Aim: To assess the efficiency of intra-articular platelet-rich plasma (PRP) injection in grade I and grade II osteoarthritis in the knee joints Study design: A longitudinal study Place and Duration: This study was conducted at Murshid Hospital and Health Care Center Karachi Pakistan from January 2021 to June 2021. Methodology: The ages of the patients were between 35 years and 65 years. All the patients were diagnosed with osteoarthritis of grade I and grade II. A total of 3 injections of PRP were injected intraarticular in the knees at an interval of 4 weeks. Patients were asked to come for a follow-up in the outpatient department. They were assessed for physical mobility and pain related to arthritis using the WOMAC score. The assessment was done when the treatment was given and after 6 months. Results: A total of 250 patients were considered in the present study. The mean age of the patients was 55.63±5.65 years. The ratio of disease in females to males was 3:1. A total of 178 patients had grade I osteoarthritis and 72 patients had grade II osteoarthritis according to Kellgren–Lawrence classification. A total of 210 patients had reported experiencing symptoms for less than 2 years and the remaining 40 had been experiencing the symptoms for more than 2 years. The mean WOMAC score was 82.9 before the treatment was started and it was 39.15 after 6 months of the treatment. The improvement of WOMAC score was more in the patients having symptoms for less than 2 years. Minor hyperemia was seen in 4 patients and those patients were managed conservatively by ice application and activity limitation. None of the patients showed signs of infection. Conclusion: The intraarticular injection of PRP proved to be beneficial and effective in the treatment of grade I and grade II early osteoarthritis. Keywords: Osteoarthritis, Platelet-rich plasma, PRP, knee joint
A total of 10% of all bone fractures are found in the ankle, making it the most often broken bone in the body. Objective: To assess the outcome and the pattern of bimalleolar ankle fractures in adults. Methods: A total of 72 individuals with bimalleolar ankle fractures were recruited in this study and followed up for a total of 12 weeks. An evaluation of the results after 12 weeks was done using the American Orthopedic Foot and Ankle Score & the Visual Analog Pain Scale. The amount of discomfort, functional ability, and alignment were the three key indicators of the results. Results: The average age of the patients was 36.4 10.4 years, ranging from 19 to 60 years. There were 3:2 more men than women. Half of the fractures were due to falls, 36.1% by automobile accidents, and 13.9% by motorcycle accidents. Of the cases, 63.9 percent included closed fractures. According to the Weber classification, B and C fractures were the most frequent, occurring in 33 (45.8%) and 31 (43.1%) individuals, respectively. The mean AOFAS at three months was 78.2. Between 1 and 3, the VAS was 43.1%. 38.8% of the patients, or 28, reported no discomfort. Conclusions: Patients tended to be young in this study. Delaying final care for up to a week after a fracture does not seem to have a negative impact on the result. The medial clean space (less than 4mm) was the primary indicator of a successful result.
Objective: The present study aims at the assessment of the radiological union and clinical outcomes of scaphoid fracture followed by fixation by Herbert Screw. Study design: A cross-sectional study Place and Duration: This study was conducted Muhammad Medical College and Hospital Mirpurkhas from may 2021 to may 2022 Methodology: A total of 20 patients were included in the study and all of them had sustained a scaphoid fracture. All of them were treated with Herbert screw fixation. Overall 18 of them were male and 2 were female. Serial radiographs were obtained for the assessment of union and the Modified Mayo wrist scoring (MMWS) system was used for the assessment of functional outcomes. The patients were called after 6 months of surgery for a follow-up visit. A total of 9 (45%) patients were treated within the first week of the injury. Overall 5 (25%) were treated in two weeks and 6 (30%) were treated in 2 to 4 weeks Results: Out of 20 patients included in the study, 17 had fractured at the waist of the scaphoid and the remaining 3 had sustained fractures at the proximal pole of the scaphoid. The dorsal and volar approach of fixation by Herbert Screw was used for treating all the fractures. A good alignment was observed post-operatively. Out of all the 20 patients, 12 (60%) patients showed excellent outcomes with a full range motion of the wrist, 6 (30%) had shown good results, and 2 (10%) showed poor results. A final follow-up was arranged during the sixth month of treatment and 18 (90%) patients showed adequate radiological union. Conclusion: Fixation of scaphoid fracture with a Herbert Screw in a convenient and effective mode of treatment which has shown excellent functional outcomes and exceptionally reduced complications. Keywords: Herbert Screw, Fixation, Functional outcomes, Scaphoid fracture
Aim: To determine the causes and treatment of birth trauma related femoral fractures. Study design: A longitudinal study Place and Duration: This study was conducted at DIMC, Dow University of Health Sciences, Karachi from January2021 to January 2022. Methodology:The study included cases of femoral fractures in neonates caused by birth trauma. The cases of birth histories were investigated in terms of gestational age, birth weight,and mode of delivery. The category of femoral fracturesand the treatment performed were both noted. Cases were followed until they were recovered.A comprehensive clinical examination was performed. Other birth traumas, fractures, nerve palsies, and/or symptoms of other musculoskeletal, genetic diseases, such as blue sclera and hypermobile joints (osteogenesis imperfecta), were noted. Results:A total of 15 newborns with femoral fractures were included in this study.The average gestational age was 38.2 weeks, with an average diagnosis time of 3 days. In the majority of cases, the infant was born breech and delivered via Caesarean section. Eleven instances had mid-shaft fractures, while four had subtrochanteric fractures. After an average of 3.1 weeks, all patients had a complete union. Conclusion:A femoral fracture in a neonate due to birth related trauma is quite uncommon. It occurs more frequently in Caesarean sections performed for breech presentation. Preterm and/or low birth weight newborns are at a higher risk. The femur shaft is commonly fractured. The prognosis for these fractures is excellent, and they heal completely after immobilization. Keywords: Birth Trauma, Femoral Fracture, Management, Risk Factors
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