International Journal of Research in Orthopaedics
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The role of diabetes in low back pain compared to non-diabetics
Get PDFBackground: Type 2 diabetes is a prevalent non-communicable disease, affecting significant proportion of the global population, with an estimated 382 million individuals affected. There exists a correlation among diabetes and low back pain. The objective of this investigation was to examine the potential association linking diabetes and low back pain by utilising the Oswestry disability Index as a gauge of the intensity of persistent lower back pain.
Methods: The study was conducted by cross sectional method in which 200 patients with low back pain were included from period of October 2020 to September 2022. Oswestry disability index questionnaire was used for the intensity of lower back pain. Statistical package for the social sciences was used for data analysis.
Results: In this study, out of 200 patients, 59 (29.5%) had diabetes and 141 (70.5%) were without diabetes, with a average age of 53.61±15.07 years. Overall, according to gender, patients were equally distributed, while female and male predominance was seen in diabetics and non-diabetics, respectively.
Conclusions: The distribution of patients as per gender and ODI score did not differ, although more diabetics had a significantly higher ODI score than non-diabetics. A significant increase in blood glucose, HbA1c, microalbuminuria, and ODI score was noted in diabetics compared with non-diabetics, with significant positive associations of ODI with age, blood glucose, and HbA1c. The increased levels of the diabetic profile parameters and their association with the ODI indicate the possible role of diabetes with low back pain
Proximal humerus fracture in a newborn-like a thief in the night
Get PDFEpiphysiolysis of the shoulder is rare in newborns. The radiographic evaluation may be limited due to the non-ossification of the epiphyses, and it can be misdiagnosed as a dislocation. Ultrasonography and MRI provide a better answer in the diagnosis of these lesions. We describe a clinical case of an epiphysiolysis of the shoulder in a newborn baby after caesarean section. A premature born with 26 weeks and 660 g shows oedema and ecchymosis of the right shoulder. Radiographies and ultrasound show a fracture-epiphysiolysis of the proximal humerus. She was treated in a conservatory way. At 8 months old, she has no complaints and has a normal range of motion of the shoulder
Case report of a new technique for with posterior cruciate ligament avulsion fractures treated with a mini transverse incision
Get PDFPosterior cruciate ligament (PCL) is a strong stabilising ligament of the knee joint originating from posterior part of Intercondylar eminence oof tibia and attaches to the anterior part of medial surface of lateral condyle of femur. The PCL plays a major role in knee stabilization, and are statistically one of the rarest injuries around the knee. Due to the surrounding neurovascular elements in the popliteal space, very few open approaches to repair such injury were performed. The ‘‘safe transverse mini-incision approach’’ to PCL avulsion fracture is a simple approach, does not require exploration of the neurovascular elements, and produced satisfactory results in the majority of patients
Calcaneus stress fracture: a case report
Get PDFCalcaneal stress fracture is a rare clinical entity associated with diverse etiological factors such as high intensity training, female sex, smoking and poor nutrition. The authors present a case of a calcaneal stress fracture treated conservatively with immobilization, limited weight bearing and vitamin D supplementation.
A prospective study of total hip arthroplasty for failed proximal femur fracture fixation
Get PDFBackground: Proximal femur fractures have been widely studied and there are several well-accepted management modalities for the same such as PFN A2, IMIL nails, and DHS. Despite several management options we do encounter significant failure rates which could be due to several factors such as post-operative time rehabilitate patients related comorbidity and differences in surgical techniques. Aim of the study was to assess the outcomes of total hip arthroplasty (THA) after failed surgical management in proximal femur fractures
Methods: The 50 patients who underwent surgical management for proximal femur fractures at any given point in time and presented with non-union or malunion and inability to bear weight affecting their activities of daily living assessed with Harris hip score were enrolled in a prospective cohort study during 2015 and 2022 after obtaining IRB approval. All these patients underwent surgical management for proximal femur fractures within 3 weeks of sustaining a fracture.
Results: A strong statistically significant difference is seen with pain, functional gait, functional activity, range of movement and total score in post-operative group of patients in comparison to patients of pre-operative group. THA had excellent outcomes in 42 patients (85.71%) of the study group. About 6 (14.29%) patients of the study group had good outcome. 2 patients that lost to follow up were removed from the study.
