International Journal of Research in Orthopaedics
Not a member yet
2153 research outputs found
Sort by
Comparison of the effectiveness between external fixations and conservative treatment for distal radial comminuted fracture
Get PDFBackground: Comminuted distal radial fracture is a potentially unstable fracture. It can be managed by external fixation and closed reduction with immobilization by plaster casting. But external fixation has better outcome than plaster casting. This study aimed to compare the effectiveness between external fixations and conservative treatment for distal radial comminuted fracture.
Methods: This prospective interventional study was carried out in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University from March, 2013 to September, 2015. 30 patients of distal radial comminuted fracture were selected. Total patients were divided into two groups. In Group A patients were treated by external fixation and in group B patients were treated by plaster cast.
Results: In this study, out of 30 patients, majority were male (60%). Mean age was 38.93(±10.45) years in group A and 40.66(±11.04) years in group B. Left side involvement was more 17 (56.7%) than right side 13 (43.3%). After 12 weeks, final follow up in group A 08 (53.3%) patients were recovered with excellent outcome. In group B 06 (40%) patients were recovered with excellent outcome. In group A, 14 (93.3%) patients were satisfactory outcome and in group B, 13 (86.7%) patients were satisfactory outcome.
Conclusions: External fixator decreases the complications of re-displacement and shortening for the treatment of comminuted distal radial fracture. It gives more satisfactory radiological, functional and clinical outcome as compared to cast immobilization
Timing of surgical interventions for open lower limb long bone fractures as a determinant of the length of hospital stay in a tertiary hospital in Nigeria
Get PDFBackground: Open fractures are major orthopaedic emergencies with known complications such as infections, amputations and death. Fractures involving the long bones of the lower limb are usually more common. Surgical interventions range from basic debridement to major surgery and vascular repairs. The timing of these interventions is debatable, with medical bodies developing differing standards to improve overall patient outcome. The aim was to determine the effect of the timing of surgical interventions on the length of hospital stay in patients with open lower limb long bone fractures.
Methods: This was a retrospective cross-sectional study of 45 patients who presented in a tertiary facility over a 5-year period with open fractures involving the long bones of the lower limb. Patients’ time to presentation/initial debridement, time to surgery, and length of stay post-surgery were evaluated. The obtained data were analysed using the IBM statistical package for social sciences (SPSS) Statistics version 26 for Windows (SPSS Inc., Chicago, IL, USA).
Results: This study revealed that all our patients fell between Gustilo-Anderson I and IIIA. Sixty-nine percent underwent initial debridement within 6 hours of injury. Forty-two percent had surgery within 1–3 days postinjury. Majority (62%) left the hospital within 1 week of surgery. Multivariate analysis revealed no significant correlation between the time of injury to surgical intervention and length of hospital stay (ρ=-0.087; p=0.590).
Conclusions: This study concluded that while the timing of surgical interventions may be important, it did not significantly affect the length of hospital stay
Analysis of donor deferrals causes in blood donation center-tertiary care hospital study
Get PDFBackground: Blood donor selection is important in providing safety to the recipients and also preventing transfusion related complications. Temporary causes for deferral should be counseled while permanent causes deferred for a life time. In this study, analysis was done to know the causes donor deferrals.
Methods: A one year cross- sectional study was conducted in our hospital from the period March 2022 to March 2023.All the donors who were unfit for blood donation were included in the study. All the reasons for the deferrals are listed and analyzed the data.
Results: Among 7147 total donations, voluntary are 3775, replacement are 3372.Out of which 150 donors are deferred, most were males 129 (86%) and the rest were females 21 (14%). The rejection rate in our study was 2.09%. The most common reason for the permanent rejection is Hepatitis-B and low hemoglobin level for temporary rejection.
