cell tumor, fungation, limb salvage surgery, endoprosthesis, mesh reconstruction.
According to World Health Organization (WHO), nearly 1.3 million people die worldwide every year as a result of RTA this is one person killed every 25 second, while 20-50 million suffer non-fatal injuries with many sustaining disability this sums to be the 6th leading cause of death overall and prime cause of death among young people aged 15-29 year and cost countries 1-3% of their Gross Domestic Product (GDP), affecting them economically as well. 1-3 In India years 18-45 accounted for more than half (61.2%) of all persons killed in accidents during 2014. 4 In 2014, total number of RTA cases reported in India being 4,50,898 has increased by 1.8% compared to 2013 with 4,43,001 cases while the deaths have a much concerning increase during 2014 with 1,41,526 deaths by 2.9% compared with 2013 with 1,37,423 deaths. 4 The rate being significant at 51 cases per hour where in 16 persons were killed. The state of Karnataka alone has an ABSTRACT Background: Over the past years, several efforts are made to establish relationship between personality characteristics and accident proneness with many researchers pursuing to construct accident proneness with personality. Current trend with exponential growth in automobile population has demanded Researchers to study about accident proneness among those drivers. With this background the following study was done with an objective of to explore the personality correlates of accident-proneness of truck drivers passing by State highway-17 of Mandya city in Indian. Methods: A cross sectional descriptive study was done in SH 17 Bangalore-Mysore highway among 200 truck drivers. The subjects included in the study were the truck drivers who were passing by SH-17 and who were able to understand Kannada or Hindi language. The data was collected by personal interview method by using semistructured questionnaire for socio-demographic information and standard big five personality test questionnaire for personality trait of drivers. Results: Out of 200 drivers 126 were accident prone and 74 were non accident prone drivers. Total driving hours in a day was found to be significantly higher in accident prone driver than non-accident prone. With respect to personality it was found that openness to experience and emotional instability/neuroticism was significantly associated with accident proneness. Conclusions: In conclusion it can be said that personality trait plays an important role in accident. In order to prevent such accident it is advisable to screen such people at the time of issue of driving license for heavy vehicle itself.
Background: Total knee arthroplasty (TKA) has been proven to be a highly efficacious procedure for patients with end-stage osteoarthritis who have persistent symptoms not managed by conservative treatment. A large percentage of standard commercially available total knee arthroplasty (TKA) implants are imported and designed based on morphometric data of Western populations, which are known to have a larger build compared to their Asian counterparts. Hence, these prostheses may sometimes not be the best fit for Indian patients. We conducted this study to examine the anthropometry of osteoarthritic knees of Indian patients, analyze anatomical differences between males and females, and compare these measurements with commercially available five TKA implants.Methods: Morphometric data were collected from 150 Indian patients with osteoarthritis of the knee using computed tomography (CT) scans. The mediolateral (ML) and anteroposterior (AP) dimensions of the distal femur and proximal tibia were measured, and aspect ratios (ML/AP) were calculated. These measurements were correlated with current commercially available implant sizes.Results: We examined CT scans of 100 female and 50 male patients' knees with a combined average age of 58.2 ± 7.5 years. The mean mediolateral and anteroposterior dimensions of the distal femur for Indian knees were 74.5 ± 5.8 mm and 58.0 ± 4.2 mm, respectively, whereas for the proximal tibia, 69.1 ± 5.5 mm and 43.8 ± 3.6, respectively. The mean aspect ratio for the femur was 129.0 ± 6.0 and for the tibia was 158.1 ± 9.1. Male dimensions were found to be greater than female dimensions in all measured aspects of the distal femur and proximal tibia for the Indian population. However, the aspect ratio of the tibia was not found to vary with gender. When compared with the dimensions of other ethnic groups, the size of Indian knees was found to be smaller than Caucasians.Conclusions: There is a mismatch between the anatomy of Indian knees and currently available TKA implants, and these implants may have drawbacks when implanted in Indian patients. The obtained anthropometric data may provide useful directions for designing TKA implants of more suitable sizes and aspect ratios for Indian patients.
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