Sciwora Syndrome is a rare form of spinal cord injury. An interesting cases of SCIWORA syndrome in a 31/2 years old boy is being reported. The patient had complete paraplegia with bowel and bladder involvement while the x-rays were within normal limits. MRI revealed spinal cord injury.
A large number of reports are published about the results of treatment of Legg- Calve- Perthes disease. Since the original description in 1910, various non-operative and operative options have been tried. Lots of controversies exist regarding the management of this condition. The purpose of, this article is to decide about operative indications, the type of operation appropriate at a particular stage of the disease and also the most appropriate time for the surgical intervention.
H.V. Crock (1976) described a lesion at the lumbosacral [L5-S1] disc which was degenerative in nature with characteristic features reduction of disc height, sclerosis of end plates, degenerative changes in apophyseal joints, retrolisthesis, and traction ostepohytes. It affected L5-S1 disc only while other discs at proximal levels were normal. We report a series of 27 patients of isolated disc sorption seen during 1996 to 1998. There were 20 females and 7 males, their age ranged from 30 to 83 years. They presented with low back pain, sciatica, and often with claudication of varying severity and duration. The symptoms arose from L5-S1 level in almost all cases. The treatment has been conservative primarily, and 3 cases were advised surgery.
A series of 40 cases, predominantly males, is presented where ACL reconstruction was done utilizing the medial third of the patellar tendon, which was implanted by a â€œmini-arthrotomyâ€�. The procedure is definitely easier than the totally arthroscopic method, does not involve sophisticated instrumentation and can be easily used by a surgeon in the initial stages of his learning curve. The capsular incision was only 2 inches long and was a deeper extension of the incision which was used for graft harvesting. There was excellent visualization of the intercondylar notch as well as the femoral and tibial tunnel sites. Graft passage was easier, and the post- operative rehabilitation was the same as with the arthroscopic methods. We encountered no complications due to the use of the medial third of the patellar tendon with respect to patellar tracking. This procedure is recommended as a good option for surgeons who are not well versed with arthroscopic ACL reconstructions or have limited facilities.
One hundred fractures of femoral shaft were treated by interlocking intramedullary nail and followed for a period of 15 months. Union was achieved in 98 out of 100 fractures, 75 patients have shown good to excellent results. The complications seen included limb length discrepancy, medial mal rotation, infection and implant failure. Two patients development Fat embolism syndrome, they improved subsequently.
Articular cartilage repair and regeneration is a poorly understood yet clinically important field of study. While cartilage defect resurfacing has been tried both by biological and non-biological materials, yet a satisfactory solution has not been attained. We present a series of 35 experimentally produced defects resurfaced with autologous periosteum in rabbits. The results of such resurfacing showed that unresurfaced defects did the poorest while those resurfaced with periosteum with its cambium layer facing the joint looked closer to normal articular surface. The regenerated cartilage was microscopically similar to original cartilage but of less durability.
Thirteen patients suffering from rupture of achilles tendon due to slip in Indian style toilet were seen. Eight of them have complete tear, while 5 were partial rupture of the tendon. They were treated by primary surgical repair with no incidence of re-rupture.
We report the results of locked Seidel nailing for 25 fractures of the humerus. There were frequent technical difficulties at operation especially with the locking mechanism and reaming the medullary canal. Protrusion of the nail above the greater tuberosity occurred in 2 cases due to inadequate locking, and resulted in shoulder pain and poor function. Poor shoulder function was also seen in two patients with no nail protrusion, presumably because of local rotator cuff damage during insertion. During reaming we encountered splintering of distal fragment in two of our cases. Our results suggest that considerable modifications are required of the nail, regarding diameter and locking mechanism, before its use can be advocated in Indian population.
An interesting and intriguing case of fracture dislocation of upper thoracic spine is presented. A 20 year old male presented with delayed paraparesis. Anterior decompression and fusion without reduction or stabilization was done. Patient had an excellent result at last follow up at 18 months.
A total of 40 patients undergoing total knee arthroplasty were divided in two groups i.e. simultaneously operated for bout knees and those getting single knee arthroplasty in same sitting, there was a significant (p<0.05) drop in Mean Arterial Pressure and CVP from their basal value. In the arterial blood gases analysis fall in the Pa02 values was recorded after each knee surgery. But there was no change in PaC02 and Sa02 in either group after tourniquet deflation.
Five patients with reflex sympathetic dystrophy (RSD) of the upper limb were managed with permanent sympathetic blockade by the posterior paralaminar approach. All patients showed immediate clinical evidence of improvement and went on to uneventful recovery. No complications attributable to the paralaminar approach were encountered.
This is a prospective study based on 51 consecutive cases with 52 tibial diaphyseal fractures (23 closed, 29 open-Gr.I and Gr II) fulfilling our inclusion criteria and stabilized with primary undreamed AO tibial locked nailing with a followup ranging from 8-30 months. 36 were males and 15 females with an age range of 18-55 years. Open fractures were classified according to Gustilo and comminuted fractures according to Winquist. Most of the fractures were locked in dynamic and 27 in static mode. All the fractures united in an average period of 5.2 months. Functional results were evaluated by the Ekeland assessment system. 6 fractures were dynamised. There was infection in 4 fractures (7.7%), delayed union in 2 fractures (3.8%) and implant failure in 2 fractures (3.8%). Results were evaluated and compared with various studies.
The Impact Of Technological Progress in Orthopaedics-Is It All For The Better?