Background: Plantar fasciitis can be defined as inflammation at the insertion of plantar fascia and is thought most commonly due to overuse injury. It usually presents as sharp shooting heel pain which is worse in the morning. The location of pain is usually plantar surface of the foot and pain may radiate proximally in long standing and severe cases. In mild cases of plantar fasciitis non steroidal anti-inflammatory drugs and activity modification may be sufficient. Severe cases may require interventions such as night splints and orthotic devices which works by reducing loading of plantar fascia. Recently local injection of autologous platelet rich plasma is used by many researchers with promising results. Aims and Objectives: This prospective cohort study was undertaken to analyze the functional and clinical outcome in patients with plantar fasciitis who were treated by autologous injection of platelet rich plasma. Materials and Methods: This was a prospective cohort study conducted in department of orthopedics of a tertiary care medical college located in an urban area. The patients diagnosed to be having plantar fasciitis were included in this study on the basis of a predefined inclusion and exclusion criteria. Patients were assessed for severity of pain by the Visual Analogue Score for pain and American orthopedic foot and ankle score (AOFAS). A VAS score of 0-3 was taken as pain relief and VAS score of 4-10 was considered as no pain relief. Whereas AOFAS scores of 90-100, 80-89, 60-79 and less than 60 were taken as excellent, good, fair and poor outcome respectively. All patients were treated by local injection of autologous platelet rich plasma. The patients were followed up at 4 weeks, 8 weeks and 12 weeks. During follow up visits the pain relief was assessed by VAS and AOFAS scores. For statistical purposed SSPS 21.0 software was used and p value less than 0.05 was taken as statistically significant. Results: A total of 60 patients were included in this study out of which there were 22 (36.67%) males and 38 (63.33%) females with a M:F ratio of 1:1.72. The most common affected age group was between the age of 41-50 years (35%) followed by 51-60 years (21.67%) and 31-40 years (20%). Twenty-seven (45%) patients were either overweight or obese. A statistically significant reduction in pain was documented at the time of follow up of 4 weeks. At the end of 12 weeks 58 (96.67%) patients experienced significant pain relief and only 2 (3.33%) patients had significant pain. Also, there was statistically significant difference between AOFAS scores at the time of presentation and at 4 weeks, 8 weeks and 12 weeks follow up visits. Conclusion: Injection of autologous platelet rich plasma for chronic plantar fasciitis is found to have promising results in terms of pain relief (reduced VAS score) and functional outcome (Improvement in AOFAS score).
Background: Fractures of the distal radius are one of the common fractures for which pediatric orthopedic consultations are sought. The usual mechanism of injury is fall on outstretched hand seen following a road traffic accident or fall. Most of these fractures are treated either conservatively or by closed reduction and immobilization in cast. In some cases, internal fixation by K-wiring may be required. We conducted this study to analyzed outcome of distal end radius fracture in pediatric age group who were treated by immobilization alone, by closed reduction and immobilization and closed reduction with internal fixation by K-Wire and immobilization in cast. Aims and Objectives: 1. To analyze outcome of distal end radius fracture in pediatric age group. 2. To study complications in children presenting with distal end radius fracture. Materials and Methods: This was an observational study conducted in the department of orthopedics of a tertiary care medical college. 60 pediatric patients with distal radius fractures and treated either by conservative management or by surgical intervention were included in this study on the basis of a predefined inclusion and exclusion criteria. Gender distribution, mean age and mechanism of injury in the affected cases were analyzed. Patients were treated either by immobilization alone, by closed reduction and immobilization and closed reduction with internal fixation by K-Wire and immobilization in cast. Patients were followed up for 8 weeks. Complications and time for complete union was assessed during follow up visits. Functional outcome was assessed by QuickDash Score. Results: Out of these 60 patients there were 52 (86.66%) males and 8 (13.33%) females with a male to female ratio of 1:0.15. The mean age of affected cases in Boys and Girls was found to be 13.09 +/- 2.93 years and 12.5+/- 3.64 years respectively. Dominant hand was involved in 41 (68.33 %) whereas non-dominant hand was involved in remaining 19 (31.66 %) cases. In 16 (26.67%) patients only casting was required whereas closed reduction and casting was done in 25 (41.67%) patients in remaining 19 (31.67%) patients closed reduction and K-Wire fixation was done. 42 (70%) patients had excellent functional outcome whereas 9 (15%) patients had good functional outcome and 9 (15%) patients were found to have satisfactory outcome. 4 (6.66%) patients developed pressure sores, 1 (1.67%) patient had stiffness and there was 1 (1.67%) case of pin site infections. All these complications were successfully managed by conservative means. Conclusion: Fractures of distal end of radius in pediatric age group can be managed successfully either by immobilization alone or by closed reduction and casting. Internal Fixation by K-Wires may be required in some cases.
