Amit Nemade - Academia.edu (original) (raw)

Papers by Amit Nemade

Aim: Parents of children affected with idiopathic clubfoot are anxious that motor development sho... more Aim: Parents of children affected with idiopathic clubfoot are anxious that motor development should progress normally. Treatment using Ponseti method involves cast immobilization, bracing, and tenotomy which inhibit the normal movement, thereby increasing parental concern. The purpose of this study was to evaluate the age at which independent walking was established in infants with idiopathic clubfoot treated using Ponseti method. Materials and Methods: There were 70 patients in this prospective longitudinal study. All subjects were full term at birth, less than <12 weeks of age at the initiation of treatment for clubfoot, and no prior outside treatment had been provided. Patients were treated using the Ponseti method. The children were evaluated prospectively for the commencement of independent walking. Results: The mean age at which independent walking started was 13.64 ± 2.74 months (9 months–22 months). About Fifty percent50% of the affected children were walking by the age ...

Traumatic antero inferior dislocations of hip a relatively rare injuries, diagnosed and managed i... more Traumatic antero inferior dislocations of hip a relatively rare injuries, diagnosed and managed in an acute setting. Usually this injury is managed acutely. Late presentation is rarely seen, but can be seen in multiple injured patients. We report a case of 4 month old, traumatic, unreduced, anterior dislocation (obturator) of right hip in a 40 yr old male. After a failed closed reduction, concentric open reduction was achieved leaving the patient with a painless functional hip after 4 years without evidence of avascular necrosis of femoral head. We conclude that although rare such injuries should be looked for in patients complaining of hip pain and even in case of late presentation good clinical outcome can be expected in patients without femoral head fractures.

Global journal for research analysis, 2018

Fractures in the distal tibial metaphysis are more complicated to treat than diaphyseal fractures... more Fractures in the distal tibial metaphysis are more complicated to treat than diaphyseal fractures. The treatment of distal metaphyseal tibial fractures remains controversial. This retrospective study was performed in a rural set up to review the outcomes of distal tibial metaphyseal fractures by locked intramedullary nailing and its outcome in rural setup.

Journal of Foot and Ankle Surgery (Asia Pacific), 2015

Achilles tendon is the strongest and the thickest tendon of the human body. Due to its superficia... more Achilles tendon is the strongest and the thickest tendon of the human body. Due to its superficial location and stress, it has to face due to loading, the tendon is susceptible to injuries and ruptures. This is aggravated due to the precarious blood supply in the region and also age-related changes that occur in the tendon. Of the specific causes age-related and steroid induced tendinosis and sports injuries are the commonest mechanism of injury. Kite playing is a very common sport in the Indian subcontinent, which involves the use of a string (manja) often coated with powdered glass to fly the kite. Many grievous injuries are reported due to its use especially in two wheeler riders. However, to the best of our knowledge a kite thread injury causing Achilles tendon tear due to direct impact has so far not been reported. In this case series, we describe two cases that had such injury and a brief note on specifics of management of this case is described. How to cite this article Bagar...

$Research paper thumbnail of A proposed radiological classification system of Hoffa’s fracture based on fracture configuration and consequent optimal treatment strategy along with the review of literature$

SICOT-J, 2019

Background: Coronal fractures of distal end femur, referred as Hoffa’s fracture are not uncommon,... more Background: Coronal fractures of distal end femur, referred as Hoffa’s fracture are not uncommon, yet easily missed injuries lacking proper classification system and consensus for ideal treatment. While most trauma surgeons adopt different strategies based on the fracture configuration and their own experience, there are no set ways to classify these based on the most appropriate treatment strategy. Methods: Thirty cases of Hoffa fracture from tertiary care centres were studied for the fracture pattern, fragment size, comminution and possible variations to formulate a radiological classification and treatment guidelines. Additionally, a literature search was used to analyze 77 case studies based on Hoffa fracture to find out the common fracture patterns and treatment modalities adopted for varying fracture patterns in these studies. Six independent observers participated in testing the inter-observer reliability of the proposed classification. Results: A new proposed radiological cl...

$Research paper thumbnail of Extra-articular distal tibial fractures, is interlocking nailing an option? A prospective study of 147 cases$

Chinese Journal of Traumatology, 2019

Distal tibia fractures comprise about 7%e10% of lower extremity trauma. Because of the peculiarit... more Distal tibia fractures comprise about 7%e10% of lower extremity trauma. Because of the peculiarity of the soft tissue and subcutaneous location of the bone there are many controversies in the ideal treatment of distal tibia fractures especially extra articular pilon fractures. Plating is fraught with complications of wound dehiscence and infection. There are limited studies which document outcomes in such cases using intramedullary interlocking nail. We intend to study the outcome and complications of extra articular distal tibial fractures treated with interlocking nailing. Methods: This is a prospective study conducted in a tertiary care orthopaedic hospital in southern India. There are 147 patients of distal tibia extra-articular fractures managed by IM nailing with follow up of more than one year were included in this study. Only cases with fresh injury (less than 1 week), fracture below the isthmus, closed and open Gustilo Anderson type 1 and 2 fractures were included in the study. Patients were reviewed at 3, 6, 12 and 24 weeks after surgery and thereafter at one year and were assessed for clinical and radiological signs of healing, any complications, time to union and functional outcome. Results: There were 102 males and 45 females (male/female ratio is 2.3:1) with a mean age of 38.96 (range 23e65) years. According to AO classification, there were 78 cases (53.06%) of 43-A1, 39 cases (26.53%) of 43-A2 and 30 cases of 43-A3 constituting 20.40%. The fracture united in all the patients at an average of 18 weeks (range 16e22 weeks), none of the patient in our series had a delayed or nonunion. Two patients (1.47%) had the fracture united in mild valgus but it was well within the acceptable limits (<5). The functional outcome was assessed in all the patients at final follow up using Olerud and Molander score all the patients fared an excellent to good score, there were no cases with poor score. Conclusion: Intramedullary nailing is a viable option to treat distal tibial fractures with excellent outcome. Wound complications related to plating can be avoided but meticulous surgical technique is key to avoid malunion.

