MyMedR

Displaying all 6 publications

Abstract:

Sort:

Fulltext Predictors of Functional Outcome in Unstable Ankle Fractures Treated Surgically - A Prospective Cohort Study

Balaji G, Bhukya S, Nema S, Rajeswari M, Vellaipandi V

Malays Orthop J, 2021 Mar;15(1):85-92.
PMID: 33880153 DOI: 10.5704/MOJ.2103.013

Introduction: Unstable ankle injuries require anatomical reduction and stabilisation for optimal outcome. In spite of adequate care, a few patients have poor outcome. In this study, we assessed the risk factors that predict the clinical outcomes in surgically treated unstable ankle fractures.
Material and methods: This prospective cohort study was conducted on 68 patients who underwent surgical management for an unstable ankle injury. Demographic details, fracture type and associated medical comorbidities were recorded. Pre-operative radiographic assessment was done for all patients. At the end of one year follow-up, clinical (American Orthopaedic foot and ankle society-AOFAS and Olerud-Molander ankle - OMAS) scores and radiological parameters were assessed and analysed.
Results: Fracture dislocation (0.008), diabetes mellitus (0.017), level of alchohol consumption (0.008) and pre-operative talocrural angle (TCA) > 100° (0.03) were significant predictors of poor outcomes as per AOFAS. Fracture dislocation (0.029), diabetes mellitus (0.004), pre-operative TCA > 100° (0.009), female gender (0.001), age more than 60 years (0.002) and open injuries (0.034) had significantly poor outcome as per OMAS. Other parameters (smoking, hypertension, classification, syndesmotic injury, medial clear space and tibiofibular overlap) did not affect the outcome significantly.
Conclusion: Our study showed that poor outcome predictors in unstable ankle fractures are age >60 years, female gender, diabetes mellitus, alcohol consumption, fracture dislocation, open fractures and pre-op TCA >100°.
Fulltext Neglected Anterior Dislocation of the Elbow Joint: Case Report of a Rare Injury

Nema SK, Behera G, Poduval M

Malays Orthop J, 2018 Jul;12(2):65-67.
PMID: 30112134 DOI: 10.5704/MOJ.1807.016

We present an unusual case of five months old neglected anterior dislocation of the right elbow joint in a 19-year old man. The patient had been initially treated by a traditional bone setter, but the elbow remained unreduced. He presented to us with pain, deformity and limited range of motion of his right elbow joint. Radiographs revealed an unreduced anterior dislocation of the right elbow joint. We describe the problems encountered during open reduction and rehabilitation and result one year after the operation with the patient having a stable elbow and a functional range of motion.
Fulltext Accuracy of Femoral Tunnel Placement between Anteromedial and Anterolateral Visualisation Portals in Anterior Cruciate Ligament Reconstruction - Outcomes of a CT based Cross-Sectional Study

Balaji G, