Dr.santosh kumar sahu | Soa University,Bhubaneswar,India (original) (raw)

Papers by Dr.santosh kumar sahu

Al-Kindy, 2023

Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been... more Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been documented as a standalone anatomical entity or, more frequently, in conjunction with other congenital anomalies. Surgical treatment for this patient population has only been reported in very few cases. In this article, we share our experience in managing a case of unilateral congenital deficiency of anterior cruciate ligament (ACL) in a 13 years old female patient by physeal sparing arthroscopic ACL reconstruction, using All-inside technique.

Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been... more Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been documented as a standalone anatomical entity or, more frequently, in conjunction with other congenital anomalies. Surgical treatment for this patient population has only been reported in very few cases. In this article, we share our experience in managing a case of unilateral congenital deficiency of anterior cruciate ligament (ACL) in a 13 years old female patient by physeal sparing arthroscopic ACL reconstruction, using All-inside technique.

Isolated osteomyelitis of the cuboid is a rare entity with very few case reports worldwide. A var... more Isolated osteomyelitis of the cuboid is a rare entity with very few case reports worldwide. A variety of treatment methods are described for these lesions, both single-stage and two staged and ranges from simple curettage to bone grafting and arthrodesis. Case Report: We present a series of two cases of chronic osteomyelitis in young adults due to puncture wound over the lateral foot. Both patients presented with purulent discharge from sinus over lateral foot. There was no involvement of adjoining bones in them. Culture yielded Staphylococcus aureus and Pseudomonas aeruginosa. Both patients were treated with adequate curetting, saucerization with cancellous bone grafting in one of the cases. Both wounds healed uneventfully with good ankle and hindfoot function. Conclusion: The cuboid is a rare site of chronic osteomyelitis due to punture wounds with foreign bodies, especially in rural population. With meticulous curettage and bone grafting, the infection can be eradicated reliably and usually with good residual function.

Pain is believed to be a poorly understood phenomenon, which is mostly regulated by neural, cellu... more Pain is believed to be a poorly understood phenomenon, which is mostly regulated by neural, cellular, hormonal & emotional components. Epidural analgesia is used for pain relief in patients undergoing primary total knee arthroplasty, though provides good pain control, many a time is associated with side effects such as hypotension, urinary retention and impaired mobility. The purpose of the current study is to compare the efficacy of ACB to local infiltration of analgesics by Intraarticular Epidural Catheter for primary total knee arthroplasty by comparing visual analog scale, knee flexion, and active SLRT on the day of surgery (POD-0), POD1-3, day of discharge, and 4 weeks after surgery. This study is prospectively randomized, the cases undergoing primary knee replacement were divided into two groups, which includes a minimum of 36 cases in each group.Group-1(36) patients received local infiltration of analgesics via IAECand Group-2(36) patients received single shot ACB. As far as age, sex, BMI(kg/m2), pre-op VAS, mean pre-op flexion, mean pre-operative varus, mean preop KSS(Knee society score), duration of surgery and hospital stay is concerned no significant difference was noticed between the two groups.Group-1(LIA via IAEC) had significantly lower VAS on a postoperative day (POD) 1-3, lower tramadol consumption, better ROM (atPOD1-3), superior quadriceps recovery(active SLRT), earlier mobilization day, better KSS (at 4weeks) postoperatively, compared to Group-2(single shot ACB).LIAby IAEC for patients undergoing primary TKA is a better option compared to single shot ACB concerning to pain levels, narcotic usage, range of motion, quadriceps recovery and KSS (Knee society score).

Acetabular fracture fixation , 2024

Context: Acetabulum fractures are commonly a result of high-velocity road traffic accidents and f... more Context: Acetabulum fractures are commonly a result of high-velocity road traffic accidents and falls from height. These fractures were previously treated nonoperatively which had led to high morbidity causing secondary osteoarthritis, limping, instability, and chronic pain. Aims: To surgically manage the functional outcome of acetabular fractures. Settings and Design: The prospective study involves 28 patients of a tertiary care hospital at Bhubaneswar, for analysis of functional and radiological outcomes of surgical management of acetabular fractures. Subjects and Methods: Patients are chosen from emergency and outpatient on the criteria of age group 18-65 years, pelvi-acetabular fractures of 2-mm displacement, more than 3-week-old fracture, with or without hip dislocation. Inflammatory arthritis and pathological fractures patients were excluded. Surgery time was 173 min with a minimum of 110 min and a maximum of 240 min. Statistical Analysis Used: All the data were analyzed using SPSS 20 software. Results: Twelve patients had excellent (42%), seven patients had well (25%), seven patients had fair (25%), and two patients had poor (8%) functional outcomes. Two patients had restricted range of movement and pain on walking and had undergone total hip replacement after 1 year. The mean score in the anatomically reduced fracture is 16.4, imperfectly reduced is 14.4, and poorly reduced is 8. The average functional outcome score was 14.2 (range-5-18). Conclusions: As the articular surface requires smooth congruity, anatomical fixation of fracture fragments is essential for early mobilization and better functional outcomes. Proper preoperative planning, anatomical reduction, adequate fixation, and early mobilization are required to achieve good functional outcomes in acetabular fractures.

