Imaging-assisted intra-operative approach to torsional alignment in paediatric femoral shaft fractures treated with hip spica.

Background: Paediatric femoral fractures in children under 6 years are commonly managed with hip spica, considered the gold standard. While the remodeling potential for shortening and angular deformities is well established, the management of torsional alignment during spica application remains inadequately explored. This study proposes a novel technique to better address torsional alignment during the treatment of paediatric femoral fractures using hip spica.

Does the WHO Surgical Safety Checklist Need Modification for Orthopaedic Surgery Practices? A Cross-Sectional Survey Among Indian Orthopaedic Surgeons.

Background: It is well known that the implementation of the WHO surgical safety checklist (SSC) leads to improved operating room team coordination and reduced perioperative complication and mortality rates. Although it is proven to be beneficial worldwide, its awareness and usage need to be evaluated in a diverse country like India. As orthopaedic surgeries involve implants and tourniquet usage, it is important to evaluate the applicability of WHO SSC specifically to orthopaedic surgeries, and whether any modifications are needed.

Paediatric bilateral 'floating elbow'.

A child sustained an ipsilateral supracondylar humerus (SCH) and distal both-bone forearm fractures bilaterally, in addition to facial injuries, following a fall from height. He was managed surgically by closed reduction and pinning for both SCH and distal end radius fractures bilaterally. At the final follow-up, all the fractures had united uneventfully, and he had no functional limitations or cosmetic concerns.

Medial versus anterior approach for open reduction of hip in children with DDH under two years - A meta-analysis of comparative studies.

Purpose: Open reduction (OR) is usually required in developmental dysplasia of hip (DDH) for children below 24 months of age, those who failed to achieve a satisfactory reduction by the closed method. OR in this age group can be performed either through a medial or anterior approach. However, there is a paucity of literature and a lack of more substantial evidence regarding which approach (medial versus anterior) is superior for performing OR in this age group with minimal complications.

Forgotten Foreign Bodies Mimicking Osteomyelitis, a Diagnostic Dilemma - A Report of Two Cases.

Introduction: The first differential diagnosis for a chronic discharging sinus on an extremity is usually chronic osteomyelitis. These patients are usually treated with surgical debridement and intravenous antibiotics. However, all discharging sinuses are not osteomyelitis.

Optimal Forearm Position Allowing Maximum Hand Function: A Quasi-experimental Study in Adolescent Children.

Purpose: The aim of this study was to determine the ideal forearm position that allows maximum upper-limb function. In certain congenital/acquired upper-limb disorders, the management boils down to sacrificing rotatory movements of the forearm. The position of fusion that facilitates maximum upper-limb function is a topic of debate and is decided upon by personal preferences and assumptions.

Drug-induced osteopetrosis.

Osteopetrosis (OPT) denotes the consequences from failure of osteoclasts to resorb bone and chondroclasts to remove calcified physeal cartilage throughout growth. Resulting impairment of skeletal modeling, remodeling, and growth compromises widening of medullary spaces, formation of the skull, and expansion of cranial foramina. Thus, myelophthisic anemia, raised intracranial pressure, and cranial nerve palsies complicate OPT when severe.

Techniques, anaesthesia preferences, and outcomes of Achilles tenotomy during Ponseti method of idiopathic clubfoot correction: A systematic review.

Background: Achilles tenotomy (AT) forms an important aspect of Ponseti's casting method and is performed in 80-90% of idiopathic clubfoot cases to correct residual hindfoot equinus. Different techniques are described in the literature with no clarity on which method is superior. This review aims to analyse the various techniques described, anaesthesia preferences, and outcomes of AT.

Risk Prediction of Injury Among Recreational Badminton Players in India.

Background/purpose: Since badminton has emerged as a frequently played non-contact recreational sport in India, it is essential to document the injury patterns and incidence. However, there is no existing literature on this topic among Indian players.

Materials And Methods: A web-based questionnaire was circulated among recreational badminton players across North India, enquiring about demographic details, injury characteristics, and factors associated with an injury like BMI, warm-up practice, and physical training.

Correction results of atypical clubfeet managed with modified Ponseti technique: A meta-analysis of 354 feet.

Background/purpose: Atypical clubfeet are distinct from idiopathic clubfeet. It is resistant to correction by conventional casting methods and often requires a modification of Ponseti's casting technique. Although the initial correction rates are reasonable, relapse and complications are frequent.

