Orthopaedic Journal of M. P. Chapter

Orthopaedic Residency Program

2023-08-16T16:31:37+0530

There should be one standard orthopaedics residency program to develop competent, qualified and highly skilled orthopaedics residents. Numerous new budding orthopaedic surgeons are coming in the orthopaedics department who are taking their training very casually. This can be prevented by strict orthopaedics residency program which can make them efficient. Basic course of Advance Trauma Life Support (ATLS) should be taught in very first year of residency so that they can apply it in emergency patient management. Thesis review should be done in once in every three months. Journals, seminars and case presentations should be done at daily basis. Complete and comprehensive teaching program can improve the academic skill of the residents. Post graduate residents should be encouraged to attend as many as conferences in their tenure to improve their knowledge. Paper presentation and publication is now essential part of their training, so complete guidance should be given to them. A compulsory anatomy dissection posting should be mandatory for every junior resident. Hands-on cadaver and simulation workshops should be made more accessible to residents at least once in 6 months to improve their surgical skill. e.g., arthroscopy, spine and AO type models. A Basic statistics knowledge is essential, and every orthopaedic trainee should have passed a certified basic statistics examination. There should be one team of one junior resident, one senior resident and one consultant for three years which can monitor the progress of post graduate resident and if any correction is required, can be done immediately. Maintenance of a logbook which should be checked and verified by the respective mentor assigned, is essential. Logbooks serve as a road map of the academic journey of an orthopaedic trainee. The trainee should be assessed and graded at regular intervals, with respect to knowledge, clinical skills, operative skills, personality and ethics. Three years of compulsory senior residency program should be enforced before an orthopaedic surgeon is allowed to practice independently as it would be the best time for a fresh orthopaedic surgeon to decide on the sub-speciality of his interest, which he would practice for his lifetime. Further prospects like focussed subspecialties should be encouraged. Orthopaedic surgery is a specialty that has an intense reputation. It’s known for being competitive, for having a hard training process and incredibly busy schedule, and for requiring a good deal of personal sacrifice in order to meet the demands of the profession.

Prospective study on outcome of distal radius treated with closed reduction and percutaneous pinning

2023-08-16T15:48:44+0530

Background: Vast majority of fractures of distal radius are articular injuries that result in disruption of both radiocarpal and radioulnar joints. Therefore, this study evaluates the functional and radiological outcomes of distal radius fractures treated by percutaneous pinning in ulno-carpal joint and distal radius.
Methodology: A Prospective Interventional Study conducted at Department of Orthopaedics, N.S.C.B. Medical College and Hospital, Jabalpur (M.P.) with the study population of patients attending OPD and casualty diagnosed with distal Radius fracture from the duration of 1st March 2021 to 31st June 2022. Total of 50 Sample size was taken estimated through the formula n= z2*pq/d2. Data analysis was done through the IBM software SPSS and the statistical association was fund with the Confidence Interval of 95% and p-value>0.5.
Results: Total of 50 patients, 30 were male, and 20 were females, who were assessed through follow-up. According to Sarmiento score of range of motion, 6 Patients have excellent score (0-2), 12 patients have good score (3-8), 12 patients have fair (9-20), and 5 patients have poor (above 21).
Conclusion: Closed reduction and percutaneous K-wire fixation is a less intrusive, safer, and successful approach to preserve the reduction, avoid radial collapse during healing, and maintain DRUJ stability even when the fracture is extensively comminuted, intra-articular, or unstable.

Functional and radiological outcome of surgically treated tibial plateau fractures

2023-08-16T15:49:17+0530

The present study included 30 patients (17 males; 13 females, mean age 40.33±12.7 years; range, 18 to 65 years) with tibial plateau fractures who were treated with various modalities. In our series, all patients were treated operatively out of which 15 (50.0%) were managed by ORIF with lateral plate, 8 (26.7%) patients were managed by CRIF with CC screw, 4 (13.3%) ORIF with lateral plate with CC screw, 2 (6.7%) ORIF with medial plate and 1 (3.3%) CRIF with CC screw. In all patients, similar standard physical rehabilitation therapy was followed. All complications including intra and post-operative were assessed and recorded. The functional outcome was assessed using Harkonen-Jarvinen criteria after a mean follow-up of 8 months. The statistical analysis was done using the paired t-test. All patients showed excellent or good results according to H J criteria. In the present study, there were no cases of secondary loss of reduction, failure of the implant, malunion, or non-union.