Endoscopic spine surgery , 2024

Грижа міжхребцевого диска попереку є поширеним захворюванням. Виникає сильний біль у ділянці сідн... more Грижа міжхребцевого диска попереку є поширеним захворюванням. Виникає сильний біль у ділянці сідниці та в нозі, який зникає протягом 6 тижнів за умов консервативного лікування. Наразі існує декілька хірургічних методик лікування гриж поперекового диска, починаючи від ламінектомії до мікродискектомії. Основні переваги ендоскопічної дискектомії включають: косметичну привабливість, мінімально інвазивний характер, кращу візуалізацію, менший термін госпіталізації та більш швидке одужання. Мета. Розглянуто спостереження за пацієнтами з дегенеративними захворюваннями поперекового відділу хребта за допомогою системи Дестандау. Автори діляться досвідом техніки хірургічного втручання та результатами черезшкірної ендоскопічної дискектомії за системою Дестандау під час лікування 51 пацієнта з грижею диска та стенозом каналу поперекового відділу хребта. Основні переваги ендоспічної системи Дестандауце невеликий розріз шкіри та мінімальне ушкодження м'яких тканин. Це малоінвазивне втручання, яке застосовують через розріз шкіри 1,5-2 см завдовжки. Із метою забезпечення точності й безпеки пацієнта як перед операцією, так під час неї застосовується рентгенівське обладнання. Під контролем ендоскопа видаляють грижу міжхребцевого диска, вільні фрагменти диска та звільняють затиснений нерв. Таким чином досягають швидкого відновлення під час післяопераційної реабілітації. Висновки. Ендоскопічна система може бути використаною для лікування всіх видів гриж міжхребцевих дисків і супутнього стенозу каналу. Це відносно безпечна процедура за умови правильного передопераційного планування та досвіченої команди лікарів. Більшість поперекових патологій, які є не повʼязані з нестабільністю, можуть бути успішно вирішені за її допомогою. Дві основні переваги ендоспинальної системи Дестандау включать малоінвазивну хірургію з мінімальним ятрогенним ушкодженням і відмінній ефективності. У разі її успішного застосування, процес відновлення значно скорочується, без будь-яких обмежень для повернення до повсякденного життя. Ключові слова. Дестандау, ендоскопія, хребет, поперековий відділ.

Journal of Evidence Based Medicine and Healthcare, Jun 15, 2015

We here with present a case of osteochondroma arising from the spinous process of L2, L3, L4 vert... more We here with present a case of osteochondroma arising from the spinous process of L2, L3, L4 vertebrae (Rt. Side) in a 28 years old male, labourer by profession presented to our hospital OPD on 08/11/2012 with chief complaint of progressive swelling over the Rt. paraspinal area of lumbar spine for last 1yr. Pain and swelling were gradually increasing. There was no h/ofever, cough or weight loss or urinary complaints or any sensory or motor involvement. X-ray showed increased density solitary mass at lumbar region (L2, L3, L4). MR imaging showed it to be contiguous with the spinous process of lumbarvertebrae-L2, L3, L4 suggesting the diagnosis of osteochondroma, a rare presentation without cord compression, and distinguishing the lesion from a calcified disk fragment. After thorough investigation we have excised the tumor and sent for histopathological examination. No residual deficit was found post-operatively. Patient was relieved of the symptoms and is now under follow-up.

International Journal of Orthopaedics Sciences, 2019

Background: Among the Health care associated infections (HAI), orthopaedic surgical site infectio... more Background: Among the Health care associated infections (HAI), orthopaedic surgical site infections (OSSI) previously termed as post-operative wound infections are one of the most common HAI in low and middle income countries. Increase in OSSI is associated with increased morbidity, as well as mortality due to emergence of antimicrobial resistant pathogens. Understanding the pathogens implicated in causing the OSSIs and their antimicrobial sensitivity place a good role in reducing the mortality and morbidity. Methods: A prospective study was conducted at a tertiary care hospital to all the patients admitted in Department of Orthopaedics for 2 years from January 2017 to December 2018. The demographic data, inclusion criteria and exclusion criteria, risk factors, clinical history, laboratory data with gram stain, culture results and antibiotic sensitivity of the isolates were collected. Results: Two hundred patients were recruited in the study and the prevalence of OSSI in the study was 3.83%. Patients who underwent emergency operations and diabetics were at higher risk of acquiring OSSI. The most commonly isolated pathogens in the study were Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Pseudomonas aeruginosa was most common isolate from orthopaedic cases of OSSI. Conclusions: Study clearly explains the various causes and risk factors associated in development of OSSI. The study guides in the type of the organism isolated and possible antibiotic of choice in treatment and management of OSSI. The prevalence of OSSI was 3.83%, which is comparable with some of the studies and lower than many of the studies.

