Multi-scale inferomedial femoral neck bone quality in type 2 diabetes patients with fragility fracture.

Both trabecular and cortical bone undergo changes at multiple scales. We previously demonstrated the multi-scale changes in trabecular bone quality that contribute to bone fragility in type 2 diabetes (T2D). The link between increased fragility in T2D and multi-scale changes in cortical bone and their interaction with glycation remains unclear.

Combined articular and ligament reconstructions in neglected fracture-dislocation of the knee.

Background: The management of neglected traumatic knee dislocations is challenging and is commonly associated with suboptimal outcomes. In this article we present two cases of neglected knee dislocations in two young trauma victims who presented late due to restrictions during the COVID-19 pandemic.

Methods: Two young patients presented at our center with neglected knee fracture-dislocations after eight weeks and six months of trauma.

Joint awareness among total hip arthroplasty patients operated through anterior approach versus posterior approach: a systematic review and meta-analysis.

Purpose: The aim of this systematic review and meta-analysis was to compare joint awareness in patients who underwent total hip arthroplasty (THA) via the anterior approach (AA) versus the posterior approach (PA). The hypothesis was that patients who underwent THA via AA would have better forgetfulness of the artificial joint.

Methods: A comprehensive search of major literature databases and bibliographic details was conducted to identify studies evaluating the forgotten joint score (FJS-12) in total hip arthroplasty (THA) patients operated through the anterior approach (AA) and posterior approach (PA).

Prognosticating acute traumatic spinal cord injury using Neurofilament (NF), Neuron Specific Enolase (NSE), Matrix Metalloproteinases (MMPs), and S-100B as biomarkers.

Background: Spinal cord injury (SCI) can result in lifelong disability. Currently, the literature suggests that biomarkers are helpful in prognosticating SCI, but there is no specific biomarker to date. This is the first study that predicted the prognosis dynamically using biomarkers.

Isolated Retropulsion of C5 Cervical Vertebral Body without any Displacement of Facet Joints: A Case Report on an Unusual Presentation of Cervical Spine Injury.

Introduction: The sub axial cervical spine is a common site for traumatic spine injury, the injury of which can be life-threatening and can also result in permanent disability. Subaxial cervical spine injury has been classified by Allen and Ferguson (earliest classification), subaxial cervical spine injury classification system (SLICS) and AO spine classification. Allen and Ferguson system has significant inter-observer variations and is difficult to apply clinically at times.

Safety and Efficacy of Tranexamic Acid in Hip Hemiarthroplasty for Fracture Neck Femur: a Systematic Review and Meta-analysis.

Purpose: Although numerous systematic reviews and meta-analyses have established the efficacy of tranexamic acid (TXA) in hip fracture surgeries, the included studies in those reviews have included all types of surgical interventions ranging from fixation to arthroplasty. Hip hemiarthroplasty is usually indicated in the elderly patients with femoral neck fracture and these patients have associated severe comorbidities and cognitive impairment. These subsets of patients with femoral neck fracture needs appropriate perioperative care and judicious use of antifibrinolytics.

Application of Modest Hypothermia in Patients with Acute Traumatic Cervical Spine Injury: A Pilot Study.

Introduction: This prospective randomized controlled study aimed to examine the role of modest systemic hypothermia in individuals with acute cervical spinal cord injury (SCI) regarding neurological improvement. Studies have shown that the application of hypothermia is safe and that it improves neurological outcomes in patients with traumatic spine injury. Hypothermia helps in decreasing a secondary damage to the cord.

Locked Plating Versus Retrograde Intramedullary Nailing for Distal Femur Fractures: a Systematic Review and Meta-Analysis.

Modern advances in techniques and implants have allowed for a better operative fixation for distal femoral fractures. Both locked plating and retromedullary nail have allowed surgeons to stabilize these fractures with minimal soft tissue dissection and preserve blood supply. Although both the implants have been used extensively for such types of fractures, the superiority of one implant over the other is still doubtful.

Effects of type 2 diabetes on the viscoelastic behavior of human trabecular bone.

Unlabelled: Type 2 diabetes (T2D) is a well-known disease that impaired bone mechanical properties and increases the risk of fragility fracture. The bone tissue is a viscoelastic material that means the loading rate determines its mechanical properties. This study investigates the impact of T2D on the viscoelastic properties of human bone and its association with microstructure and biochemical properties.

Mycobacterium tuberculosis Infection of the Spine Secondary to Oxygen - Ozone Therapy for Prolapse Intervertebral Disc: A Scoping Review.

Introduction: Ozone therapy is one of the evolving, yet far from conclusive, alternative minimally invasive treatment option in the management of herniated disc in the cervical and lumbar spine. It causes the decrease in the volume of herniated disc by dehydration.

Case Report: We hereby present the first reported case of Mycobacterium infection of the spine secondary to ozone therapy with the aim to caution the surgeons regarding the complications of intradiscal ozone therapy.

Can fingernail quality predict bone damage in Type 2 diabetes mellitus? a pilot study.

Type 2 diabetes mellitus (T2DM) adversely affects the normal functioning, intrinsic material properties, and structural integrity of many tissues, including bone. It is well known that the clinical utility of areal bone mineral density (aBMD) is limited to assess bone strength in individuals with T2DM. Therefore, there is a need to explore new diagnostic techniques that can better assist and improve the accuracy of assessment of bone tissue quality.

Is Minimally Invasive Plating Osteosynthesis Better Than Conventional Open Plating for Humeral Shaft Fractures? A Systematic Review and Meta-Analysis of Comparative Studies.

