Background: Covering soft tissue defect of the foot is important with respect to function and aesthetic means. It is a challenging task and requires a clear cut planning so as to use the right flap for the right size and site in the foot. Materials & methods: A total of fifty three patients with soft tissue defects in the foot admitted between August 2014 to April 2015 under Hand & Microsurgery, Department of Orthopaedics, were included in this study. Post-operatively they were monitored for any flap related complications. Results: The most common defects were trauma related followed by trophic ulcers and infective causes. Various coverage options which include fasciocutaneous flaps, muscle flaps, free flaps and split thickness skin grafts (STSG) were used. All the flaps were satisfactorily taken up at the end of follow-up period (three months). Conclusion: Planning of the defect based on site and size is very important so as to obtain satisfactory result.

The critical shoulder angle is defined as the angle formed between the plane of the glenoid and the line connecting the most lateral border of the acromion process, as seen on the true anteroposterior radiograph of the shoulder. The purpose of this study was to determine the association between the critical shoulder angle and shoulder pathologies like rotator cuff tears and glenohumeral osteoarthritis. It was also to assess the reproducibility and accuracy of critical shoulder angle values, which were measured with radiographs. Objective The aim of the study was to find out the association between the critical shoulder angle and shoulder injuries in a rural population cohort. The secondary aims were to assess clinical and radiological correlations between the critical shoulder angle and the symptomology of shoulder pain.

Introduction: A global concern is vitamin D deficiency and insufficiency. There is a particularly high risk for pregnant women, people of color (Blacks, Hispanics, and those with increased skin melanin pigmentation), obese children and adults, and children and adults who are abstinent from direct sun exposure. The goal of this study was to understand the incidence of vitamin D deficiency in patients with osteoporotic hip fractures in our rural population and also to know its association with osteoporosis and osteoporotic hip fractures in a tertiary care trauma center. Methods: This prospective research was performed at our tertiary trauma treatment center in Kolar, Karnataka, India by the Department of Orthopedics from September 2019 and July 2020. The age category was 45-90 years, intertrochanteric fractures were graded using the Boyd and Griffin classification and femoral neck fractures the Garden's staging. The research included all patients with fractures after a trivial trauma such as slip and fall while standing/walking and excluded patients with a serious history of trauma such as road traffic accidents/falls from height and pathological fractures. This study involved 30 patients. Age and gender, type of fracture, vitamin D levels, Singh’s index, and comminution of fracture site were reported in patient demographics. Results: Thirty patients comprised the study population. Most of them were female. Females comprised 18 out of the 30. There were twelve, thirteen, and five persons in our sample population between the ages of 45-60, 61-75, and >75 years. The Singh's index was tabulated. Mean vitamin D levels were 9.64+/-3.23 in the femur fracture group and 13.42+/-5.31 in the intertrochanteric fracture group. Mean levels of vitamin D are included as a graphical representation. The comminution of the fracture site in groups of the femur and intertrochanteric fractures was eight and six, respectively. Conclusion: Early diagnosis and treatment of these patients with vitamin D for osteomalacia and anti-osteoporotic osteoporosis regimens will hopefully enhance bone, muscle, and general health, minimizing falls and fractures.

Introduction: In today's orthopaedic practice, meniscus and anterior cruciate ligament (ACL) injuries are prevalent. It is more common in sports injuries and automobile accidents. In patients with ACL tears, meniscus problems are also common. Several studies have linked meniscus injuries to the development of osteoarthritis in early stages. Early onset of osteoarthritis has been observed in ACL-repaired patients with meniscus tears. As a result, meniscus tears should be detected and corrected as soon as possible to avoid degenerative changes in the knee joint. The goal of the study was to see if there was a link between meniscus injuries and ACL injuries in our rural community. Methods: This retrospective study was conducted on 48 patients at the R.L. Jalappa Hospital & Research Centre from January 2012 to December 2019. Patients between the ages of 18-65 diagnosed with ACL tear with/without meniscus damage in their knees were included in the study. Patients with posterior cruciate ligament (PCL) tear, medial collateral ligament (MCL) or lateral collateral ligament (LCL) injury, previously operated index knees, and patients with more than grade 3 knee osteoarthritis (Kellgren and Lawrence classification) were excluded. Clinical assessment of patients with knee injuries, MRI and diagnostic arthroscopy of the knee joint details were collected. After obtaining the data, we estimated the incidence of meniscus injuries associated with chronic ACL injuries. We also calculated the percentage of side/laterality injury (medial meniscus or lateral meniscus) and part of meniscus injury (anterior horn, body, and posterior horn) in chronic ACL-deficient knees. Patient characteristics such as age and gender were correlated with functional knee assessment using a modified Lysholm score. P-value and chi-square tests were used to assess the data. P-value of less than 0.5 was considered significant. Results: Average age of the participants was 32.31 years. There were 42 men and six women in the group. Isolated medial meniscus, lateral meniscus, and combined medial and lateral meniscus had average ages of 31.83, 31.16, and 40.28 years, respectively. ACL injuries on the right side were seen in 23 patients the left side was seen in 25 patients. In comparison to the right side, the isolated medial meniscus injury on the left side was more severe. In case of a combination of medial and lateral meniscus tears, the right side suffered more damage than the left. Eleven patients had an isolated ACL tear without a meniscus injury, while the other 37 had a meniscus injury and an ACL tear. Excellent scores were observed in 11 cases, satisfactory scores in 26, and unsatisfactory in 11 cases. Age group was categorized into three groups, less than 30, 30-45, and more than 45 years. Excellent, satisfactory, and unsatisfactory scores were observed in seven, eleven, and seven patients on the left side and excellent, satisfactory, and unsatisfactory scores in four, fifteen, and four patients on the right side, respectivel...

Background: Orthopedic surgeons face a difficult task in treating serious open fractures, which usually result in complications, morbidity, and even amputation. Compound fracture wounds were traditionally treated with a standard saline dressing. To avoid infection and problems during therapy, several studies found that open fractures require early skeletal stability as well as soft tissue repair. In favoring the above fact vacuum-assisted closure (VAC) is now undergoing a paradigm shift. With this background, this study aimed to compare the effects of VAC dressing versus standard wound dressing on compound fracture wounds. Methodology: This study has been conducted as a single-blind randomized control trial among 128 patients who got admitted to the Department of Orthopedics, R L Jalappa Hospital attached to Sri Devaraj Urs Medical College, Karnataka, India from August 2019 to November 2021. The study participants were randomly allotted into two groups negative pressure wound therapy (NPWT) and standard wound therapy (SWT) consisting of 64 participants in each group. VAC dressing was used on group NPWT, while normal saline wound dressing was used on group SWT. Both groups were followed up for a month after their discharge from the hospital. Frequency in dressing changes wound healing time, infection presence, and hospitalization days were all recorded and compared over one month. The data collection was done using questionnaires and the statistical analysis was done with SPSS version 21 (Chicago, IL: IBM Corp.). Results: There was a statically significant difference favoring group NPWT compared to group SWT with a hospital stay, number of dressings required, wound size reduction, wound healing time, and deep infection rate (p<0.05). Conclusions: The use of NPWT speeds up the healing of compound fracture wounds significantly. It is affordable and can be used as a substitute in resource-constrained areas to reduce infection and manage open fracture wounds quickly.