Conclusions: A vast majority of donors were rejected permanently 103 (68.6%), while the rest of them were rejected temporarily 47 (31.4%)
A systematic study on the elevated risk of ankylosing spondylitis in adolescents engaged in intense physical exercise
Get PDFThis study investigates the link between intense physical activity during adolescence and the onset of ankylosing spondylitis (AS), particularly in individuals having the human leukocyte antigen (HLA)-B27 antigen, a known genetic marker for AS. The systematic literature review included studies published between 2014 and 2024. . Keywords and search terms included combinations of "ankylosing spondylitis," "HLA-B27," "adolescence," "intense physical exercise," and "genetic predisposition. Inclusion criteria focused on studies involving adolescents aged 15-24 years with genetic predispositions such as HLA-B27. Exclusion criteria included studies with unrelated outcomes such as individuals not within the target adolescent age range, non-peer-reviewed articles, and those with insufficient data on the target population. Findings revealed that adolescents with the HLA-B27 antigen who engaged in heavy weight exercise were at a heightened threat of developing AS. The mechanical stress from intense physical activity potentially triggered or exacerbated inflammation at entheses in genetically predisposed individuals. However, the onset of AS was not universally observed in all HLA-B27 positive individuals who participated in strenuous exercise, suggesting other genetic and environmental factors’ involvement. The study suggests that strenuous exercise during adolescence may act as a significant contributing factor to the onset of AS in individuals having a genetic predisposition such as HLA-B27. While not all individuals having HLA-B27 develop AS, genetic and environmental factors’ combination, including intense physical activity, may accelerate disease progression
Prevalence of food-related misbeliefs among postoperative patients at a tertiary care health center: a pilot survey and future directions
Get PDFBackground: Effective postoperative recovery is significantly influenced by nutrition, yet pervasive food-related misbeliefs can impede this process. This is particularly prevalent in regions with high rates of medical misinformation and cultural dietary restrictions.
Methods: A survey was conducted with 917 postoperative patients at a tertiary care center in India from July 2019 to December 2019. A structured questionnaire was used to identify prevalent dietary misconceptions and their potential impact on wound healing.
Results: The survey revealed that 18.9% of patients harboured detrimental food-related misbeliefs, with the majority avoiding high-protein foods such as meat and dairy due to unfounded fears of adverse effects on wound healing.
Conclusions: The findings highlight a critical need for targeted educational interventions to correct these misbeliefs and promote nutritional practices that support recovery. Given the scope of this issue, further research is recommended to explore the broader implications of dietary misconceptions on post-surgical outcomes across different regions and cultures
Hip preservation in crisis: total hip replacement for osteoid osteoma-induced degeneration in a young adult
Get PDFOsteoid osteoma is a small, benign tumor known for causing severe pain, especially at night. Intra-articular osteoid osteomas are rare and often misdiagnosed due to overlapping symptoms with other joint disorders like osteoarthritis or synovitis. These tumors require advanced imaging for accurate diagnosis and may necessitate surgical intervention when conservative treatments fail. A 22-year-old female presented with a four-year history of left hip and loin pain, initially treated with NSAIDs. Her symptoms progressively worsened, leading to imaging studies that revealed a sclerotic lesion in the hip joint. A biopsy confirmed osteoid osteoma, and due to the extent of joint damage, total hip replacement (THR) was performed. Postoperative recovery was excellent, with full functional restoration and no complications. This case illustrates the diagnostic and therapeutic challenges of intra-articular osteoid osteomas. THR proved to be a successful treatment in restoring function and alleviating pain, underscoring the need for early diagnosis and individualized surgical management in advanced cases
Trends in incidence and complications of ankle arthrodesis and total ankle arthroplasty
Get PDFBackground: Total ankle arthroplasty (TAA) and ankle arthrodesis (AA) are surgical treatment options for end-stage ankle arthritis. Providers should have a current understanding of the overall trends of these procedures as both are frequently used. Thus, the objective of the current study is to assess the trends in utilization, patient characteristics and outcomes after TAA and AA.
Methods: The PearlDiver Mariner database was used to capture patient characteristics and outcomes related to 2,494 patients who underwent TAA and 5,901 patients who underwent AA between 2010 and 2018.
Results: The incidence of TAA increased over the course of the study period (p<0.001) while the incidence of AA decreased (p=0.045). Length of stay (LOS) following AA significantly increased (3.02 vs 4.50, p<0.001) while LOS following TAA significantly decreased (2.78 vs 1.65, p=0.004). Furthermore, incidence of infections significantly increased following both procedures (AA 1.7% vs 6.6%, p=0.004; TAA 0.8% vs 2.7%, p=0.008). In 2018, patients who underwent TAA had a significantly decreased LOS (1.65 vs 4.50, p<0.001), risk of major complications (1.5% vs 3.9%, p=0.042), risk of any medical complication (7.1% vs 14.9%, p=0.004), and risk of infection (2.7% vs 6.6%, p=0.011) compared to those who underwent AA.
