The controversy regarding the radiographic parameter which best represents the various deformities of clubfoot continues. The aim of our study was to clear up this controversy. Fifty surgically treated (soft-tissue release) congenital clubfeet were studied clinically using Laaveg and Ponseti score and radiologically using twelve different radiographic parameters in weight-bearing AP and lateral views. The talo-calcaneal angle (TCA) in AP and lateral view showed statistically significant correlation with the functional rating, but significant variation in the dimension of the angles among the different functional groups was found with AP angle only. The talo-first metatarsal angle in AP and lateral view averaged 10°and 19°respectively, and showed significant correlation with the functional rating. The talo-navicular subluxation in AP, the calcaneo-fifth metatarsal angle and the first-fifth metatarsal angle in lateral view did not show any significant correlation with function. Talo-calcaneal index averaged 44°in the clubfeet and showed significant correlation. The wide range of parameters representing each of the deformities gives a better radiological assessment of the clubfoot than any single parameter.
We present our experience in the correction of congenital vertical talus deformity in a single stage using dorsal approach. We operated on 20 feet using the dorsal approach and the average age of patients at the time of surgery was 16 months. Talonavicular reduction was achieved in all the feet and there was significant improvement in postoperative talo-calcaneal and talo-first metatarsal angles, which were well maintained at a follow-up of 4 years. In conclusion, the dorsal approach efficiently manages the deformities of a congenital vertical talus foot and provides consistent radiological and clinical outcome with minimal complications such as revision surgeries and osteonecrosis of the talus.
<p class="abstract"><strong>Background:</strong> Among all the forearm fractures Monteggia fractures account for approximately 1-2%. Early recognition with anatomical reduction and stable internal fixation is most important in the management of Monteggia fractures. This study was performed to evaluate clinical profile and functional outcome of Monteggia fracture dislocation<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This retrospective study was done on 381 forearm fractures, out of which 31 were Monteggia fracture dislocation. All adults patients who were >20 years were included in the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> During the study period, of 381 cases 31 (8.1%) were having Monteggia fracture dislocation. Most of the study participants were males in (61.2%) compared to females (39%). The cause of the fracture in most of the cases was road traffic accidents accounted by 45%. In most of the cases, the outcome of the operation was excellent (61.3%)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> If the injury is properly classified and if stable anatomical reduction is achieved at the proper time then the results will always be excellent. In present study all the patients achieved excellent results after surgery<span lang="EN-IN">.</span></p>
Popliteal cysts, although commonly seen, are rarely associated with motion restriction or calcification. Radiological features are of soft-tissue swelling, with occasional reports of calcifications or small osteochondral bodies inside the cysts. We report a giant osteochondral body in a popliteal cyst, with significant mechanical block to flexion. This type of mass has to be differentiated from synovial osteochondromatosis, calcifications in the cyst, extraosseous and intraarticular osteochondromas. Complete excision of the cyst resulted in complete recovery of range of motion.
INTRODUCTIONTrauma is one of the biggest health hazards of the recent times. This is mainly due to the increased speed of the vehicles as well as the unruly traffic with increased vehicular population on the roads. Fractures of the shaft of the femur are one of the major causes of morbidity and mortality among these patients. 7% of the total femoral fractures are reported to be distal femoral fractures.1 If the hip fractures are excluded, they account to 31% of all the distal femoral fractures. In Europe, the incidence of the distal fractures has been reported to be 10 less frequent than the proximal femoral fractures, with a rate of approximately 6%. 2 Often, these fractures are unstable and comminuted. They mainly occur in the elderly, especially women and in adolescent males of 15-24 years range. 2 ABSTRACTBackground: An extensive soft tissue damage, intra articular extension, severe comminution and injury to the quadriceps mechanism make the management of the distal fractures of the femur a significant challenge. The advent of techniques such as dynamic condylar screw surgery and distal femoral locking compression plate technique have improved the, management of these fractures compared to the conventional methods. We in the present study have attempted to compare the outcomes of Dynamic condylar screw surgery and distal femoral locking compression plate technique. Methods: 72 patients over the age of 20 years who sustained simple or compound factures of the lower 1/3rd of femur and admitted into our hospital were included into the study. The patients were divided into 2 groups, one group who underwent Dynamic condylar screw surgery and the other groups were managed by distal femoral locking compression plate technique. Results: The most common cause of fracture was road traffic accidents, involving both two wheelers as well as four wheelers (51.4%). 19.4% of the patients had a fall from height and 13.9% had a fall from standing height. The mean operative time in DCS was about 121 minutes in comparison to 118 minutes in the LCP. The average hospital stay and the no of RBCs used were comparable in both the cases. Although the mean number of days for full weight bearing as well as the average time of union of the fracture was marginally lower in LCP than in DCS, it was not significant. Conclusions: It is therefore observed that both condylar screw and the locking plate are very similar in their performance and satisfaction to the patients, although distal femoral locking plate is better in comminuted distal fracture compared to the dynamic condylar screw fracture management.
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