Effect of Preoperative Oral Carbohydrate Intake on Perioperative Hyperglycemia in Indian Patients Undergoing Hip Fracture Fixation.

Objective: Preoperative fasting leads to a catabolic state aggravated by surgical stress. This leads to poor patient outcomes. This study aimed to determine the effect of preoperative oral carbohydrate administration on perioperative hyperglycemia and patient comfort.

Drug Resistance in Osteoarticular Tuberculosis: A Study From an Endemic Zone.

The present study was undertaken to determine the incidence of drug resistance against anti-tubercular drugs among patients from an endemic zone.  Methodology: Forty consecutive clinico-radiologically diagnosed patients of osteoarticular tuberculosis (29: spine, 11: extraspinal) were enrolled. Pus from needle aspiration was taken in 31 cases, tissue following spinal decompression in seven, synovial in one, and sinus edge biopsy in one.

Effect of COVID-19 on the Burden and Profile of Orthopaedic Patients Admitted Post-Resumption of Routine Services in a Tertiary Care Hospital in Delhi.

Purpose On resumption of routine services post-lockdown during coronavirus disease 2019 (COVID-19), we expected a backlog of orthopaedic patients who could not get appropriate and timely care and would now present with complications due to missed or delayed treatment. This study aimed to quantify the effect of COVID-19 on the burden and profile of orthopaedic patients admitted post-resumption of routine services. Materials and methods Data on all the patients admitted to the orthopaedic department were collected using an interviewer-administered schedule for a complete one-year period after the resumption of routine orthopaedic services in a tertiary care hospital in Delhi.

Comparison of Outcomes of Long Versus Short Cephalomedullary Nails for the Fixation of Intertrochanteric Femur Fractures: A Systematic Review and Meta-analysis of 14,547 Patients.

Purpose: Intertrochanteric Femur Fractures (IFF) fixation could be done with short or long Cephalomedullary Nails (CMNs). Nevertheless, despite several studies in the literature, there has been a continued lack of consensus on which design of CMN is better than the other. Hence, the current review aimed to evaluate the evidence about short versus long CMNs for the fixation of IFF.

Assessment of inter and intra-observer variation of Leonetti and Tigani CT bases classification of tibial pilon fractures.

Introduction: tibial pilon fracture constitutes 5-7% of all tibial fractures. The treatment of choice is an open reduction with anatomical articular reconstruction and stable fixation. A relievable fracture classification is needed for the preoperative planning the surgical management of these fractures.

Wound Assessment Using Bates Jensen Wound Assessment Tool in Acute Musculoskeletal Injury Following Low-Cost Wall-Mounted Negative-Pressure Wound Therapy Application.

Background: Negative-pressure wound therapy (NPWT) is an alternative method of wound management for spontaneous healing. However, availability and high cost of a conventional NPWT system remain a challenge. Bates Jensen wound assessment tool (BWAT) has been used to assess wound healing in diverse wound treatments.

Comparison between reliability of Schatzker's classification and CT based four quadrant classification for tibial plateau fractures.

Introduction: Conventionally used Schatzker and AO/OTA classification, do not identify posterior column injuries in tibial plateau fractures. CT based Four quadrant classification, has been proposed to identify fractures of tibial plateau and help in surgical planning of treatment. However, to assess its validity, there is scanty literature about its reliability (inter and intra-observer variation) and comparison of its reliability with that of the more popular Schatzker classification in classifying tibial plateau fracture.

Outcomes of Displaced, Comminuted, Intracapsular Neck Femur Fracture in Young Adults Managed with Three Screw Inverted Triangle Versus Four Screw Diamond Configuration: A Comparative Pilot Study.

Background: Three cannulated cancellous screws (CCS) inverted triangle configuration is considered to be the gold standard for management of displaced intracapsular neck femur (ICNF) fractures in young adults. However, some authors have recommended four CCS in diamond configuration in the presence of comminution. However, there are no comparative studies to assess the superiority of one over the other.

Study of Cell Viability and Etiology of Contamination in Decalcified Bone Allograft: A Pilot Study.

Background: Bone allografts can elicit immune responses which is correlated with the presence of Human Leukocyte Antigen (HLA) and cellular DNA. It also has risk of causing occult infection arising out of contamination during its processing and storage. The presence of immunogenic materials like cells, cellular remnants and DNA in a decalcified bone allograft during different phases of processing has never been studied.

Change in granulation tissue coverage and bacteriological load using Low Cost Negative Pressure Wound Therapy in acute musculoskeletal wounds.

Background: Low cost Negative Pressure Wound Therapy (NPWT) dressings have been considered as an alternative to traditional daily dressings. There is scanty literature evaluating the change in the percentage area of wound covered by granulation tissue following application of low-cost NPWT. The change in the bacteriological flora following application of low-cost NPWT devices has also not been evaluated.

Outcome of Dome Osteotomy With Plate Osteosynthesis for Genu Valgum in Late Adolescents and Young Adults.