A Novel, Low-Cost Telescopic Nail Design for Prevention and Treatment of Osteogenesis Imperfecta Associated Long-Bone Pathological Fractures in Children.

Telescopic nailing and intermittent doses of bisphosphonates are now considered the standard treatment for preventing long bone pathological fractures in osteogenesis imperfecta (OI) children. Even though the telescopic nail designs have evolved over time, we are yet to get an affordable, worldwide uniformly and easily available, surgeon-friendly telescopic nail with good rotational stability. We designed a telescopic nail with modifications in Küntscher nail (outer, hollow component) and square nail (inner, solid component).

Paediatric Anterior Cruciate Ligament (ACL) Injuries: Current Concepts Review.

Background: Over the past two decades, there has been a documented increase in paediatric ACL injuries because of a rise in younger age sports participation at the competitive level, awareness about sports-related injuries, and advanced imaging modalities.

Methods: A PubMed electronic database search was done, which revealed 1366 hits over the last five years (2016 - 2020). Finally, 37 articles that contributed to new findings were included.

Is modified reverse step-cut osteotomy better than Yun's reverse V osteotomy in paediatric cubitus varus deformity correction? A prospective, double-blinded, randomized controlled trial.

Background: Various corrective osteotomy techniques have been described in the literature for correcting paediatric cubitus varus. But we are still in search of the perfect technique that gives maximum possible deformity correction and cosmetic appearance that satisfies parents with minimal complications. We compared the outcomes of two technically sound osteotomy techniques having minimal postoperative lateral condyle prominence described in the literature.

Characteristics of Musculoskeletal Involvement in Pediatric Patients with Disseminated Sepsis in a Tertiary Care Center.

Background: Pediatric bone and joint infections account for one of the major causes of childhood morbidity. Disseminated sepsis being a systemic disorder with multisystem involvement, overshadows the timely recognition of bone and joint infections. Hence, we did this cross sectional study to evaluate the prevalence of septic arthritis and osteomyelitis in disseminated sepsis in children, the organisms implicated, and their antibiotic sensitivities.

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.

Evaluation of a Customized 3D Printed ORGAN-Hand Orthotic Device for Unilateral Cerebral Palsy: a Pilot Study.

To achieve intensive activity-based and goal-directed rehabilitation for unilateral cerebral palsy (UCP), several static and functional upper limb orthoses have been used but with limited robust evidence-base. The current pilot study evaluated the feasibility and efficacy of a customized 3D-printed orthotic device in children with UCP. The attainment of a prespecified goal and Shriners Hospital Upper Extremity Evaluation (SHUEE) at 3 and 6 mo were the efficacy measures.

FAST- Fixator Assisted Submuscular plating Technique-A simplified technique of submuscular plating in paediatric femur fractures.

The surgical management of paediatric femur fractures has evolved over the last few decades. Intramedullary stabilization with titanium elastic nail (TENS) is the preferred surgical management for length stable and mid diaphyseal femur fractures in children between 5-11 years of age. However, TENS is not preferred in length unstable fractures and in proximal or distal metaphyseal femur fractures due to higher incidence of angulation and shortening at fracture site.

Management of Missed Type-2 Monteggia Fracture Equivalent in a 9-Year-Old Child: A Case Report.

Case: A 9-year-old girl presented with a painful stiff elbow consequent to an injury she had sustained 4 months ago. The radiographs were suggestive of a type 2 Monteggia equivalent injury. She underwent an open reduction of the radial neck fracture and proximal ulna extension osteotomy to restore radiocapitellar alignment.

Ilizarov Frame Application Based on Ponseti Principles for Clubfoot Correction: A Case Report and Description of Surgical Technique.

Ilizarov external fixator has proved to be a successful method in the management of neglected and relapsed clubfoot cases as it has lesser surgical morbidity, better functional outcome and does not cause shortening of foot as compared to other surgical methods. Though Ilizarov has been routinely used in the management of neglected/relapsed CTEV, residual varus and equinus deformities are still present/recur in some cases. Here we demonstrated a surgical technique in a case of 8-year-old child with residual club foot who achieved good functional outcome after being treated using Ilizarov frame application in lieu with Ponseti's principles.