Plate osteosynthesis of humeral shaft fractures is an established surgical procedure. Iatrogenic radial nerve palsy appears to be common complication in treating these fractures. A case series of 20 fracture shafts of humerus were treated with anteromedial plating through anterolateral approach. There was no radial nerve palsy in any of the cases and all achieved fracture union.
<p class="abstract"><strong>Background:</strong> Proprioception of the knee joint is an important factor for establishing balance, and smooth walking. The effect of arthroplasty on proprioception can be a determinant of post-operative function and subjective feeling of the arthroplasty. We wished to check the status of osteoarthritic knees and how their proprioceptive function is, in comparison to knees post total knee replacement.</p><p class="abstract"><strong>Methods:</strong> We compared 80 unilateral knee replacement patients with their osteoarthritic counterpart in the opposite knee. There was 50% Cruciate Retaining (n =40), Posterior Stabilized 50% (n =40). We assessed the proprioception using threshold to detection of passive motion and conscious awareness of passive joint position.<strong></strong></p><p class="abstract"><strong>Results:</strong> 73.8% (n =59) of patients experienced a better joint position sense, 21% (n =17) had decreased joint position sense and 5% (n =4) had the same, when compared to the contralateral osteoarthritic knee. The mean of threshold to detection of passive motion was 2.16+0.68 for the replaced knees versus 2.72±0.61 for the contralateral osteoarthritic knee.</p><p class="abstract"><strong>Conclusions:</strong> The proprioception of the knees that were replaced with arthroplasties had a better proprioceptive function then the osteoarthritic knees. This further solidifies the reasons to replace the dysfunctional osteoarthritic knee. </p>
Introduction: Severe open injuries of limbs, especially of the femur and tibia when associated with vascular injuries, present major challenges in management. The decision to amputate or salvage can often be a difficult one even for experienced surgeons. Mangled lower extremity results due to high-energy trauma, especially due to motor vehicle accidents, and is defined as injury to three of the four systems in the extremity that is soft tissues, bone, vascular, and nerve. Open fractures are classified by Gustilo and Anderson’s classification in which type 3B is an injury where soft-tissue loss and primary closure of the wound are not possible and type 3C is any open fracture with vascular compromise. Case Report: We report a series of six ipsilateral fractures of the femur and the tibia treated at the Department of Orthopaedics, Sri Ramachandra Medical College and Hospital, Chennai, Tamil Nadu, over a 3-year period (2014–2017). The mean age of our patients was 30 years old, and there were five men and one woman. The right side lower limb was frequently involved (five cases), and the main etiology was road traffic accidents (six cases). Articular involvement was found in six cases. Skin wounds were noticed in all cases (type III C of the Gustilo classification). Urgent wound care, fluid replacement, and antibiotic therapy were undertaken for open fractures. According to modified Fraser classification, all six cases was classified under type II-C. Mangled extremity severity score for five cases was 7 and for one case it was 8. Ganga Hospital Open Injury Severity Score was also used which was found to be in borderline range of 16 score for three cases, 15 score for two cases, and 14 score for one case. All six cases were managed with serial wound debridement + Ilizarov fixator + soft-tissue repair with involvement of orthopedic, vascular, and plastic surgery team. Limb salvage was done for all six cases after considering all the factors. Postoperatively, rehabilitative
Dual-energy X-ray absorptiometry (DEXA) scan is the gold standard investigation for diagnosing osteoporosis. The limitations of "gold standard" Dual-energy X-ray absorptiometry scan were many. The aim of this study is to find whether urinary n telopeptide can be used to diagnose osteoporosis — prospective cohort study done at Sri Ramachandra Medical University between August 2014 to December 2018. The study was done amongst the postmenopausal females and older males who came to the University hospital as an inpatient or an outpatient with suspected osteoporosis. We had 110 persons participated in the study. The patients were divided into two groups. Group, I was cases whose Dexa scan was osteoporosis/ osteopenia, and Group II was a control that had standard Dexa. The results from Dexa Scan are taken as the gold standard against urinary n telopeptide and a 2x2 table formed. Sensitivity, specificity, positive predictive value, likelihood ratio, area under ROC curve will be calculated. The mean value of urinary N Telopeptide in the case group was 182.5 and in control group was 49.8. The ROC curve was formed and cut off was calculated to be 71. Urinary N telopeptide can very well be considered as a diagnostic test and can’t be considered as a gold standard diagnostic test as there is some limitation as it is a bone resorption biomarker having some pre-analytical and biochemical variability which can alter the results. It can be used as an adjuvant and as a screening test along with gold standard Dexa in diagnosing osteoporosis.
Background: Plantar fasciitis is the most common cause of inferior heel pain resulted from repeated trauma leading to a microscopic tear in the plantar fascia. There is a need to study the non-invasive nature of low-level laser therapy in reducing pain and enhance healing. Therefore the study aimed to find out the efficacy of low-level laser therapy in plantar fasciitis. Methods:The study design is a pre-post experimental design. Thirty patients(21 females & 9 males) with plantar fasciitis who fulfilled the inclusion criteria participated in the study. Baseline parameters using musculoskeletal ultrasonogram of the plantar fascia, numerical pain rating scale, ankle joint mobility testing and foot and ankle ability measure questionnaire were recorded. Subjects in the control group received ultrasonic therapy, while the experimental group received irradiation of Low-Level Laser Therapy (LLLT) for two weeks comprising 12 sessions and the above-specified outcome measures were re-evaluated after two weeks. Results:The results showed significant improvement in pain severity (p<0.04) and ankle dorsiflexion range of motion (p<0.00) and ankle ability measure but no significant change in plantar fascia thickness following low-level laser therapy was observed. A positive correlation (r=0.9) was found between plantar fascia thickness and post foot and ankle ability measure-ADL scores (p=0.02). Conclusion:The findings suggest that low-level laser therapy helps in pain reduction and improving range of motion in plantar fasciitis with minimal effect on the thickness of plantar fascia.
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