World Journal of Orthopedics, 2017

Treatment paradigms for Early Onset Scoliosis have changed from fusion to fusionless methods as t... more Treatment paradigms for Early Onset Scoliosis have changed from fusion to fusionless methods as the harmful effects of early fusion on the growing spine and thorax were realized. Magnetic rods are a recent addition to fusionless technology for controlling scoliosis in a growing spine. The clinical evidence base on magnet driven growth rods (MDGR) has accumulated over the last 4 years. It has implications for reduction in the number of repeat surgeries required with similar complications as the traditional growth rods (TGR) and at a higher initial cost. However in terms of patient psyche and avoidance of repeat surgeries which are necessary with the TGR, MDGR treatment works out less expensive in the long run with definitely better patient comfort. The authors look at the available literature coupled with their own experience to discuss the current status, limitations and future prospects for this type of technology.

Journal of orthopaedic case reports

Primary synovial osteo chondromatosis (PSOC) is chondroid metaplasia with multi¬nodular prolifera... more Primary synovial osteo chondromatosis (PSOC) is chondroid metaplasia with multi¬nodular proliferation of the synovial lining of a diarthrodial joint, bursa, or tendon sheath. It usually occurs in third-fifth decade and shoulder joint involvement is infrequent. It is very rare in children and primary extraarticular PSOC of the shoulder has been reported very rarely in children. We present a case of primary PSOC of the long head of biceps in 8year child. It presented as painful swelling in proximal arm. The pain radiograph was showing multiple calcified loose bodies on anteromedial aspect of humerus. MRI scan showed fluid filled cysts with calcified wall. The lesion was excised through deltopectoral approach. He had complete resolution of symptoms without recurrence at 1 year.The diagnosis was confirmed on histopathological examination. We want to emphasize that one should keep a differential diagnosis of this rare condition in patients presenting with cystic swelling with calcified w...

Current Orthopaedic Practice, 2017

The treatment of early onset scoliosis has improved with recent advances in the last ten years. T... more The treatment of early onset scoliosis has improved with recent advances in the last ten years. The purpose of this review was to provide the reader with a brief description of the new therapeutic modalities, their indications, and outcomes. In children with a progressive curve that is less than 60 degrees and in whom no surgical treatment has been performed, derotational bracing may be considered; however, the role of bracing is mostly limited to maintenance of correction after surgery. Dual growing rods appear to afford better correction initially, maintenance of correction, increased T1-S1 length, and decreased implant-related issues. However, complication rates remain problematic with younger children, children with neuromuscular disorders or syndromes, and children with a greater degree of curvature having the highest rates. Patient heterogeneity and short follow-up after surgery largely explain the subjectivity of surgical decisions that are not reproducible.

Journal of Orthopaedics and Allied Sciences, 2015

Gluteal compartment is a rare site for compartment syndrome. Gluteal compartment syndrome has mos... more Gluteal compartment is a rare site for compartment syndrome. Gluteal compartment syndrome has most commonly been described in the literature as occurring after prolonged immobility associated with substance abuse, improper operative positioning, sickle cell-induced infarct, post-traumatic and spontaneous superior gluteal artery rupture, exercise, and post-arterial embolization of the internal iliac artery prior to abdominal aortic aneurysm repair. Trauma is rarely associated with this syndrome. Gluteal compartment syndrome occurs in approximately 0.9% of trauma patients. Posttraumatic gluteal compartment syndrome develops because of edema with traumatic contusions, crush injuries and hematoma formation due to blunt superior or inferior gluteal artery injuries in all compartments of the gluteal region Only 6 previous cases have been reported in the literature. Two previous cases involved positioning for urological procedures, while the other cited causes of bilateral gluteal compartment syndrome include exercise-induced, trauma, and prolonged immobilization from substance abuse. One of the most immediately devastating results of a missed compartment syndrome is the risk of the development of rhabdomyolysis with the resulting squeal of myoglobinuria, hyperkalemia, and acidosis resulting in renal failure, shock, multiple organ failure, disseminated intravascular coagulation, and possibly death. Here we report a case of posttraumatic bilateral compartment syndrome which developed secondary to pressure due to patient being trapped under a vehicle following a vehicular accident. He was operated upon and a bilateral fasciotomy was done. Although he did not develop any renal complications, the sciatic nerve palsy on the left side did not recover. The patient is still under follow up.

Journal of Surgical Technique and Case Report, 2013

Journal of Pediatric Orthopaedics B, 2012

Hip dislocation is a serious but rarely reported complication of femoral lengthening in congenita... more Hip dislocation is a serious but rarely reported complication of femoral lengthening in congenital short femora. We report a retrospective series of three hip dislocations that occurred during lengthening, analyze the factors contributing to the dislocation, and discuss the treatment of this difficult problem. The average lengthening achieved was 9 cm. We found progressive acetabular dysplasia and decreasing center edge angle. Closed reduction failed. Treatment included soft tissue release, open reduction with femoral shortening, and acetabular procedures. At a mean follow-up of 4.4 years, two patients had a good modified Mckay score and a modified Severin score of 3. Excessive lengthening should be avoided.