Management Guidelines for Infection After ACL Reconstruction: Expert Opinion Statement Based on the Modified Delphi Survey of Indian Arthroscopy Surgeons.

Aim: Infection after anterior cruciate ligament (ACL) reconstruction, though rare, is a potentially devastating complication and the evidence-based recommendation on the various topics in its management is limited. The purpose of this study was to develop recommendations for the prevention and management of infections in ACL reconstruction surgery by performing a structured expert consensus survey using Delphi methodology.

Materials And Methods: 22 topics of relevance in the prevention and management of infection following ACL reconstruction were chosen from an extensive literature review.

Comparison of Clinico-radiological Outcomes of Monolateral Fixator in Infected Non-union of Tibia Based on Bone Gap Quantification.

Introduction: Monolateral rail fixators are more comfortable to the patients and have a lesser learning curve compared to ring fixators. Guidelines are still lacking for rational use of monolateral fixator for bone transport. This retrospective study aimed to analyze and compare the clinico-radiological outcomes of monolateral fixator in infected non union of tibia based on bone gap quantification.

Prospective randomized comparison of quality of regenerate in distraction osteogenesis of ring monolateral fixator in patients with infected nonunion of the tibia using digital radiographs and CT.

Aims: In this randomized study, we aimed to compare quality of regenerate in monolateral circular frame fixation in 30 patients with infected nonunion of tibia.

Patients And Methods: Both groups were comparable in demographic and injury characteristics. A phantom (aluminium step wedge of increasing thickness) was designed to compare the density of regenerate on radiographs.

Demographic Study of Orthopedic Trauma among Patients Attending the Accident and Emergency Department in a Tertiary Care Hospital.

Background: Trauma causes a major burden on the health system and economy of the country. A better understanding of the epidemiology of trauma can be of great help in planning preventive and curative strategies.

Materials And Methods: A total of 4834 patients of trauma presenting during 1 year were included in this observational study.

Implantless patellar fixation in medial patellofemoral ligament reconstruction.

Purpose: The medial patellofemoral ligament (MPFL) acts as primary restraint to lateral patellar dislocation and its rupture has been reported in almost all cases of acute patellar dislocation. Various surgical techniques have been described for MPFL reconstruction, using many femoral and patellar fixation techniques and different grafts. This article details our technique for MPFL reconstruction using semitendinosus graft which avoids the use of implant at patellar end.

Tubercular Tenosynovitis of Hand: A Rare Presentation.

Introduction: Tuberculosis tenosynovitis of the wrist and hand is an unusual condition. It mimics a number of other clinical conditions such as ganglion, De quervan's disease, carpal tunnel syndrome, granulomatous gout, neurofibroma, and haemangioma.

Case Report: We present case of 58-year-old male patient with swelling over thenar region of left hand where the initial fine needle aspiration cytology (FNAC) report suggested diagnosis of ganglion/synovial cyst, but the patient did not improve with conservative treatment.

A prospective study to evaluate the clinico-radiological outcomes of arthroscopic single bundle versus double bundle anterior cruciate ligament reconstruction.

Introduction: The aim of the study was to compare clinical and radiological outcomes of arthroscopic single-bundle versus double-bundle anterior cruciate ligament (ACL) reconstruction.

Patient And Methods: 60 patients with isolated ACL injury were divided into single bundle (SB) ( = 30) and double bundle (DB) reconstruction groups ( = 30) and operated between July 2009 and July 2012. Outcome evaluation was performed using GNRB arthrometer, International Knee Documentation Committee & Lysholm scale.

Outcome of distraction osteogenesis by ring fixator in infected, large bone defects of tibia.

Background: Salvage of large, infected bone defects in tibia poses a formidable problem. The present prospective study aimed to evaluate radiologic and functional outcome of ring fixator in infected, large (≥6 cm) bone defects of tibia treated with distraction osteogenesis.

Materials And Methods: The study included 35 patients (30 males and 5 females) who had minimum of 6 cm gap after radical resection of necrotic bone and presence or history of active infection.

Comparative analysis of arthroscopic debridement in osseous versus soft tissue anterior ankle impingement.

Background: Arthroscopic debridement has been a gold standard procedure for anterior ankle impingement, both in cases of osseous and soft tissue impingement. There is sparse literature on comparative outcome with respect to functional results between the two types of impingement post-arthroscopic debridement.

Methods: Our study included 14 patients diagnosed as cases of anterior ankle impingement on the basis of clinical and radiological examination.

Contralateral reversed distal femoral locking plate for fixation of subtrochanteric femoral fractures.

Purpose: Subtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success. However, these implants require precise placement under image intensifier guidance, which exposes the surgeon to substantial amount of radiation. It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available.

