Neeraj Garg - Academia.edu (original) (raw)
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Papers by Neeraj Garg
Skeletal Radiology, 2003
Objective To design a reproducible method to measure femoral anteversion in children under 1 year... more Objective To design a reproducible method to measure femoral anteversion in children under 1 year old. Design and patients We conducted a prospective, observational study to determine intra- and inter-observer reproducibility of the sonographic measurement of femoral anteversion in infants. The method involves imaging of the proximal femur using a vertical transducer with the infant in the lateral position. Anterior femoral anteversion is measured using a vertical baseline and a line tangential to the anterior femoral head and the trochanter (anterior anteversion). We similarly measured true femoral anteversion using a line passing through the centre of the femoral head and the femoral neck (true anteversion). Anteversion measurements were taken at the time of routine ultrasound screening for developmental dysplasia of the hip when infants were an average of 10.4 weeks old. Anteversion measurements were made in 74 hips (37 infants). Results Our results showed that for the anterior anteversion measurements intra-observer repeatability was ±6.2° and inter-observer repeatability was ±7.8°. For true anteversion measurements intra-observer repeatability was ±9.5°, but inter-observer repeatability was ±23.5°. Conclusions Our results have shown that our method for measuring "anterior femoral anteversion" has an acceptable level of inter- and intra-observer agreement. The method used to determine "true anteversion", however, proved to have an unacceptable level of inter-observer variability.
Skeletal Radiology, 2000
Objective. To investigate whether the injection of Ethibloc into aneurysmal bone cysts can be an ... more Objective. To investigate whether the injection of Ethibloc into aneurysmal bone cysts can be an effective treatment modality. Design and patients.Ethibloc is an alcoholic solution of zein (corn protein) which has thrombogenic and fibrogenic properties. Ten patients with aneurysmal bone cysts were treated with CT-guided percutaneous injection of Ethibloc into the cyst cavity. Ethibloc injection was the primary treatment in five patients. Four patients had recurrence following previous curettage and bone grafting and one patient had not responded to injection into the lesion of autologous iliac crest bone marrow aspirate. Three patients needed a second injection. The median follow-up was 27 (6–60) months. Results and conclusion.Symptoms were relieved in all patients. At imaging, seven patients had resolution of the lesion and three had partial response at the most recent follow-up. Complications consisted of a local transitory inflammatory reaction in two patients and an aseptic abscess in one patient. This relatively simple, minimally invasive procedure makes an operation unnecessary by stopping the expansion of the cyst and inducing endosteal new bone formation. This technique may be used as the primary management of aneurysmal bone cysts excluding spinal lesions.
Archives of Orthopaedic and Trauma Surgery, 2007
Ignacio Ponseti in 1950, pioneered a method of treating congenital idiopathic clubfoot by using m... more Ignacio Ponseti in 1950, pioneered a method of treating congenital idiopathic clubfoot by using manipulation and casting followed by percutaneous tenotomy of tendoachillis to correct residual equines [1, 2]. The main reasons for failure of this treatment method ...
Journal of Trauma-injury Infection and Critical Care, 2008
The majority of the pediatric diaphyseal forearm fractures are treated with closed reduction and ... more The majority of the pediatric diaphyseal forearm fractures are treated with closed reduction and the application of an above elbow cast for a varying period, depending on the age of the child. Some forearm diaphyseal fractures require osteosynthesis mainly because of the presence of an unacceptable angular deformity, fracture instability, presence of an open injury or failure of conservative management in the form of redisplacement in the cast after manipulation. We present our experience with elastic stable intramedullary nailing (ESIN) for displaced and unstable pediatric diaphyseal fractures. A consecutive series of 21 patients treated with ESIN between 1997 and 2005 have been reviewed retrospectively. There were 14 boys and 7 girls with a median age of 11.8 years. All fixations were protected in an above elbow plaster cast. Patients were followed up for an average of 12.8 months (Range, 12-21.5 months). Clinical and radiologic union was achieved within 13 weeks after the procedure in 19 children. One patient had delayed union of the ulna which finally united at 9 months after operation without any further intervention. Another patient had nonunion of ulna that required autologous bone marrow injection after 1 year before full consolidation occurred. Complications were all modest and transient and eventually all patients achieved a good functional clinical outcome. We think that the technique has many merits over a more traditional plating technique including a minimally invasive technique, a less time consuming procedure and easier metal work removal. We think that cosmesis is perhaps the most important to our patients because the wounds are small and less conspicuous than the traditional Henry approach for plating which leaves a long unsightly volar forearm scar. We think that ESIN is an attractive treatment option for displaced and unstable diaphyseal forearm fractures in children.