Aim To evaluate the degree of correction and outcomes after correction of genu valgum deformity using dome osteotomy with plate osteosynthesis in late adolescents and young adults. Methods A total of 27 knees in 21 patients underwent correction using dome osteotomy fixed with 3.5-mm low-profile proximal humeral locking system (PHILOS) plate.

Type III monteggia equivalent injury with compartment syndrome in an 8 year old child: A case report.

A rare case of a type III Monteggia fracture equivalent with compartment syndrome is reported here. Literature is very scanty about this rare combination of injuries which we are discussing. Timely intervention can lead to a satisfactory outcome even in these complex injuries.

Evaluation of Healed Status in Tuberculosis of Spine by Fluorodeoxyglucose-positron Emission Tomography/Computed Tomography and Contrast Magnetic Resonance Imaging.

Background: The healed status (end-point of treatment) in tuberculosis (TB) spine is not defined; hence optimum antitubercular therapy (ATT) duration is unresolved. We, for the first time, prospectively evaluated the healed status in TB spine by fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) and contrast magnetic resonance imaging (MRI) with the objective to define end-point of treatment in TB spine.

Materials And Methods: Thirty seven patients of TB spine diagnosed on clinicoradio imaging/cytology/histologically/molecular methods were enrolled, treated and were evaluated radiologically, by contrast MRI and FDG-PET/CT at 9 months.

Four Screws Diamond Configuration Fixation for Displaced, Comminuted Intracapsular Fracture Neck Femur in Young Adults.

Background: Four cannulated cancellous screws (CCS) in diamond configuration have been recommended by some authors for fixation of intracapsular neck of femur (ICNF) fracture with posterior comminution in adults. This is also supported by biomechanical studies. However, the clinical usefulness of this biomechanical advantage is not known.

Exposed versus Buried Kirschner Wires Used in Displaced Pediatric Fractures of Lateral Condyle of Humerus.

Background: Comparision of results and complications of exposed versus buried Kirschner wires (K-wires) after open reduction of lateral condyle fractures is scarce and mainly from western population; hence, we envisaged to study the safety and efficacy of exposed and buried K-wires used for fixation of displaced pediatric fracture of the lateral condyle of humerus in Indian setup.

Materials And Methods: A prospective, nonrandomized, comparative study was conducted in 50 patients with age <12 years, presenting with displaced fracture of lateral condyle of humerus of <2 weeks duration, without associated ipsilateral upper limb injury, who were treated by open reduction and internal fixation with either exposed or buried K-wires ( = 25 in each group). At a minimum followup of 3 months, status of fracture reduction, union, evidence of osteomyelitis, carrying angle at the elbow, and elbow range of motion (ROM) were assessed clinicoradiologically.

Factors Responsible for Redisplacement of Pediatric Forearm Fractures Treated by Closed Reduction and Cast: Role of casting indices and three point index.

Background: Pediatric forearm fractures are still considered an enigma in view of their propensity to redisplace in cast. The redisplacement may be a potential cause for malalignment. We prospectively analyzed the role of risk factors and above casting indices in predicting significant redisplacement of pediatric forearm fractures treated by closed reduction and cast.

Femoral fracture acting as an "ominous masquerade" in a 7-year-old child.

A pathological fracture is one which occurs in diseased bone with trivial trauma or even without it. However, fracture occurring as a result of significant injury can masquerade underlying ominous bone pathology, which is highly likely to be missed in the garb of overwhelming traumatic aetiology. Pathological fracture as the manifestation of tumour in children less than 10 years of age is rare.

Assessment of the geometry of proximal femur for short cephalomedullary nail placement: An observational study in dry femora and living subjects.

Background: Intramedullary devices have increasingly become popular and are widely used for fixation of unstable intertrochanteric and subtrochanteric fractures. These implants have been designed taking into consideration of the anthropometry of the western population which varies from those of other ethnic groups. This study was carried out to assess the geometry of proximal femur for the placement of short cephalomedullary nails in our subset of patients and suggest suitable design modifications based on these parameters.

Malunion in displaced intracapsular fracture of femoral neck: A rare case.

Intracapsular fracture of femoral neck is treated by anatomical reduction (preferably closed) and cannulated cancellous lag screw fixation. Malunion of these fractures have been described in the coronal plane (coxa valga or coxa vara). We reported a case of young adult patient with displaced intracapsular fracture of femoral neck that had malunited in sagittal plane with callus formation with excellent functional outcome.

Outcome of low level lasers versus ultrasonic therapy in de Quervain's tenosynovitis.

Background: de Quervain's tenosynovitis is an inflammation of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) muscle tendon sheaths at the level of radial styloid process. Its conservative management includes nonsteroidal anti-inflammatory drugs, wrist and thumb immobilization, ultrasonic therapy (US Th.) and low level laser therapy (LLLT).

Bone and Joint Infections in Children: Septic Arthritis.

The pathological invasion of a joint and subsequent inflammation is known as septic arthritis. The knee and hip are the most frequently involved joints. Staphylococcus aureus is the most common cause of septic arthritis in children.