Introduction: Pigmented villonodular synovitis (PVNS)is a very uncommon lesion that involves the ... more Introduction: Pigmented villonodular synovitis (PVNS)is a very uncommon lesion that involves the synovium of joints, tendon sheaths, or bursae. Approximately 2.5% of cases occur around the ankle. PVNS was earlier considered to be a synovial malignancy. Complete surgical excision is curative if bony destruction is not there. Radiotherapy is rarely helpful for residual lesions. Case Report: We share a case report on PVNS of ankle in a 22-years old male patient. Clinical diagnosis was confirmed with the help of magnetic resonance imaging and histopathology. A surgical excision with synovectomy was carried out. There were no signs of recurrence in 1.5 years follow-up. Conclusion: Complete surgical excision with radical synovectomy is crucial for the treatment of PVNS in rare locations like the ankle joint.

Congenital absence of ACL, 2023

Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been... more Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been documented as a standalone anatomical entity or, more frequently, in conjunction with other congenital anomalies. Surgical treatment for this patient population has only been reported in very few cases. In this article, we share our experience in managing a case of unilateral congenital deficiency of anterior cruciate ligament (ACL) in a 13 years old female patient by physeal sparing arthroscopic ACL reconstruction, using All-inside technique.

The incidence of the hip fracture has been rising with an aging population in many parts of the w... more The incidence of the hip fracture has been rising with an aging population in many parts of the world. Growing number of population and the road traffic accidents have resulted in an enormous increase in these types of fractures. In younger patients the fractures usually result from high energy trauma like RTA and fall from height and accounts for only 10%. Older patients suffering from a minor fall can sustain fracture in this area because of weakened bone due to osteoporosis or pathological fracture and these accounts for 90%. Surgical management of trochanteric fractures aims at restoring the pre-fracture functional status of patients as far as ambulatory skills are concerned. A variety of implants of internal fixation have been employed to achieve this goal with variable success. The diversity of fixation devices available for treatment of trochanteric fractures illustrates the difficulties encountered for fixation, and the discussion about ideal implant for such cases continues...

International Journal of Orthopaedics Sciences, 2016

The best treatment for scaphoid nonunion fractures is still controversial. The objective of this ... more The best treatment for scaphoid nonunion fractures is still controversial. The objective of this article is to report our clinical experience in the treatment of patients with scaphoid fracture with delayed union or non-union with minimal sclerosis using percutaneous cancellous bone graft and Herbert’s screw and to study the functional outcome with an average of one year follow-up. We reviewed 35 patients treated with percutaneous cancellous bone graft and Herbert’s screw fixation from October 2012 to January 2016. Preoperative clinical manifestations and postoperative results were assessed by radiography, and functional results, including grip force, range of motion of the wrist joint, and Cooney’s scoring chart, were evaluated. The union rate was 91.42%. The average grip power, as well as wrist flexion and extension were significantly improved. Using Cooney’s scoring system, 28(80%) patients were rated excellent and 4(11.42%) good. For successful union, anatomical reduction with c...

International Journal of Orthopaedics Sciences, 2019

Neer Group (IV-VI) Proximal humeral fractures often are related to persistent disability despite ... more Neer Group (IV-VI) Proximal humeral fractures often are related to persistent disability despite surgical treatment. The optimal surgical management of theses fractures in elderly patients remains unclear. We retrospectively compared the outcome after open reduction and internal fixation with the PHILOS and primary hemiarthroplasty in patients with Neer Group IV-VI fractures focusing on Speed of recovery, shoulder function, health-related quality of life, and complications.

Journal of Evidence Based Medicine and Healthcare, 2015

We here with present a case of post-traumatic fracture non-union of proximal humerus with comprom... more We here with present a case of post-traumatic fracture non-union of proximal humerus with compromised rotator cuff in a 50 yrs old retired BSF jawan, who presented to our OPD with a chief complaint of pain, decreased ROM of rt.shoulder. He had an h/o previous injury following RTA on 16/2/2012 & was treated with ORIF on 25/2/2012. X-ray shows fracture nonunion of proximal humerus with migration of humeral head relative to glenoid in superior direction, also there is acetabularisation of acromion & femoralisation of proximal humerus. MRI shows compromised rotator cuff. Both x-ray & MRI are suggestive of rotator cuff arthropathy. After, thorough investigations &rulling out any other associated co-morbidities, pre-operative planning was done to maintain gothic arch, modularity (for reestablishing normal gleno-humeral anatomic relationship), Inferior tilting of glenoid component by 15. Implant was removed & reverse shoulder arthroplasty was done. Per-operative & post-operative periods we...