Skeletal Radiology, 2003
Objective To design a reproducible method to measure femoral anteversion in children under 1 year... more Objective To design a reproducible method to measure femoral anteversion in children under 1 year old. Design and patients We conducted a prospective, observational study to determine intra- and inter-observer reproducibility of the sonographic measurement of femoral anteversion in infants. The method involves imaging of the proximal femur using a vertical transducer with the infant in the lateral position. Anterior femoral anteversion is measured using a vertical baseline and a line tangential to the anterior femoral head and the trochanter (anterior anteversion). We similarly measured true femoral anteversion using a line passing through the centre of the femoral head and the femoral neck (true anteversion). Anteversion measurements were taken at the time of routine ultrasound screening for developmental dysplasia of the hip when infants were an average of 10.4 weeks old. Anteversion measurements were made in 74 hips (37 infants). Results Our results showed that for the anterior anteversion measurements intra-observer repeatability was ±6.2° and inter-observer repeatability was ±7.8°. For true anteversion measurements intra-observer repeatability was ±9.5°, but inter-observer repeatability was ±23.5°. Conclusions Our results have shown that our method for measuring "anterior femoral anteversion" has an acceptable level of inter- and intra-observer agreement. The method used to determine "true anteversion", however, proved to have an unacceptable level of inter-observer variability.
Skeletal Radiology, 2000
Objective. To investigate whether the injection of Ethibloc into aneurysmal bone cysts can be an ... more Objective. To investigate whether the injection of Ethibloc into aneurysmal bone cysts can be an effective treatment modality. Design and patients.Ethibloc is an alcoholic solution of zein (corn protein) which has thrombogenic and fibrogenic properties. Ten patients with aneurysmal bone cysts were treated with CT-guided percutaneous injection of Ethibloc into the cyst cavity. Ethibloc injection was the primary treatment in five patients. Four patients had recurrence following previous curettage and bone grafting and one patient had not responded to injection into the lesion of autologous iliac crest bone marrow aspirate. Three patients needed a second injection. The median follow-up was 27 (6–60) months. Results and conclusion.Symptoms were relieved in all patients. At imaging, seven patients had resolution of the lesion and three had partial response at the most recent follow-up. Complications consisted of a local transitory inflammatory reaction in two patients and an aseptic abscess in one patient. This relatively simple, minimally invasive procedure makes an operation unnecessary by stopping the expansion of the cyst and inducing endosteal new bone formation. This technique may be used as the primary management of aneurysmal bone cysts excluding spinal lesions.
Archives of Orthopaedic and Trauma Surgery, 2007
Ignacio Ponseti in 1950, pioneered a method of treating congenital idiopathic clubfoot by using m... more Ignacio Ponseti in 1950, pioneered a method of treating congenital idiopathic clubfoot by using manipulation and casting followed by percutaneous tenotomy of tendoachillis to correct residual equines [1, 2]. The main reasons for failure of this treatment method ...
Journal of Trauma-injury Infection and Critical Care, 2008
The majority of the pediatric diaphyseal forearm fractures are treated with closed reduction and ... more The majority of the pediatric diaphyseal forearm fractures are treated with closed reduction and the application of an above elbow cast for a varying period, depending on the age of the child. Some forearm diaphyseal fractures require osteosynthesis mainly because of the presence of an unacceptable angular deformity, fracture instability, presence of an open injury or failure of conservative management in the form of redisplacement in the cast after manipulation. We present our experience with elastic stable intramedullary nailing (ESIN) for displaced and unstable pediatric diaphyseal fractures. A consecutive series of 21 patients treated with ESIN between 1997 and 2005 have been reviewed retrospectively. There were 14 boys and 7 girls with a median age of 11.8 years. All fixations were protected in an above elbow plaster cast. Patients were followed up for an average of 12.8 months (Range, 12-21.5 months). Clinical and radiologic union was achieved within 13 weeks after the procedure in 19 children. One patient had delayed union of the ulna which finally united at 9 months after operation without any further intervention. Another patient had nonunion of ulna that required autologous bone marrow injection after 1 year before full consolidation occurred. Complications were all modest and transient and eventually all patients achieved a good functional clinical outcome. We think that the technique has many merits over a more traditional plating technique including a minimally invasive technique, a less time consuming procedure and easier metal work removal. We think that cosmesis is perhaps the most important to our patients because the wounds are small and less conspicuous than the traditional Henry approach for plating which leaves a long unsightly volar forearm scar. We think that ESIN is an attractive treatment option for displaced and unstable diaphyseal forearm fractures in children.