Table of Contents
JBMH l Volume 1 l Number 1
Volume 1
Case Report- Traumatic Posterior Hip Dislocation with Posterior wall Acetabular Fracture Associated with Ipsilateral Femoral neck Fracture – An Unclassified Rare Case Report
Introduction: Posterior hip dislocation is not an uncommon injury in high-impact road traffic accidents. A combination of
posterior wall fracture–dislocation with ipsilateral neck fracture without involving the head is a rare pattern of injury reported
in the literature. Case Report: We describe a case of such complex fracture (unclassified injury), which was managed by
emergent open reduction and internal fixation using a posterior approach without doing trochanteric flip osteotomy. Postoperative
review after 2 years showed a healed fracture and a stable hip joint with some heterotopic ossifications. Conclusion:
Osteosynthesis of complex hip injuries remains a big challenge due to its variable outcome. A better understanding of the
fracture mechanism, the techniques, and the sequence of fracture reduction minimizes the risk of mal-reduction, avascular
necrosis, and arthritis.
Review Article- Role of Platelet-Rich Plasma in Osteoarthrosis of Knee Joint among Indian Population
Osteoarthritis (OA) is a widespread condition that can cause pain and reduced functional ability in approximately half
of the population at some point in their lives. To alleviate symptoms and postpone surgical intervention, new nonoperative
treatments are being suggested to treat early stages of joint deterioration. For knee OA, platelet rich plasma
(PRP) is a new treatment option knee osteoarthritis (KOA). Studies have examined the efficacy of intra-articular
PRP, which may only partially treat KOA since it ignores extra-articular tissue dysfunction. A straightforward and
minimally intrusive treatment option for treating knee OA in primary care is PRP therapy. Numerous growth factors
included in PRP may speed up the healing of tendons. A relatively recent treatment for tendinopathies is local PRP
injection. As of now, there have been no negative effects associated with PRP injections used to treat tendinopathy.
The important advantages and disadvantages in the use of PRP in OA and its scope for long-term use will be discussed
in this review.
Review Article- History and Recent Developments in Internal Plate Fixation of Fractures
Since more than a century ago, metal plates have been utilized to internally treat fractures. Even while early issues like corrosion
and insufficient strength have been fixed, more contemporary designs still have some issues. To create a plate that speeds up
fracture healing without affecting bone physiology, more study is required. The biggest change to plate-fixation of fractures
came with the invention of rigid plates. However, after the plate was removed, it caused cortical porosis, delayed bridging, and
refractures. These unintended consequences were allegedly brought on by bone-plate contact obstructing cortical perfusion.
Further plate improvements, therefore, sought to prevent necrosis and eventual porosis by reducing this contact area. The
biggest change to plate-fixation of fractures came with the invention of rigid plates. However, after the plate was removed, it
caused cortical porosis, delayed bridging, and refractures. These unintended consequences were allegedly brought on by boneplate
contact obstructing cortical perfusion. Further plate improvements, therefore, sought to prevent necrosis and eventual
porosis by reducing this contact area. The treatment of bone fractures, particularly refractory fractures, should be improved by
further advancements in bio metals and their design for orthopedic bone plates.
Review Article- History and Recent Developments in Internal Plate Fixation of Fractures Read More »
Review Article- Functional Results after Plating the Proximal Humeral Internal Locking System for Displaced Fractures
Complications with using plates and screws to fix proximal humeral fractures include the possibility of the screws coming out
of osteoporotic bone, subacromial impingement, and avascular necrosis of the humeral head as a result of severe periosteal
stripping. Revealed that using T-buttress plates to treat proximal humeral fractures resulted in a significant incidence of fixation
failure. About 87% of patients who had three- and four-part fractures treated with T-buttress plates saw good intermediate- and
long-term results. The patients in their study were 48 years old on average. Recently, more modern implants have been utilized
to treat proximal humeral fractures, such the proximal humeral internal locking system (PHILOS) plate, Polaris nail, and plan
tan humerus fixator plate. PHILOS plate treatment for proximal humerus fractures results in a favorable functional outcome.
The number of fracture pieces and the timing of the procedure had no bearing on the outcomes.
Original Article- Comparative Study of Functional Outcome of Idiopathic Congenital Talipes Equinovarus Treated between Ponseti Technique and Accelerated Ponseti Technique using Pirani Score
Background and Objectives: Congenital talipes equinovarus (CTEV), also known as clubfoot, is one of the most prevalent
birth disorders affecting the musculoskeletal system and affects one in 1000 live births. The tried-and-true Ponseti method of
therapy entails weekly adjustment of the deformity followed by a long-leg cast. Modified accelerated treatment protocols were
designed to reduce the total duration of treatment. This study was conducted to compare the efficacy of accelerated Ponseti
method versus standard Ponseti method. Methods: A randomized controlled study was conducted with participants randomized
to two groups-Study group and Control groups. All feet were scored using Pirani score, recorded by an independent assessor at
each visit. Plaster treatment was continued until clinical correction achieved. Results: The study had 100% subject retention in
both the groups from baseline to follow-up. The current study had comparable demographic distribution between the groups.