International Journal of Current Research and Review, 2020

Background: The management of plateau fractures of the tibia with minimally invasive percutaneous... more Background: The management of plateau fractures of the tibia with minimally invasive percutaneous plating osteosynthesis has been a revelation. It has avoided many complications such as a large surgical scar, disruption of musculo osseous vascularity. It has significantly enhanced the preservation of soft tissues circulation and biologic fixation mechanism. The management of these fractures patterns can be done with indirect manipulation and effective reduction techniques. Methods: The details of the patients were recorded soon after the admission process, after documentation of history and examining them clinically. The fracture patterns were classified as per Schatzger, radiologically. Two approaches were followed:anterolateral and anteromedial for all the patients. The follow up was done in 6-8 weeks intervals. The period of study was from March 2018 to March 2020 which included 38 patients of the age group from 20-75 years. Results: Out of 38 patients, the maximum number of patients were of the age group from 20-50 years (68%). Schatzger's type 4 and 5 constituted the maximum number of fracture types, as per classification associated with high velocity injuries.1patient had joint stiffness,2 patients had wound infection and the equal number of patients had varus deformity.26 patients showed excellent results, good results in 6 cases and fair and poor results were obtained in 3 cases each. Conclusion: MIPPO technique for fractures of the proximal tibia had a very good outcome in terms of healing and also facilitated strong bone union due to the advantage of biological preservation of fracture site and less tissue damage.

International Journal of Orthopaedics Sciences, 2016

Foreign body injuries with date thorns, is common in developing countries like India, where walki... more Foreign body injuries with date thorns, is common in developing countries like India, where walking barefoot is common, thus making the feet vulnerable to various trivial injuries. Some of the injuries lead to cellulitis or abscess formation, if neglected or improperly managed results in osteomyelitis of foot structures, usually involving the tarsal or metatarsals, in countries with limited resources, the emphasis should be on clinical assessment for diagnosis, and good surgical technique for treatment. We report 5 patients with thorn prick osteomyelitis of the foot following barefoot walking. After thorough investigation, all were treated with thorn removal, surgical debridement, and oral ofloxacin and the materials were sent for HPE & CSE. Only one of the 5 cases showed growth of microorganisms. Surgical removal of the thorn is the key to successful treatment and to avoid recurrent infection.

Journal of Evidence Based Medicine and Healthcare, 2015

BACKGROUND: Shoulder instability and its treatment were described even in ancient times by the Gr... more BACKGROUND: Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart's lesion using suture anchors is a noble technique. A suture anchor is a tiny screw with a thread attached to it. The screw is inserted into the bone over the glenoid rim while the sutures hold onto the labral tissue. These anchors provide a stable base for reattachment of the capsulolabral complex. We conducted a study on evaluation of long term effect of arthroscopic repair of Bankart's lesion using suture anchors and compared our results with other studies published in literature. MATERIALS & METHODS: Since June 2012, arthroscopic Bankart's repair using suture anchors was performed on 35 patients, who presented with recurrent anterior dislocation of shoulder. 34 man and 1 woman patients were included in the study. METHOD OF COLLECTION OF DATA: Adult patients with recurrent dislocations of shoulder with. INCLUSION CRITERIA: All patients >15 years but <60 years of age, with post traumatic recurrent dislocation of the shoulder with Bankart lesion. No. of dislocations >=2. EXCLUSION CRITERIA: Age group <15 & >60 years. Clinical evidence of multidirectional instability. Surgery of injured shoulder before 1 st episode of traumatic shoulder dislocation. Number of dislocations <2. Generalised ligamentous laxity. Presence of neuromuscular disorders. Presence of other comorbid conditions. Majority of patients were in the age group between 17 years to 49years, with mean age of 27.43 years. Most patients were young active individuals in the age group of 25 to 35 years. 20 patients (57%) were involved in significant occupation requiring overhead activity such as students with sporting activities, agriculturists. 21(60%) patients had their Right shoulder involved, rest 14(40%) patients had Left shoulder involved. The mean follow-up period was 12 months (range 8-28 months). The patients were evaluated by visual analogue score (VAS), ROWE's score at final follow-up. RESULTS: 34/35 patient's regained almost preoperative range of forward flexion at the last follow-up. Preoperative scores were compared with the most recent follow-up scores for all variables with the help of paired t test. All patients had significant improvement in visual analogue score and ROWE's score. In the preoperative period 18(51.43%) patients had full range and 14(48.57%) patient had painful/limited terminal range of motion, as regards external rotation with arm at the side (ER1). And 07(20%) patients had 0-65º, 22(62.85%) patients had 0-70º, 3(8.57%) patient had 0-70º with pain at terminal range of motion, 3(8.57%) of patients had full range of motion, as regards external rotation at 90º abduction (ER2). At the last follow-up, 33/35(94.28%) patients had full range of ER1 & 32/35(91.42%) patients had full range of ER2.

Journal of Health Science and Medical Research

We present our experience of managing a case of revision anterior cruciate ligament (ACL) reconst... more We present our experience of managing a case of revision anterior cruciate ligament (ACL) reconstruction associated with a Hoffa fracture involving the medial femoral condyle (MFC). A 37-year-old male patient was referred to our hospital following a road traffic accident. The patient had a history of ACL reconstruction surgery done in the same 6 years previously in our hospital. Preoperative radiology suggested a Hoffa fracture involving the MFC. An magnetic resonance imaging suggested a full thickness tear of the reconstructed ACL and partial thickness tears of both the PCL and MCL. This case was managed with arthroscopic reconstruction of the ACL with an ipsilateral peroneus longus autograft and fixation of the femoral condyle by a paramedial approach with cannulated cancellous screws.

