Modified Kocher-Langenbeck approach in combined surgical exposures for acetabular fractures management.

Background: Displaced fractures of the acetabulum are best treated with anatomical reduction and rigid internal fixation. Adequate visualization of some acetabular fracture types may necessitate extensile or combined anterior and posterior approaches. Simultaneous anterior iliofemoral and posterior Kocher-Langenbeck (K-L) exposures with two surgical teams have also been described.

Atraumatic Myositis Ossificans of Iliopsoas Excised through an ASIS Osteotomy: Case Report and Description of a Novel Technique.

With a well-established incidence of 15% to 20% following a spinal injury, the occurrence of neurogenic myositis ossificans of the hip is quite rare. The most widely accepted theory supporting its occurrence is the repeated microtrauma by forceful passive mobilization during rehabilitation. An extensive involvement around the hip is quite disabling to the patient.

Evaluation of the Behavior of Spinal Deformities in Tuberculosis of the Spine in Adults.

Study Design: A prospective clinical study.

Purpose: The objective of the present study was to evaluate the behavior of spinal deformities in tuberculosis (TB) of the spine during the initial 2 years and to suggest remedial measures.

Overview Of Literature: Spinal TB is the most common cause of a kyphotic deformity in many parts of the world.

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.

External iliac artery thrombus masquerading as sciatic nerve palsy in anterior column fracture of the acetabulum.

We report a case of ischemic neuropathy of the sciatic nerve in a patient with an anterior column fracture of the acetabulum operated by ilioinguinal approach. It resulted from occlusion of the blood supply to the sciatic nerve. There were no signs of a vascular insult until ischemic changes ensued on the 6(th) postoperative day on the lateral part of great toe.

Computed tomographic evaluation of the proximal femur: A predictive classification in displaced femoral neck fracture management.

Background: Femoral neck fracture is truly an enigma due to the high incidence of avascular necrosis and nonunion. Different methods have been described to determine the size of the femoral head fragment, as a small head has been said to be associated with poor outcome and nonunion due to inadequate implant purchase in the proximal fragment. These methods were two dimensional and were affected by radiography techniques, therefore did not determine true head size.

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.

Mini incision acromio-clavicular joint reconstruction using palmaris longus tendon graft.

Introduction: Conservatively managed acromio-clavicular dislocations leave the patients with significant disability. Various techniques have been described to manage such injuries operatively. However, all such techniques involve exposure of the coracoid and use of metallic implants.

Outcome of pedicle screw fixation and monosegmental fusion in patients with fresh thoracolumbar fractures.

Study Design: Prospective clinical study.

Purpose: The present prospective study aims to evaluate the clinical, radiological, and functional and quality of life outcomes in patients with fresh thoracolumbar fractures managed by posterior instrumentation of the spine, using pedicle screw fixation and monosegmental fusion.

Overview Of Literature: The goals of treatment in thoracolumbar fractures are restoring vertebral column stability and obtaining spinal canal decompression, leading to early mobilization of the patient.

Long term results after surgical management of posterior wall acetabular fractures.

Background: Posterior wall fractures are the most common of all acetabular fractures, and there is universal consensus that displaced fractures are best treated with anatomical reduction and stable internal fixation. Though early and mid term results for such studies are available, few shed light on long term results. This study was performed to evaluate long term functional and radiological outcomes in patients with posterior wall acetabular fractures and to determine factors that may contribute adversely to a satisfactory final outcome.

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.

Lumbar plexus injury in an anterior fracture dislocation of sacroiliac joint: a case report and review of literature.

Displaced unstable pelvic fractures are commonly associated with disruption of the osteoarticular junction of the sacroiliac joint. Posterior sacroiliac dislocation are commonly reported but there are only few reports the anterior type of sacroiliac dislocation where the iliac bone fractures and displaces anterior to sacrum, often in combination with fractures of pubic rami and symphyseal injuries. We present a case of an anterior type of sacroiliac fracture dislocation which was associated with a lumbar plexus injury involving both motor and sensory components.

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.

Improvisations in classic and modified techniques of flap surgery to improve the success rate for pressure ulcer healing in patients with spinal cord injury.

The recurrence of pressure ulcers (PrUs) and dehiscence of reconstructive flap have always been a problem. The present study aimed to evaluate the results of reconstructive flap surgeries in patients with spinal cord injury (SCI) having PrUs, using classic and modified flaps with improvisations to decrease wound dehiscence, flap necrosis and tension in flap. This is a prospective clinical study.

Conservatively treated acetabular fractures: A retrospective analysis.

Background: There are a few studies reporting the long term outcome of conservatively treated acetabular fractures. The present study aims to evaluate the quality of reduction, and radiological and functional outcome in displaced acetabular fractures treated conservatively.

Materials And Methods: Sixty-nine patients (55 men and 14 women) with 71 displaced acetabular fractures (mean age 38.

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.

Bladder management methods and urological complications in spinal cord injury patients.

Background: The optimal bladder management method should preserve renal function and minimize the risk of urinary tract complications. The present study is conducted to assess the overall incidence of urinary tract infections (UTI) and other urological complications in spinal cord injury patients (SCI), and to compare the incidence of these complications with different bladder management subgroups.

Materials And Methods: 545 patients (386 males and 159 females) of traumatic spinal cord injury with the mean age of 35.

Modified Kocher-Langenbeck approach for the stabilization of posterior wall fractures of the acetabulum.

This article describes a modification of Kocher-Langenbeck approach for the treatment of select posterior wall fractures of acetabulum. The technique aims at achieving osteosynthesis by creating two windows: between the gluteus medius and piriformis superiorly and between the external rotators and ischial tuberosity inferiorly. The approach spares the division of external rotators and of the abductors of the hip, thus preventing iatrogenic damage to the vascularity of the head of the femur and of the fracture fragments.

Morphometric measurements of cadaveric thoracic spine in Indian population and its clinical applications.

Study Design: Analysis of morphometric data obtained from direct measurements of 100 cadaveric thoracic spines in Indian population.

Purpose: To collect a base line morphometric data and analyze it in reference to the musculoskeletal anatomy and biomechanics of the spine; implants and instrumentations; and to suggest the requisite modification in spinal surgery instrumentations.

Overview Of Literature: Most of the previous studies in the world literature have focused primarily on the parameters of the pedicle and to the authors' knowledge; no study has been published from the Indian subcontinent reporting a detailed morphometry of the thoracic spine.

Intra-operative migration of dynamic hip screw into the pelvis.

The authors report a rare per-operative complication of intra-pelvic migration of dynamic hip screw, during osteosynthesis of an inter-trochanteric fracture. Possible reasons of migration are analyzed along with the importance of careful execution of the surgical technique to avoid such iatrogenic complications and medico-legal implications.

Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods.

Background: No consensus exists regarding the optimal treatment of ipsilateral femoral neck and shaft fractures. The three major issues related to these fractures are the optimal timing of surgery, which fracture to stabilize first, and the optimal implant to use. In an effort to find answers to these three key issues, we report our experience of managing 27 patients with ipsilateral femoral neck and shaft fractures by using two different treatment methods, i.

Modified Pauwels' intertrochanteric osteotomy in neglected femoral neck fracture.

Unlabelled: Many reported treatment methods for neglected femoral neck fractures do not always satisfactorily address nonunion, coxa vara, and limb shortening. We retrospectively reviewed the functional outcome of the modified Pauwels' intertrochanteric osteotomy in 48 adults (mean age, 48.1 years) to determine whether this approach would correct those problems.