Arthroscopic anatomical double bundle anterior cruciate ligament reconstruction: A prospective longitudinal study.

Background: Single bundle anterior cruciate ligament (ACL) reconstruction has been the current standard of treatment for ACL deficiency. However, a significant subset of patients continue to report residual symptoms of instability with a poor pivot control. Cadaveric biomechanical studies have shown double bundle (DB) ACL reconstructions to restore the knee kinematics better.

Congenital pseudoarthrosis of the clavicle with bifurcation.

Congenital pseudoarthrosis of clavicle is a rare clinical entity. It usually presents as a swelling in the clavicular region at birth or soon after birth. Fitzwilliam's original description of 60 subtypes of congenital pseudoarthrosis of clavicle have addressed several anatomical variants, e.

Ossicle in anterior cruciate ligament: a rare occurrence.

The occurrence of an intra-articular ossicle is not rare in the knee, with reports suggesting the existence of meniscal osscile. There are also reports describing the attachment of the posterolateral bundle of the anterior cruciate ligament (ACL) to an accessory ossicle. However, despite an extensive search of the English literature we did not find much written about an intrasubstance ossicle in the ACL.

Fixation of delayed union or non-union posterior cruciate ligament avulsion fractures.

Purpose: To report the outcome of fixation for delayed union or non-union posterior cruciate ligament (PCL) avulsion fractures.

Methods: Seven men and 4 women aged 24 to 35 (mean, 28) years underwent lag screw or suture fixation for non-union or delayed union of avulsion fracture of PCL tibial attachment after a mean delay of 8.6 (range, 4-14) months.

Missed ulnar nerve injury and closed forearm fracture in a child.

Ulnar nerve injury in closed fracture of forearm in children is uncommon.Commonly, neurapraxia is the reason for this palsy but other severe injuries or nerve entrapment has been reported in some cases. The importance of diagnosis concerning the types of the nerve injury lies in the fact that they have totally different management.

Pseudoarthrosis of medial tibial plateau fracture----role of alignment procedure.

Nonunion in tibial plateau fractures is very rare. Limited literature is available on Pubmed search on intraarticular tibial nonunion. Most of the cases reported have been following failed surgical treatment and none was neglected fractures.

Dorsally comminuted fractures of the distal end of the radius: osteosynthesis with volar fixed angle locking plates.

Background. Dorsally comminuted distal radius fractures are unstable fractures and represent a treatment challenge. The objective of this study was to evaluate the functional and radiological outcome of dorsally comminuted fractures of the distal radius fixed with a volar locking plate.

Simultaneous use of cannulated reamer and schanz screw for closed intramedullary femoral nailing.

Introduction. Closed reduction is a critical component of the intramedullary nailing and at times can be difficult and technically challenging resulting in increased operative time. Fluoroscopy is used extensively to achieve closed reduction which increases the intra-operative radiation exposure.

Locked intramedullary femoral nailing without fracture table or image intensifier.

The present retrospective study aims to evaluate the outcome in 41 patients of femoral shaft fractures, who had closed intramedullary nailing in lateral decubitus position without fracture table or image intensifier. Mean age was 33.2 (range, 18-70) years.

Functional outcome in athletes at five years of arthroscopic anterior cruciate ligament reconstruction.

Introduction. The purpose of this study was to analyze the functional outcome in competitive level athletes at 5 years after ACL reconstruction with regard to return to sports and the factors or reasons in those who either stopped sports or showed a fall in their sporting levels. Methods.

Meniscal ossicle.

Meniscal ossicle, or bone within the substance of meniscus, is a rare entity and commonly confused with a loose body both clinically and radiologically. MRI is the modality that can definitely diagnose meniscal ossicle and avoid unnecessary diagnostic arthroscopy. Here we report one such case diagnosed using MRI; this patient is doing well without surgery one year after diagnosis.

An unusual case of foreign body knee that spontaneously migrated inside and out of the joint: arthroscopic removal.

Cause of acute knee pain and locking episodes in a young sports person can be due to foreign bodies which penetrated unnoticed into the joint cavity. Here we report an unusual injury of this kind where a glass foreign body remained in the subcutaneous tissue for many years and then migrated late into the knee joint cavity. Complaints occurred for the first time in adult age.

Subtrochanteric fracture managed by intramedullary nail in a patient with pycnodysostosis.

A rare case of a 54-year-old man with pycnodysostosis having subtrochanteric fracture of right femur is being reported. This patient had this fracture after a trivial fall while walking. He had typical facial features, short stature, open fontenella, short stubby hands, high arched furrowed palate and radiological features including open cranial sutures, obtuse angle of mandible, dysplasia of lower end of radius and ulna, notching of lumbar vertebra and generalized skeletal sclerosis.