Al-Kindy, 2023

Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been... more Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been documented as a standalone anatomical entity or, more frequently, in conjunction with other congenital anomalies. Surgical treatment for this patient population has only been reported in very few cases. In this article, we share our experience in managing a case of unilateral congenital deficiency of anterior cruciate ligament (ACL) in a 13 years old female patient by physeal sparing arthroscopic ACL reconstruction, using All-inside technique.

Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been... more Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been documented as a standalone anatomical entity or, more frequently, in conjunction with other congenital anomalies. Surgical treatment for this patient population has only been reported in very few cases. In this article, we share our experience in managing a case of unilateral congenital deficiency of anterior cruciate ligament (ACL) in a 13 years old female patient by physeal sparing arthroscopic ACL reconstruction, using All-inside technique.

Isolated osteomyelitis of the cuboid is a rare entity with very few case reports worldwide. A var... more Isolated osteomyelitis of the cuboid is a rare entity with very few case reports worldwide. A variety of treatment methods are described for these lesions, both single-stage and two staged and ranges from simple curettage to bone grafting and arthrodesis. Case Report: We present a series of two cases of chronic osteomyelitis in young adults due to puncture wound over the lateral foot. Both patients presented with purulent discharge from sinus over lateral foot. There was no involvement of adjoining bones in them. Culture yielded Staphylococcus aureus and Pseudomonas aeruginosa. Both patients were treated with adequate curetting, saucerization with cancellous bone grafting in one of the cases. Both wounds healed uneventfully with good ankle and hindfoot function. Conclusion: The cuboid is a rare site of chronic osteomyelitis due to punture wounds with foreign bodies, especially in rural population. With meticulous curettage and bone grafting, the infection can be eradicated reliably and usually with good residual function.

Pain is believed to be a poorly understood phenomenon, which is mostly regulated by neural, cellu... more Pain is believed to be a poorly understood phenomenon, which is mostly regulated by neural, cellular, hormonal & emotional components. Epidural analgesia is used for pain relief in patients undergoing primary total knee arthroplasty, though provides good pain control, many a time is associated with side effects such as hypotension, urinary retention and impaired mobility. The purpose of the current study is to compare the efficacy of ACB to local infiltration of analgesics by Intraarticular Epidural Catheter for primary total knee arthroplasty by comparing visual analog scale, knee flexion, and active SLRT on the day of surgery (POD-0), POD1-3, day of discharge, and 4 weeks after surgery. This study is prospectively randomized, the cases undergoing primary knee replacement were divided into two groups, which includes a minimum of 36 cases in each group.Group-1(36) patients received local infiltration of analgesics via IAECand Group-2(36) patients received single shot ACB. As far as age, sex, BMI(kg/m2), pre-op VAS, mean pre-op flexion, mean pre-operative varus, mean preop KSS(Knee society score), duration of surgery and hospital stay is concerned no significant difference was noticed between the two groups.Group-1(LIA via IAEC) had significantly lower VAS on a postoperative day (POD) 1-3, lower tramadol consumption, better ROM (atPOD1-3), superior quadriceps recovery(active SLRT), earlier mobilization day, better KSS (at 4weeks) postoperatively, compared to Group-2(single shot ACB).LIAby IAEC for patients undergoing primary TKA is a better option compared to single shot ACB concerning to pain levels, narcotic usage, range of motion, quadriceps recovery and KSS (Knee society score).

Acetabular fracture fixation , 2024

Context: Acetabulum fractures are commonly a result of high-velocity road traffic accidents and f... more Context: Acetabulum fractures are commonly a result of high-velocity road traffic accidents and falls from height. These fractures were previously treated nonoperatively which had led to high morbidity causing secondary osteoarthritis, limping, instability, and chronic pain. Aims: To surgically manage the functional outcome of acetabular fractures. Settings and Design: The prospective study involves 28 patients of a tertiary care hospital at Bhubaneswar, for analysis of functional and radiological outcomes of surgical management of acetabular fractures. Subjects and Methods: Patients are chosen from emergency and outpatient on the criteria of age group 18-65 years, pelvi-acetabular fractures of 2-mm displacement, more than 3-week-old fracture, with or without hip dislocation. Inflammatory arthritis and pathological fractures patients were excluded. Surgery time was 173 min with a minimum of 110 min and a maximum of 240 min. Statistical Analysis Used: All the data were analyzed using SPSS 20 software. Results: Twelve patients had excellent (42%), seven patients had well (25%), seven patients had fair (25%), and two patients had poor (8%) functional outcomes. Two patients had restricted range of movement and pain on walking and had undergone total hip replacement after 1 year. The mean score in the anatomically reduced fracture is 16.4, imperfectly reduced is 14.4, and poorly reduced is 8. The average functional outcome score was 14.2 (range-5-18). Conclusions: As the articular surface requires smooth congruity, anatomical fixation of fracture fragments is essential for early mobilization and better functional outcomes. Proper preoperative planning, anatomical reduction, adequate fixation, and early mobilization are required to achieve good functional outcomes in acetabular fractures.

