Context: Osteoarthritis knee is a common degenerative disorder for which various treatment modalities are available. Our aim was to evaluate the functional outcome and effectiveness of proximal fibular osteotomy (PFO) in patients who are unwilling to undergo total knee arthroplasty or high tibial osteotomy (HTO). Aims: To evaluate functional outcome of medial compartment osteoarthritis managed with PFO, clinically as well as radiologically in Indian study settings. Settings and Design: Study was done at the Department of Joint Replacement and Orthopedics, Tata Main Hospital, Interventional prospective cohort study. Subjects and Methods: Consecutive samples fulfilling study criteria were evaluated preoperatively with visual analogue scale (VAS) and preoperative functional status was assessed. The functional outcome was measured by pre- and postoperative VAS, Tegner Lysholm Knee score; X rays were used to measure pre- and postoperative “Medial joint space” and “Femoro-tibial angle (FTA).” Statistical Analysis: All the data were tabulated, and then analyzed with appropriate statistical tools “MedCalc. Chi-square test, test of significance and student paired and unpaired T-test were used. Results: There was a significant improvement in VAS score, Tegner Lysholm score postoperatively as compared to the pre-perative scores. FTA and medial joint space were also increased postoperatively. Conclusions: PFO is a good surgical alternative for medial compartmental osteoarthritis of the knee with an excellent functional outcome. A simple surgical procedure, non-requirement of specialized instruments, and low cost of surgery are some of the advantages for patients who do not want to undergo HTO or total knee replacement (TKR).
BackgroundShoulder dislocation is one of the most common injuries encountered in daily practice. Among shoulder dislocations, anterior shoulder dislocation is the most common variant. There are many techniques described to reduce a dislocated shoulder. Reduction of a dislocated shoulder joint may be performed under anesthesia or without anesthesia. In this study, we have evaluated the efficacy of Prakash's method in reducing anterior shoulder dislocations without anesthesia. MethodologyThis study is a prospective study that was conducted from March 2018 to February 2020 in the department of joint replacement and orthopedics in Tata Main Hospital, Jamshedpur. One hundred two shoulders fulfilling the inclusion criteria were included in this study, and observations were noted. ResultsThe results were statistically analyzed, and it was found that this new method was successful in reducing 97.06% shoulders without any anesthesia. Out of the total 102 patients enrolled in this study, 17 (n=102, 16.67%) patients had left-sided shoulder dislocation, and 85 (n=102, 83.33%) patients had right-sided shoulder dislocation. In 91.18% (n=90 out of 102) of the patients, the reduction could be achieved on the first attempt. A second attempt was needed in 7.84% (n=8 out of 102). No complications were noted. ConclusionPrakash's method to reduce anterior shoulder dislocation is a simple technique to reduce dislocated shoulders. Through our study, we conclude that it is also an effective technique for reducing anteriorly dislocated shoulders. As there is no requirement of anesthesia, we recommend that orthopedic surgeons as well as emergency care providers should acquaint themselves with this technique.
A giant cell tumour (GCT) is a benign and locally aggressive tumour that is usually observable in a skeletally mature patient involving the end of long bones. The reported incidence of this tumour in a skeletally immature patient is extremely rare. However, we report one such case in the distal radius of a seven-yearold female patient.Having presented with painful swelling of the right distal forearm, she underwent clinical and radiological examination, and a diagnosis of distal radius GCT was made. The tumour was treated with curettage, fibular graft, and synthetic bone graft. This case report shows the importance of including GCT in children as a differential diagnosis. This tumour may have a good prognosis if diagnosed and treated early.
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