Conclusions: THA is an effective procedure for failed proximal femur fracture fixation patients despite the challenges such as distorted anatomy of femoral head, poor bone quality, longer operative times, larger amounts of blood loss, high rates of intra-operativities and post operative complications
Comparative analysis of the outcome between aperture and suspensory graft fixation methods in anterior cruciate ligament reconstruction surgeries: a systematic review
Get PDFHuman knee joint is a complex hinge joint which is relatively unstable compared to other joints of the body. The ligaments of the knee stabilize the joint during the different range of motion and are under continuous tension. This results in anterior cruciate ligament (ACL) being injured during unnatural movement of the joint particularly in sports. With the advent of arthroscopy and better understating of ligament injuries with the use of MRI, the ligament reconstruction procedures have increased. The Reconstructive procedures for the ACL impart use of an Autograft which is secured in the bony tunnels of femur and tibia using various methods. As with any fixation these materials are subjected to various biological and mechanical forces. Suspensory or aperture graft fixation are the two most commonly employed methods in recent times. Both these methods have different tensile strengths and failure rates. Various studies have been conducted to assess the outcomes of these methods to evolve the most suitable and fail-safe method of securing the ACL allograft in the bony tunnels
Diagnosis and treatment of subchondral bone insufficiency fracture of the knee joint: case series
Get PDFSubchondral insufficiency fracture of the knee (SIFK) is a stress fracture that happens under the cartilage usually due to repetitive stress to the bone which is already weakened by non-cancerous diseases which impacts the bone strength and fragility. SIFK is a new nosologic entity that has replaced the diagnosis of spontaneous osteonecrosis of the knee. Primary avascular necrosis of the femoral condyles is a differential diagnosis of subchondral fracture of bone insufficiency of the knee joint, which requires a different approach to treatment. The aim of our study was to evaluate the effectiveness of conservative treatment of subchondral bone insufficiency fracture of the knee joint (SIFK)
Evaluation and compare the outcomes of patients undergoing either a unipolar or bipolar hemiarthroplasty for fractures of the femoral neck in aged patients
Get PDFBackground: Treatment of displaced intra-capsular femoral neck fractures in older patients remains controversial. Factors such as age, fracture type, bone quality, and socio-economic status influence treatment decisions. Surgical options like hemiarthroplasty and internal fixation are considered, each with distinct outcomes and considerations. The study aimed to compare radiological and clinical outcomes, as well as functional results, between elderly patients undergoing unipolar and bipolar hemiarthroplasty for femoral neck fractures.
Methods: The prospective interventional study conducted over a period of 30 months, from July 2021 to December 2023. A total of 72 patients were included in this prospective interventional study, which was conducted at the 250-bed general hospital Gopalganj and the Sheikh Sayera Khatun Medical College Hospital. Of them, 36 underwent treatment with a unipolar prosthesis and another 36 underwent treatment with a fenestrated bipolar prosthesis via a lateral approach. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 24.
Results When the unipolar and bipolar groups were compared, comparable demographic distributions and mean ages (71.12 years) were found. Statistically significant differences were observed in hip scores (p value=0.019), activity on stairs (p value=0.043), and wearing shoes (p value=0.023), with the bipolar group demonstrating better outcomes in these aspects. Satisfactory outcomes were achieved by 80.55% of the unipolar group and 72.22% of the bipolar group, with 19.45% and 27.78% experiencing unsatisfactory outcomes, respectively.
Conclusions: Bipolar hemiarthroplasty with a fenestrated stem may offer older patients with displaced intracapsular femoral neck fractures better functional outcomes and fewer complications compared to Austin-Moore unipolar prostheses
Total knee arthroplasty stabilized with autologous bone graft for tibial bone defect correction
Get PDFEvaluate the functional results obtained with total knee arthroplasty stabilized with autologous bone graft to correct axis deviation with tibial bone failure. A retrospective study with a convenience sample, consisting of fifteen patients operated between February 2015 and June 2019. Data were obtained through analysis of medical records: age, biological gender, affected side, pre- and postoperative radiographs, description of the surgical technique and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire results preoperatively and 6 months after surgery. The average age of the patients was 67 years, majority male (53.3%) and varus deformity (80%). The mean time to release the load was 31 days and all patients were discharged two days after surgery, with no complaints of complications. In the preoperative period, pain and physical function had the highest scores in WOMAC questionnaire. After total knee arthroplasty, there was a significant improvement in the three dimensions of WOMAC, with a reduction of 78.6% in the total score. Total knee arthroplasty stabilized with autologous bone graft to correct axis deviation with tibial bone failure resulted in improvement of symptoms and physical function in most patients evaluated, reducing pain and functional disability due to gonarthrosis
Patterns of traumatic long-bone fractures in North-Eastern Nigeria: a prospective multicenter study in 5 tertiary hospitals in Nigeria
Get PDFBackground: Traumatic musculoskeletal injuries have formed a significant burden on healthcare delivery worldwide. Long bone fractures are the most common musculoskeletal injuries encountered in this category and with the advent of insurgency in the northeastern part of Nigeria, there has been a rising incidence of assaults, gunshots, and other traumatic causes of long bone fractures.
Methods: A prospective cross-sectional study of patients with traumatic long-bone fractures in north-east Nigeria presenting in the tertiary hospitals involved in the study during the 6months study period (September, 2023 to February 2024). information of all patients presenting with traumatic long bone fractures were collected; biodata, presenting complains and findings on examination including the Glasgow coma scores were collected and documented. Radiological findings and intervention given. All information were collected and documented using a structured questionnaire. Data collected were analyzed using SPSS version 29.
Results: 227 patients were seen from the five major tertiary centers in north-eastern Nigeria that participated in the study. The 123 patients (54.2%) from Abubakar Tafawa Balewa university teaching hospital (ATBUTH)-Bauchi, 43 patients (18.9%) from Modibo university teaching hospital (MAUTH)-Yola, 32 patients (14.1%) were seen in Federal medical center (FMC)-Jalingo, 18 patients (7.9%) from federal teaching hospital (FTH)-Gombe and 11 patients (4.8%) from Maiduguri teaching hospital Maiduguri (UMTH)-Maiduguri. The 178 (79.1%) were males and 47(20.9%) females, making a male to female ratio of 4:1.
Conclusions: Long bone fracture causes a significant health care burden in north-East Nigeria with a high incidence of road traffic accidents, assaults and gunshots likely from the increasing effects of insurgency and kidnappings activities in this region.