Endoscopic spine surgery , 2024

Грижа міжхребцевого диска попереку є поширеним захворюванням. Виникає сильний біль у ділянці сідн... more Грижа міжхребцевого диска попереку є поширеним захворюванням. Виникає сильний біль у ділянці сідниці та в нозі, який зникає протягом 6 тижнів за умов консервативного лікування. Наразі існує декілька хірургічних методик лікування гриж поперекового диска, починаючи від ламінектомії до мікродискектомії. Основні переваги ендоскопічної дискектомії включають: косметичну привабливість, мінімально інвазивний характер, кращу візуалізацію, менший термін госпіталізації та більш швидке одужання. Мета. Розглянуто спостереження за пацієнтами з дегенеративними захворюваннями поперекового відділу хребта за допомогою системи Дестандау. Автори діляться досвідом техніки хірургічного втручання та результатами черезшкірної ендоскопічної дискектомії за системою Дестандау під час лікування 51 пацієнта з грижею диска та стенозом каналу поперекового відділу хребта. Основні переваги ендоспічної системи Дестандауце невеликий розріз шкіри та мінімальне ушкодження м'яких тканин. Це малоінвазивне втручання, яке застосовують через розріз шкіри 1,5-2 см завдовжки. Із метою забезпечення точності й безпеки пацієнта як перед операцією, так під час неї застосовується рентгенівське обладнання. Під контролем ендоскопа видаляють грижу міжхребцевого диска, вільні фрагменти диска та звільняють затиснений нерв. Таким чином досягають швидкого відновлення під час післяопераційної реабілітації. Висновки. Ендоскопічна система може бути використаною для лікування всіх видів гриж міжхребцевих дисків і супутнього стенозу каналу. Це відносно безпечна процедура за умови правильного передопераційного планування та досвіченої команди лікарів. Більшість поперекових патологій, які є не повʼязані з нестабільністю, можуть бути успішно вирішені за її допомогою. Дві основні переваги ендоспинальної системи Дестандау включать малоінвазивну хірургію з мінімальним ятрогенним ушкодженням і відмінній ефективності. У разі її успішного застосування, процес відновлення значно скорочується, без будь-яких обмежень для повернення до повсякденного життя. Ключові слова. Дестандау, ендоскопія, хребет, поперековий відділ.

Journal of Evidence Based Medicine and Healthcare, Jun 15, 2015

We here with present a case of osteochondroma arising from the spinous process of L2, L3, L4 vert... more We here with present a case of osteochondroma arising from the spinous process of L2, L3, L4 vertebrae (Rt. Side) in a 28 years old male, labourer by profession presented to our hospital OPD on 08/11/2012 with chief complaint of progressive swelling over the Rt. paraspinal area of lumbar spine for last 1yr. Pain and swelling were gradually increasing. There was no h/ofever, cough or weight loss or urinary complaints or any sensory or motor involvement. X-ray showed increased density solitary mass at lumbar region (L2, L3, L4). MR imaging showed it to be contiguous with the spinous process of lumbarvertebrae-L2, L3, L4 suggesting the diagnosis of osteochondroma, a rare presentation without cord compression, and distinguishing the lesion from a calcified disk fragment. After thorough investigation we have excised the tumor and sent for histopathological examination. No residual deficit was found post-operatively. Patient was relieved of the symptoms and is now under follow-up.

International Journal of Orthopaedics Sciences, 2019

Background: Among the Health care associated infections (HAI), orthopaedic surgical site infectio... more Background: Among the Health care associated infections (HAI), orthopaedic surgical site infections (OSSI) previously termed as post-operative wound infections are one of the most common HAI in low and middle income countries. Increase in OSSI is associated with increased morbidity, as well as mortality due to emergence of antimicrobial resistant pathogens. Understanding the pathogens implicated in causing the OSSIs and their antimicrobial sensitivity place a good role in reducing the mortality and morbidity. Methods: A prospective study was conducted at a tertiary care hospital to all the patients admitted in Department of Orthopaedics for 2 years from January 2017 to December 2018. The demographic data, inclusion criteria and exclusion criteria, risk factors, clinical history, laboratory data with gram stain, culture results and antibiotic sensitivity of the isolates were collected. Results: Two hundred patients were recruited in the study and the prevalence of OSSI in the study was 3.83%. Patients who underwent emergency operations and diabetics were at higher risk of acquiring OSSI. The most commonly isolated pathogens in the study were Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Pseudomonas aeruginosa was most common isolate from orthopaedic cases of OSSI. Conclusions: Study clearly explains the various causes and risk factors associated in development of OSSI. The study guides in the type of the organism isolated and possible antibiotic of choice in treatment and management of OSSI. The prevalence of OSSI was 3.83%, which is comparable with some of the studies and lower than many of the studies.