Background: Chondrosarcomas are tumors that predominantly consist of cartilage and account for approximately 25% of all bone sarcomas. These tumors are relatively resistant to chemo and radiotherapy. They are classified into conventional Chondrosarcomas, de-differentiated Chondrosarcoma, mesenchymal Chondrosarcoma, juxtracortical Chondrosarcoma and secondary Chondrosarcoma on the basis of histopathology and whether or not they have occurred in a previously benign cartilaginous lesion. They are further subdivided into low grade, intermediate grade and high grade Chondrosarcoma on the basis of cellularity, atypia and pleomorphism. The clinical features of Chondrosarcoma include dull aching pain especially during night time, neurological symptoms (due to nerve involvement) and pathological fractures. Diagnosis is done by imaging and histopathology. Surgery is the primary treatment and consists of complete and wide excision whenever possible. Chemo and radiotherapy has got a limited role. We conducted this retrospective study of 30 patients with Chondrosarcoma treated with uniform surgical protocol at our institution. Materials and Methods: After obtaining approval from institutional ethical committee we conducted a retrospective study of 30 patients diagnosed with chondrosarcoma. Since Chondrosarcomas are rare we searched for the patients records diagnosed with Chondrosarcoma and details were studied from case papers and patient examination during follow up. All patients had undergone surgical treatment of primary tumors. The various surgeries done in these patients included wide excision, Tikhoff-Linberg procedures, wide chest wall resections and hemipelvectomies depending upon the site and size of the tumors. Minimum follow up was 24 months. The data was tabulated and analyzed using SPSS 16.0 version software. Results: This study consisted of 30 patients having been diagnosed with Chondrosarcoma. There were 18 men and 12 women with a mean age of 34 years (range 18-50 years). The most common clinical features these patients presented with were swelling (76.66%) followed by pain (66.66 %), neurological symptoms due to nerve involvement (16.66%), fumigating skin lesion (13.33%) and pathological fractures (6.66%). Patients were diagnosed on the basis of Imaging (XRAY/CT /MRI) and biopsy followed by histopathological examination. Most common bones involved were femur (30%) followed by pelvic bones (26.67%) and humerus (13.33%). Various surgical procedures done included complete excision in 15 patients (50%) followed by Likhoff-Linberg procedure (20%), chest wall resections (16.66%) and hemipelvectomy (13.33%). 9 patients were lost to follow up. Out of remaining 21 patients 15 patients (50%) remained recurrence free during a follow up period of 24 months while 6 patients (20%) presented with either localized recurrence or metastasis. Conclusions : Chondrosarcomas are heterogeneous group of tumors ranging from low-grade to very aggressive, high-grade forms. In individuals presenting with localized disease wide s...
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Calcaneum is usually fractured following high energy axial traumas such is seen in cases of fall from height or road traffic accidents. If not properly managed these fractures can be a cause of prolonged morbidity in the form of pain, stiffness and deformities. We have conducted this prospective study of fracture calcaneum with the method described by Allan et al which constitute of open reduction and bone grafting without any implants. The objective of the was to determine the clinical approach, described by Allan et al for treatment of fracture calcaneum and to discuss in short the results, pitfalls and challenges associated with this.</span></p><p class="abstract"><strong>Methods:</strong> A prospective study was done on 42 patients who were diagnosed with intra-articular calcaneal fractures depending upon a predefined inclusion and exclusion criteria. All fractures of the study subjects were treated using a lateral approach by Allan’s procedure. Final outcome was assessed on the basis modified Rowe score.<strong></strong></p><p class="abstract"><strong>Results:</strong> In this study a total of 42 patients with intra-articular calcaneal fractures and treated by open reduction and bone grafting without any implants were studied. There were 36 men and 6 women. Majority of the patients tolerated the procedure well and most of the patients (95.23%) had a complete or partial restoration of heel shape. Significant residual pain was seen in only 1 (2.38 %) patient. 36 patients (85.71 %) had excellent outcome 5 patients (11.90%) had good and 1 patient (2.38%) had satisfactory outcome<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> The management of intra-articular calcaneal fracture by open reduction and bone grafting without any implants give good results with excellent functional outcome. Since no implants are used in this technique this can be a preferable procedure in rural areas and in patients with low socioeconomic status<span lang="EN-IN">.</span></p><p class="abstract"> </p>
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