Introduction: The aim of systematic review and meta-analysis was to find out whether minimally invasive plate osteosynthesis (MIPO) is better than open reduction and internal plate fixation (ORIF) in terms of functional outcome, achieving union (union time and incidence of non-union), intraoperative parameters (surgical duration, blood loss, and radiation exposure), and complications (iatrogenic radial nerve palsy and infection) for humeral shaft fractures.

Materials And Methods: We searched online databases (Pubmed, Embase, Scopus, and The Cochrane Library) from inception till 3rd September 2020 for articles comparing MIPO with ORIF for humeral shaft fractures. The methodological quality of randomized controlled trials (RCTs) was done by Cochrane Risk of Bias assessment tool 2 (RoB2) and of non-randomized studies (case-control and cohort studies) by Methodological Index for non-randomized studies (MINORS).

Efficacy of antifibrinolytics in reducing blood loss during hip reconstruction surgery in cerebral palsy children. A systematic review and meta-analysis.

Background: Cerebral palsy (CP) children undergoing hip reconstruction are more prone to blood loss during surgery due to poor nutritional status, antiepileptic medication intake, depletion of clotting factors, and the extent of surgery involved. We conducted this present review to analyze whether antifibrinolytics during hip surgery in CP children would reduce surgical blood loss and transfusion requirements.

Methods: Three databases (PubMed, EMBASE, and Cochrane library) were searched independently for publications mentioning the use of antifibrinolytics during hip reconstruction surgery in CP children.

Tuberculosis of the spine and drug resistance: a review article.

Pott's spine is tuberculosis of spine caused due to hematogenous spread of mycobacterium from a primary focus. It constitutes about 50% of skeletal tuberculosis cases. Paradiscal type is the most common type of spinal tuberculosis.

Orthopedic Residency in a Tertiary Care Hospital of India: Positives, Negatives and Perspectives for Change.

Background: Orthopaedic residency training is a 3-year period of preparation that converts a raw medical student into a proficient orthopaedic surgeon. Due to wide variations at different centers in India, the program in a tertiary hospital is presented, in an attempt to improve the overall levels of training.

Materials And Methods: PGIMER has produced many good surgeons who are well settled across the country and the world.

Long-term survival of CLS Spotorno femoral stem: a systematic review of literature.

Background: CLS Spotorno is a time-tested femoral stem design with excellent early results; the present review was designed to assess the published evidence on CLS Spotorno stem in the literature to evaluate its long-term outcomes and compare it to two other popular stem designs the uncemented Corail™ and the cemented Exeter™ stems.

Research Question: Do CLS Spotorno stems provide adequate long-term rates of survival in terms of revisions and functional outcomes?

Methodology: Medline, EMBASE and SCOPUS databases were searched for relevant articles and a total number of 670 hits were obtained, out of which 14 relevant studies were included in this review. Pooled analysis of revisions rates, subsidence and Harris Hip scores (HHS) were done.

Prediction of mechanical properties of trabecular bone in patients with type 2 diabetes using damage based finite element method.

Type-2 diabetic (T2D) and osteoporosis (OP) suffered patients are more prone to fragile fracture though the nature of alteration in areal bone mineral density (aBMD) in these two cases are completely different. Therefore, it becomes crucial to compare the effect of T2D and OP on alteration in mechanical and structural properties of femoral trabecular bone. This study investigated the effect of T2D, OP, and osteopenia on bone structural and mechanical properties using micro-CT, nanoindentation and compression test.

Intramedullary Nailing Versus Plating for Proximal Tibia Fractures: A Systematic Review and Meta-analysis.

Introduction: Extra-articular proximal tibia fractures make up to one-tenth of all tibia shaft fractures. Treatment options include conservative, nailing, plating and external fixation. There is no consensus on which method is superior if the patient is to be managed surgically.

Minimally Invasive Surgery versus Open Surgery for Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis.

Minimally invasive surgery (MIS) is being recommended over more invasive methods. MIS advantages are less time in the operating room, less blood loss, a shorter recovery time, and shorter length of stay. A systematic review and meta-analysis were performed using the literature from minimally invasive and open surgery for adolescent idiopathic scoliosis (AIS).

Comparing Three Modalities of Treatment for Frozen Shoulder: A Prospective, Double-Blinded, Randomized Control Trial.

Purpose: To compare the effects of three modalities of pain management i.e. SSNB (suprascapular nerve block) with NIR (non invasive rehabilitation), IAI (intra articular injection) with NIR and, NIR alone in idiopathic frozen shoulder patients.

Bioaerosols in orthopedic surgical procedures and implications for clinical practice in the times of COVID-19: A systematic review and meta-analysis.

Introduction: Orthopedic surgical procedures (OSPs) are known to generate bioaerosols, which could result in transmission of infectious diseases. Hence, this review was undertaken to analyse the available evidence on bioaerosols in OSPs, and their significance in COVID-19 transmission.

Methods: A systematic review was conducted by searching the PubMed, EMBASE, Scopus, Cochrane Library, medRxiv, bioRxiv and Lancet preprint databases for studies on bioaerosols in OSPs.

Need for Testing and Supplementation of Vitamin D3 After Release of COVID-19 Lockdown in Patients with Increased Musculoskeletal Pain.

Aims: To evaluate vitamin D3 levels in patients who presented with increased musculo-skeletal pain after release of lockdown period when compared to pre-lockdown status.

Introduction: During this COVID pandemic, many countries have implemented lockdown measures and people have to work from home and many students and workers have to restrict themselves to home. During this period, their outdoor activities were limited.