Accelerated Ponseti technique has relatively shorter duration of manipulation compared to the standard Ponseti technique.
Total number of casts used is not significantly different for accelerated Ponseti technique compared to the standard Ponseti
technique. Accelerated Ponseti technique for club foot management was found to be equally effective compared to the standard
Ponseti technique in managing idiopathic CTEV assessed by Pirani scoring. Interpretation and Conclusion: According to
the best evidence synthesis, no evidence exists to support the use of a cast change interval of 1 week. It can be concluded that
the accelerated versions of the Ponseti method can safely be used in the treatment of clubfoot without risking any significant
increase in the required number of casts.
Original Article- The Effect of Steroid in the Treatment of Simple Bone Cysts in Comparision with Autogenous Bone Marrow Injection
Background: Simple bone cysts (SBC) are well-known lesions; however, there is currently no cure for them. Studies using a
common treatment technique – steroid injection – reported results that were quite diverse from one another. The outcomes of patients
with pathological fractures who were not on any treatment were evaluated in comparison to the steroid injection method. Materials
and Methods: A total of 44 patients had steroid injection therapy (Group – I) and 38 were treated with autogenous bone marrow
injection (ABMI). For comparisons, Capanna’s plain radiographic evaluation criteria were applied, and magnetic resonance imaging
(MRI) was utilized. The outcomes were graded in accordance with MRI and X-ray findings. Results: The first and most important
finding was that the majority of ABMI patients responded well following their initial injection. We discovered that the majority of
patients fell within the range of 5 months–1 year, taking into consideration the time between the start of conservative treatment and
the mechanical repair of the cyst (CI lower than 3 and cortical width lower than 2 mm). Conclusion: Failure after a steroid injection
is possible, and healing before the third injection only rarely happens, ABMI is a straightforward, cost-free procedure that works on
both active and dormant cysts, and in the majority of cases, after the initial injection, certain symptoms of healing appear.
Original Article- Radiological Assessment of Spondylolisthesis
Spondylolisthesis is a condition, in which one vertebral body slips with respect to an adjacent vertebral body. Radiographs
are the standard diagnostic modality for its diagnosis. Loss of alignment of one vertebral body to the next is the diagnostic
hallmark. Radiographs have a larger role to play apart from diagnosis, as the classification and grading of spondylolisthesis
are based on radiographs. We demonstrate the complete radiological analysis of spondylolisthesis including the description of
method of drawing the several parameters, and their significance. We provide a pictorial representation of the assessment of
Meyerding’s grading by measurement of slip, slip angle/kyphotic angle, sacral slope, pelvic tilt, and pelvic incidence on digital
radiographs.
Original Article- Radiological Assessment of Spondylolisthesis Read More »
Original Article- Does Proximal Humeral Nailing or Proximal Humerus Internal Locking System Plating Better for Proximal Humeral Fractures?
Background: Proximal humeral nailing (PHN) and proximal humerus internal locking system (PHILOS) plate fixation for
the proximal humeral fractures offer good anatomic fracture reduction and stable primary fixation to ensure rapid fracture
healing and immediate post-operative functional therapy without prolonged immobilization. We aimed to assess the
fracture union and the functional outcome of proximal humerus fractures using proximal humeral nail and PHILOS plate.
Materials and Methods: A comparative prospective study was conducted from October 2016 to October 2019 with 53
consecutively reported proximal humeral fractures with 26 cases for PHN group and 27 cases for PHILOS group. The follow-up
period was 24 months. Results: According to Neer’s criteria, out of 26 cases in the PHN group, seven cases (26.9%) had
excellent, 12 cases (46.1%) had satisfactory, five case (19.2%) had unsatisfactory, and two cases (7.6%) had failure outcome,
whereas out of 27 cases in the PHILOS group, six cases (22.2%) had excellent, 17 cases (62.9%) had satisfactory, two cases
(7.4%) had unsatisfactory, and two cases (7.4%) had failure outcome. There was no significant difference (P > 0.05) between
the two groups. Conclusion: Both the treatment options are effective in treating the proximal fractures and there was no
significant difference between functional outcome between the two groups at 2 years follow-up.
Editorial- Current Scenario in Osteoporotic Vertebral Fracture
Authors: Anil Mehtani l Page range- 1-2 l Received- 07-06-2022, Accepted- 16-06-2022 PDF XML
Editorial- Current Scenario in Osteoporotic Vertebral Fracture Read More »