Conclusions: The present study demonstrates increased utilization of TAA for treatment of end-stage ankle arthritis compared to AA in recent years. Over the time period of this study, infection rates have increased and LOS has decreased for TAA while both infection rate and LOS have increased for AA
Beyond 25 millimetres makes the difference: a prospective study on tip apex distance in dynamic hip screw treatment of intertrochanteric fractures
Get PDFBackground: The tip apex distance (TAD) is a key indicator of screw cut-out risk in dynamic hip screw (DHS) treatment for intertrochanteric fractures. This study sought to assess the prognostic significance of TAD in intertrochanteric fractures managed with DHS.
Methods: This prospective observational study encompassed 50 patients with intertrochanteric fractures who had DHS fixing treatment. TAD was measured on postoperative radiographs. Patients were followed clinically and radiologically for a minimum of 3 months. The primary outcome was screw cut-out.
Results: The mean TAD was 25.5 mm, with a range of 10 to 47 mm. Four screw cut-outs were seen, all in patients with TAD exceeding 35 mm. The mean TAD was 24.18 mm for successfully treated fractures, in contrast to 40.89 mm for those who experienced cut-out. No cut-outs were seen with TAD <25 mm. The inferior-central region of the femoral head was the predominant site for screw placement, occurring in 30% of cases.
Conclusions: TAD is a dependable predictor of screw cut-out risk in DHS fixation of intertrochanteric fractures. Maintaining a TAD <25 mm and screw position in the inferior-central zone of the femoral head may help minimize cut-out risk. Surgeons should aim for proper screw placement and consider TAD when treating these fractures
A comparative study of intramedullary nailing versus minimally invasive percutaneous plate osteosynthesis for extra articular distal tibia fracture
Get PDFBackground: Distal tibia fractures are among the most challenging orthopaedic injuries due to their subcutaneous location, limited blood supply and proximity to the ankle joint. These fractures often result in complications such as delayed-union, non-union, wound infection and malalignment. This study aims to compare the effectiveness of two minimally invasive surgical methods: Intramedullary Nailing (IMN) and Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) in treating extra- articular distal tibia fractures.
Methods: A prospective study was conducted on 30 patients with extra-articular distal tibia fractures. The participants were divided into two groups, 15 patients receiving IMN and 15 patients MIPPO. Clinical assessments were carried out to evaluate functional outcomes, union time and complications. Radiological evaluations were used to monitor the progress of fracture healing.
Results: Both IMN and MIPPO were effective in treating distal tibia fractures, with each technique having its advantages and drawbacks. IMN showed a shorter union time and fewer wound complications compared to MIPPO, which demonstrated better alignment and fewer malunions. However, IMN was associated with a higher incidence of anterior knee pain, whereas MIPPO had more cases of implant irritation leading to reoperation.
Conclusions: Both IMN and MIPPO offer viable treatment options for extra-articular distal tibia fractures. IMN is preferred in cases where early weight-bearing and faster union are critical, particularly in patients with soft tissue concerns. Conversely, MIPPO is advantageous in achieving better alignment and should be considered when soft tissue conditions allow. We conclude by Intramedullary Nailing as better treatment modality for distal tibia extra articular fractures
Evaluation of functional outcome of arthroscopic isolated anterior cruciate ligament reconstruction with quadriceps tendon
Get PDFBackground: The anterior cruciate ligament (ACL) is one of the most important intra-articular ligaments in the knee joint. It is regarded as the main barrier preventing the tibia from anteriorly translating onto the femur. The greatest incidence occurs in 15 to 25-year-old participants of work and pivoting sports. This study aimed to assess the functional outcome of arthroscopic isolated ACL reconstruction with quadriceps tendon.
Methods: This was a prospective interventional study conducted in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from March 2020 to August 2022. In our study, we included 30 patients with anterior cruciate ligament injuries who attended the orthopaedic department within the study period.
Results: The preoperative Lysholm score was found to be poor in all cases. Nine months after arthroscopic isolated ACL reconstruction with quadriceps tendon Lysholm score was found as excellent in 18 (60%) cases, good in 8 (26.7%), and fair in 4 (13.3%) cases. During the last follow-up of 9 months after arthroscopic isolated ACL reconstruction with quadriceps tendon, 26 (86.7%) patients were found as satisfactory results, and only 4 (13.3%) patients were found as unsatisfactory. A significant difference was observed between preoperative and postoperative functional outcomes.
Conclusions: In our study, we found that arthroscopic isolated ACL reconstruction with quadriceps tendon showed satisfactory functional outcomes for the treatment of ACL injury, and all the functions of the knee were improved in compared with their pre-operative status