Introduction: Pigmented villonodular synovitis (PVNS)is a very uncommon lesion that involves the ... more Introduction: Pigmented villonodular synovitis (PVNS)is a very uncommon lesion that involves the synovium of joints, tendon sheaths, or bursae. Approximately 2.5% of cases occur around the ankle. PVNS was earlier considered to be a synovial malignancy. Complete surgical excision is curative if bony destruction is not there. Radiotherapy is rarely helpful for residual lesions. Case Report: We share a case report on PVNS of ankle in a 22-years old male patient. Clinical diagnosis was confirmed with the help of magnetic resonance imaging and histopathology. A surgical excision with synovectomy was carried out. There were no signs of recurrence in 1.5 years follow-up. Conclusion: Complete surgical excision with radical synovectomy is crucial for the treatment of PVNS in rare locations like the ankle joint.

Congenital absence of ACL, 2023

Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been... more Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been documented as a standalone anatomical entity or, more frequently, in conjunction with other congenital anomalies. Surgical treatment for this patient population has only been reported in very few cases. In this article, we share our experience in managing a case of unilateral congenital deficiency of anterior cruciate ligament (ACL) in a 13 years old female patient by physeal sparing arthroscopic ACL reconstruction, using All-inside technique.

The incidence of the hip fracture has been rising with an aging population in many parts of the w... more The incidence of the hip fracture has been rising with an aging population in many parts of the world. Growing number of population and the road traffic accidents have resulted in an enormous increase in these types of fractures. In younger patients the fractures usually result from high energy trauma like RTA and fall from height and accounts for only 10%. Older patients suffering from a minor fall can sustain fracture in this area because of weakened bone due to osteoporosis or pathological fracture and these accounts for 90%. Surgical management of trochanteric fractures aims at restoring the pre-fracture functional status of patients as far as ambulatory skills are concerned. A variety of implants of internal fixation have been employed to achieve this goal with variable success. The diversity of fixation devices available for treatment of trochanteric fractures illustrates the difficulties encountered for fixation, and the discussion about ideal implant for such cases continues...

International Journal of Orthopaedics Sciences, 2016

The best treatment for scaphoid nonunion fractures is still controversial. The objective of this ... more The best treatment for scaphoid nonunion fractures is still controversial. The objective of this article is to report our clinical experience in the treatment of patients with scaphoid fracture with delayed union or non-union with minimal sclerosis using percutaneous cancellous bone graft and Herbert’s screw and to study the functional outcome with an average of one year follow-up. We reviewed 35 patients treated with percutaneous cancellous bone graft and Herbert’s screw fixation from October 2012 to January 2016. Preoperative clinical manifestations and postoperative results were assessed by radiography, and functional results, including grip force, range of motion of the wrist joint, and Cooney’s scoring chart, were evaluated. The union rate was 91.42%. The average grip power, as well as wrist flexion and extension were significantly improved. Using Cooney’s scoring system, 28(80%) patients were rated excellent and 4(11.42%) good. For successful union, anatomical reduction with c...

International Journal of Orthopaedics Sciences, 2019

Neer Group (IV-VI) Proximal humeral fractures often are related to persistent disability despite ... more Neer Group (IV-VI) Proximal humeral fractures often are related to persistent disability despite surgical treatment. The optimal surgical management of theses fractures in elderly patients remains unclear. We retrospectively compared the outcome after open reduction and internal fixation with the PHILOS and primary hemiarthroplasty in patients with Neer Group IV-VI fractures focusing on Speed of recovery, shoulder function, health-related quality of life, and complications.

Journal of Evidence Based Medicine and Healthcare, 2015

We here with present a case of post-traumatic fracture non-union of proximal humerus with comprom... more We here with present a case of post-traumatic fracture non-union of proximal humerus with compromised rotator cuff in a 50 yrs old retired BSF jawan, who presented to our OPD with a chief complaint of pain, decreased ROM of rt.shoulder. He had an h/o previous injury following RTA on 16/2/2012 & was treated with ORIF on 25/2/2012. X-ray shows fracture nonunion of proximal humerus with migration of humeral head relative to glenoid in superior direction, also there is acetabularisation of acromion & femoralisation of proximal humerus. MRI shows compromised rotator cuff. Both x-ray & MRI are suggestive of rotator cuff arthropathy. After, thorough investigations &rulling out any other associated co-morbidities, pre-operative planning was done to maintain gothic arch, modularity (for reestablishing normal gleno-humeral anatomic relationship), Inferior tilting of glenoid component by 15. Implant was removed & reverse shoulder arthroplasty was done. Per-operative & post-operative periods we...

