No abstract

AIM AND OBJECTIVESAim and objective of this study is to assess role of synovectomy during TKR on joint effusion, haemarthrosis, patellar clunk, recurrent synovitis, and histopathological diagnosis in patients undergoing Total Knee Arthroplasty (TKA). MATERIAL AND METHODSWe studied prospectively 30 patients with osteoarthritis of knee treated with total knee arthroplasty with near-total synovectomy. Patients were in the age group 55-70 years. The overall efficacy of both procedures was assessed postoperatively by determination of blood loss from the drain, pain, and Lysholm knee functional score. RESULTSAll 30 patients have been followed up for an average of 3 years for assessment for postoperative pain, knee joint effusion, patellar clunk, range of movement, and stability of prosthesis. During the postoperative 48 hours, the mean blood loss was slightly higher. To conclude, supplementing near-total synovectomy along with TKA may provide complete pathological diagnosis, beneficial in inflammatory arthritis, and some special synovial pathology like pigmented villonodular synovitis, rheumatoid arthritis, tuberculous arthritis, and haemophilic arthritis. Better long-term pain relief and functional outcome due to the removal of pathological synovium have been observed after synovectomy along with total knee arthroplasty. CONCLUSIONPerforming synovectomy in TKA will give complete pathological diagnosis, avoiding persistence of synovial pathology along with long-term benefits of synovectomy in the form of minimal to no joint effusion, less pain, absence of synovial hypertrophy, patellar clunk, and good range of movement of knee.

Traumatic Extensor Carpi Ulnaris (ECU) sublaxation is often missed and undiagnosed or wrongly diagnosed. ECU muscle plays a key role in active movement of wrist extension, ulnar deviation and also in providing suport to the ulnar side of wrist. Its position relative to the other structures in the wrist changes with forearm pronation and supination. As such it must be mobile yet stable. This structure can be injured in a variety of different athletic activity and following fall on outstretched hand. It lies subcutaneously and easily palpated and visualized, allowing early diagnosis and management. We in our study report a case of traumatic ECU sublaxation. An 18 year old female patient presented to our OPD with ulnar side wrist pain. MRI showed volar subluxed ECU tendon with ruptured ECU sheath. We had done open ECU sheath repair and excision of bursa. Very few literature shows traumatic ECU sublaxation report. The case is reported for the rarity of presentation and likely to misdiagnose in day to day clinical scenario.

Background: There is alays been a dilemma in the treatment of intra-articular distal radius fracture (DRF). Close reduction and cast application gives satisfactory result in extra-articular Distal Radial Fractures but there is alays been debate beteen open and close reduction in the intra-articular fracture. Hence, this study is to evaluate effectiveness of open reduction and internal fixation of intra-articular Distal Radial Fractures. Materials and Methods: This prospective observational study as carried out in the department of orthopedics, All India Institute of Medical Sciences, Patna, from August 2016 to March 2019. The patient ere included ho qualified the inclusion criteria. The included patient ere treated by open reduction and internal fixation ith distal radius plate. The outcome as assessed in term of anatomical variables (radial dorsal tilt, length, and angle), residual deformity, and subjective result evaluation using Sarmiento's modification of Lind Storm criteria. The complication if any as also noted. Results: This study included 30 cases of intra-articular DRF, 12 fractures of AO type B, and 18 fractures of AO type C. Anatomically, 24 patients (80%) had excellent restoration of anatomy, 4 patients (13%) had good restoration and 2 had fair (7%) restoration of anatomy. 93% of patients had excellent to good alignment of fragments and good reduction could not be achieved in 7% of patients resulting in fair or poor results. Functionally, 22 patients (73%) had excellent, 5 good (17%), and 3 patients had fair (10%) restoration of functions. Conclusion: Open reduction and internal fixation ith volar plate and scres fixation gives satisfactory (good to excellent) result in intra-articular Distal Radial Fractures.

Background: The purpose of this prospective study was to evaluate the functional results of surgical stabilization of clavicule fractures by Locking Compression Plate in adults, decided on specific selection criteria. Materials and Methods: Twenty patients with clavicule fractures) were recruited in the study between Nov 2013 and Dec 2015 at our,