A prospective study for initial assessment of functional outcome of high tibial osteotomy in active young adults in early osteoarthritis of knee

2023-08-16T16:27:30+0530

Introduction: Knee osteoarthritis is typically the result of wear and tear and progressive loss of articular cartilage. Common clinical symptoms include knee pain, stiffness and swelling that worsens over time. Osteoarthritis commonly affects the medial compartment of knee giving rise to varus deformity. High tibial osteotomy (HTO) is a valuable treatment modality in correcting malalignment and thereby relieving the symptoms associated with medial unicompartmental osteoarthritis.
Methodology: Twenty-eight young patients with complaints of knee pain were screened and those diagnosed as early knee osteoarthritis (grade I-III on Kellgren-Lawrence grading scale) were operated by high tibial osteotomy. Follow-up evaluation was done at 3, 6 and 9 months by Knee Society Scoring Scale and Visual Analogue Scale (VAS) for pain.
Results: The mean knee score was 53.3 pre-operatively and post-operatively the score improved gradually to the mean of 83.2 at 9 months. The visual analog scale for pain in all patients showed a significant improvement at the final follow-up.
Conclusion: High tibial medial opening wedge osteotomy is a good option in the treatment of unicompartmental osteoarthritis knee. It relieves pain and improves functional outcome. Accurate preoperative planning and good surgical technique gives better results.

Fluroscopic guided capsular distention with and without suprascapular nerve block in frozen shoulder patients a prospective comparative study

2023-08-16T16:28:40+0530

Background: In general practise, frozen shoulder is a common condition, in which pain and gross restriction of movement around affected shoulder joint occur. Aim of our study is to compare the effectiveness of fluoroscopic guided capsular distension with and without suprascapular nerve block to relieve pain and improve range of movement.
Material & method: An observational study of 60 patients of frozen shoulder to compare capsular distension with steroid, local anaesthetic and normal saline in 30 patients with suprascapular nerve block (group A). Capsular distension with steroid, local anaesthetic and normal saline without suprascapular nerve block in 30 patients (Group B). After capsular distension all patients advised physiotherapy, ranges of movement and pain over shoulder joint were assessed over a 12-week period.
Results: In comparison to fluoroscopic guided capsular distension without suprascapular block (Group B), fluoroscopic guided capsular distension with suprascapular block (group A) has a more decreased SPADI and VAS score
Conclusions: According to this study, suprascapular nerve block is a more safe and effective method of treating frozen shoulder than distension with no nerve block.

Comparative study between laminectomy and fenestration surgery in lumbar prolapsed intervertebral disc (PIVD)

2023-08-16T16:29:45+0530

Background: Comparative study between laminectomy and fenestration surgery in lumbar prolapsed intervertebral disc (PIVD).
Material and method: In this study, 44 cases of Lumbar Prolapsed Intervertebral Disc (PIVD) were admitted and divided into two procedure groups, i.e; laminectomy and fenestration and operated via either of the procedure and the outcome after the surgery was assessed by the Oswestry Disability index (ODI).
Results: In Present study, the fenestration group’s ODI score was significantly decreased post-operatively after one month and after 6-12 months with p<0.05 with ODI values pre-operatively, post- operatively after one month and after 6-12 months with mean 28.05±4.03, 4.68±2.42 and 3.50±4.11, respectively. In present study, the laminectomy group’s ODI score was Significantly decreased post-operatively after one month and after 6-12 months with p<0.05 with ODI score values pre- operatively, post-operatively after one month and after 6-12 months with mean 30.05±4.01, 6.27±3.27 and 5.14±5.51 respectively.
Conclusion: No significant difference was found in post-operative after one month and post operative 6-12 months ODI scores between both study groups laminectomy and fenestration with p>0.05. Fenestration is advantageous over Laminectomy in perioperative parameters,i.e; less soft tissue injury, less blood loss, less duration of surgery, good spinal function, smooth patient recovery, early rehabilitation