International Journal of Current Research and Review, 2020

Background: The management of plateau fractures of the tibia with minimally invasive percutaneous... more Background: The management of plateau fractures of the tibia with minimally invasive percutaneous plating osteosynthesis has been a revelation. It has avoided many complications such as a large surgical scar, disruption of musculo osseous vascularity. It has significantly enhanced the preservation of soft tissues circulation and biologic fixation mechanism. The management of these fractures patterns can be done with indirect manipulation and effective reduction techniques. Methods: The details of the patients were recorded soon after the admission process, after documentation of history and examining them clinically. The fracture patterns were classified as per Schatzger, radiologically. Two approaches were followed:anterolateral and anteromedial for all the patients. The follow up was done in 6-8 weeks intervals. The period of study was from March 2018 to March 2020 which included 38 patients of the age group from 20-75 years. Results: Out of 38 patients, the maximum number of patients were of the age group from 20-50 years (68%). Schatzger's type 4 and 5 constituted the maximum number of fracture types, as per classification associated with high velocity injuries.1patient had joint stiffness,2 patients had wound infection and the equal number of patients had varus deformity.26 patients showed excellent results, good results in 6 cases and fair and poor results were obtained in 3 cases each. Conclusion: MIPPO technique for fractures of the proximal tibia had a very good outcome in terms of healing and also facilitated strong bone union due to the advantage of biological preservation of fracture site and less tissue damage.

International Journal of Orthopaedics Sciences, 2016

Foreign body injuries with date thorns, is common in developing countries like India, where walki... more Foreign body injuries with date thorns, is common in developing countries like India, where walking barefoot is common, thus making the feet vulnerable to various trivial injuries. Some of the injuries lead to cellulitis or abscess formation, if neglected or improperly managed results in osteomyelitis of foot structures, usually involving the tarsal or metatarsals, in countries with limited resources, the emphasis should be on clinical assessment for diagnosis, and good surgical technique for treatment. We report 5 patients with thorn prick osteomyelitis of the foot following barefoot walking. After thorough investigation, all were treated with thorn removal, surgical debridement, and oral ofloxacin and the materials were sent for HPE & CSE. Only one of the 5 cases showed growth of microorganisms. Surgical removal of the thorn is the key to successful treatment and to avoid recurrent infection.

Journal of Evidence Based Medicine and Healthcare, 2015

BACKGROUND: Shoulder instability and its treatment were described even in ancient times by the Gr... more BACKGROUND: Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart's lesion using suture anchors is a noble technique. A suture anchor is a tiny screw with a thread attached to it. The screw is inserted into the bone over the glenoid rim while the sutures hold onto the labral tissue. These anchors provide a stable base for reattachment of the capsulolabral complex. We conducted a study on evaluation of long term effect of arthroscopic repair of Bankart's lesion using suture anchors and compared our results with other studies published in literature. MATERIALS & METHODS: Since June 2012, arthroscopic Bankart's repair using suture anchors was performed on 35 patients, who presented with recurrent anterior dislocation of shoulder. 34 man and 1 woman patients were included in the study. METHOD OF COLLECTION OF DATA: Adult patients with recurrent dislocations of shoulder with. INCLUSION CRITERIA: All patients >15 years but <60 years of age, with post traumatic recurrent dislocation of the shoulder with Bankart lesion. No. of dislocations >=2. EXCLUSION CRITERIA: Age group <15 & >60 years. Clinical evidence of multidirectional instability. Surgery of injured shoulder before 1 st episode of traumatic shoulder dislocation. Number of dislocations <2. Generalised ligamentous laxity. Presence of neuromuscular disorders. Presence of other comorbid conditions. Majority of patients were in the age group between 17 years to 49years, with mean age of 27.43 years. Most patients were young active individuals in the age group of 25 to 35 years. 20 patients (57%) were involved in significant occupation requiring overhead activity such as students with sporting activities, agriculturists. 21(60%) patients had their Right shoulder involved, rest 14(40%) patients had Left shoulder involved. The mean follow-up period was 12 months (range 8-28 months). The patients were evaluated by visual analogue score (VAS), ROWE's score at final follow-up. RESULTS: 34/35 patient's regained almost preoperative range of forward flexion at the last follow-up. Preoperative scores were compared with the most recent follow-up scores for all variables with the help of paired t test. All patients had significant improvement in visual analogue score and ROWE's score. In the preoperative period 18(51.43%) patients had full range and 14(48.57%) patient had painful/limited terminal range of motion, as regards external rotation with arm at the side (ER1). And 07(20%) patients had 0-65º, 22(62.85%) patients had 0-70º, 3(8.57%) patient had 0-70º with pain at terminal range of motion, 3(8.57%) of patients had full range of motion, as regards external rotation at 90º abduction (ER2). At the last follow-up, 33/35(94.28%) patients had full range of ER1 & 32/35(91.42%) patients had full range of ER2.

Journal of Health Science and Medical Research

We present our experience of managing a case of revision anterior cruciate ligament (ACL) reconst... more We present our experience of managing a case of revision anterior cruciate ligament (ACL) reconstruction associated with a Hoffa fracture involving the medial femoral condyle (MFC). A 37-year-old male patient was referred to our hospital following a road traffic accident. The patient had a history of ACL reconstruction surgery done in the same 6 years previously in our hospital. Preoperative radiology suggested a Hoffa fracture involving the MFC. An magnetic resonance imaging suggested a full thickness tear of the reconstructed ACL and partial thickness tears of both the PCL and MCL. This case was managed with arthroscopic reconstruction of the ACL with an ipsilateral peroneus longus autograft and fixation of the femoral condyle by a paramedial approach with cannulated cancellous screws.