Publications by authors named "Balaji Saibaba"

Introduction: Total hip arthroplasty (THA) has been termed as 'operation of the century' as it provides a stable and mobile hip to patients who are debilitated by pathologies affecting the hip. Acetabular fractures pose a challenge for their initial management as well for the management of secondary osteoarthritis which is often the outcome of these fractures. The study attempts to evaluate the short term radiological, functional and quality of life outcomes of THA done in patients with prior acetabular fractures and to find a correlation between various factors.

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The physis of a long bone may get 'sandwiched' and crushed between the metaphysis and the epiphysis if it is traumatically loaded along its long axis. Such a physeal injury may lead to complications like angular deformities and growth restrictions and hence, management of such injuries requires adequate planning and attentive execution. Two patients with distal femoral physeal crush injury were treated using a ring fixator such that one ring had the wires passing through the epiphysis and the other through the femoral shaft.

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We report a unique case of post-traumatic avascular necrosis of tibia in a 12-year-old boy following a Salter-Harris type II physeal injury of the proximal tibia. The diagnosis was made on the basis of classical radiological findings. The only clinical symptom was diffuse shin pain.

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Article Synopsis
  • * The study reports on nine cases of SC joint TB, highlighting common diagnostic delays as these cases were often treated for inflammation in other areas first.
  • * Treatment varied, with most patients responding well to antitubercular chemotherapy, and some requiring additional therapies; the need for awareness of TB's atypical presentations is emphasized for quicker diagnosis and treatment.
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Background: Vascular trauma associated with bony injuries is an orthopaedic emergency. Lack of timely intervention can lead to loss of limb or even life. Inspite of the rising incidence of high speed road traffic accidents in India, there is paucity of literature regarding the demographic pattern, clinical morbidity, management strategies and outcome of arterial injuries associated with lower limb trauma.

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Osteoarthritis (OA) is a degenerative disease of the joints and is one of the leading causes of disability in adults. However, there are no key therapeutics for OA and medical treatment is based on managing the symptoms and slowing down progression of the disease. Diagnostics based on clinical examination and radiography have provided little information about metabolic changes in joint tissues, disease onset and progression.

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Inferior dislocation of the hip is a rare clinical entity, wherein closed reduction maneuver could be challenging, especially if the attending surgeon is not familiar with the specific anatomy associated with this injury. Due to the rarity of this type of injury, large case series are lacking in the literature; hence, case reports form the major source of our knowledge regarding the clinical presentation and management. An extensive literature search revealed a change in age group presenting with this specific injury, with a male predilection.

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Article Synopsis
  • Osteofibrous dysplasia, or ossifying fibroma, is a rare benign growth that typically occurs in children, most often found in the maxilla and mandible, and sometimes in the tibia as a painless swelling.
  • This condition in the clavicle has not been documented in English literature prior to this case.
  • The presented case describes a unique instance of osteofibrous dysplasia in the clavicle that appears similar to chronic osteomyelitis in its clinical presentation.
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Tubercular dactylitis is a rare manifestation of skeletal tuberculosis in the paediatric population. Its clinical diagnosis is often delayed as local symptoms may easily be missed in children and constitutional features such as loss of weight, loss of appetite, night sweats, evening rise of temperature and history of close contact with a patient of tuberculosis may not always be present. Parents seek treatment only when they notice significant swelling or tenderness of fingers or hand in their children.

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Article Synopsis
  • Conjoint bicondylar coronal plane fractures are rare injuries often resulting from high-impact trauma, typically involving a flexed knee.
  • Only two cases of this specific fracture have been documented in English literature, one in adults and one in children, with this being the first report of a case featuring an incarcerated patella.
  • Effective treatment includes prompt open reduction and internal fixation, followed by early mobilization of the knee to improve recovery outcomes.
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The incidence of traumatic hip dislocations in children is rising in this fast developing world along with increasing numbers of high-velocity road traffic accidents. Anterior dislocation of the hip has a lower incidence compared with posterior dislocation of the hip. We encountered a rare case of the obturator type of anteriorly dislocated hip associated with ipsilateral fracture of the shaft femur in an 11-year-old child.

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Article Synopsis
  • Skeletal neurofibromatosis (NF) generally presents with conditions like scoliosis and tibial dysplasias, but NF affecting the pelvic area is very uncommon.
  • A unique case is presented involving a patient with NF-1 who experienced a pathological fracture of the acetabulum leading to an anterior hip dislocation, which has not been previously documented.
  • The management involved tumor removal and iliofemoral arthrodesis, demonstrating that this approach can be effective for young patients dealing with such fractures.
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Multicentric reticulohistiocytosis (MRH) is a rare systemic disease, which commonly manifests as muco-cutaneous papulonodules and inflammatory erosive polyarthropathy. In this research, we report the clinical manifestations and management of a rare case of MRH with destructive arthropathy of bilateral hip joints and arthritis mutilans presenting with characteristic deformities. Disabling hip arthropathy that occurs secondary to MRH can be successfully managed with bilateral total hip arthroplasty (THA).

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Synovial chondromatosis is a rare, usually benign disorder affecting the population predominantly in the third and fourth decades of life and mainly involving the large weightbearing joints of the lower limb-the knees and the hip. In this report, we highlight an unusual pediatric clinical presentation of synovial osteochondromatosis involving the subtalar joint and discuss its surgical management; we also provide a comprehensive up-to-date literature review of the disorder. This patient was successfully treated with en masse surgical excision.

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Purpose: To identify and quantify the presence of extra-articular tibia vara that might influence the mechanical axis alignment after total knee arthroplasty (TKA).

Materials And Methods: A total of 48 TKAs in 30 osteoarthritic Indian patients were prospectively evaluated. The hip-knee-ankle angle (HKA), joint line convergence angle, and varus angulation at the femur and tibia were measured from the preoperative and postoperative standing hip-to-ankle radiographs.

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Fractures of the tibia are one of the most commonly seen orthopedic injuries. Most of them result from a high velocity trauma. While intramedullary nailing of tibial diaphyseal fractures is considered as the golden standard form of treatment for such cases, many metaphyseal and metaphyseal-diaphyseal junction fractures can also be managed by nailing.

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Skeletal myxomas are rare benign tumours. Their occurrence in long bones of the extremities is rarely reported. A 45-year-old man presented with pain in his left proximal thigh for a duration of 4 months.

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Purpose: To evaluate outcomes of 36 patients who underwent curettage, use of phenol, and reconstruction using the sandwich technique for giant cell tumour (GCT) of bone around the knee.

Methods: 22 women and 14 men aged 19 to 46 (mean, 29.6) years underwent intralesional curettage, use of phenol, and reconstruction using the sandwich technique for GCT of the proximal tibia (n=23) or distal femur (n=13).

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Background. Tuberculosis is a chronic disease which may have varied presentations. Though pulmonary tuberculosis is the commonest, extrapulmonary tuberculosis involving skeletal system is often seen.

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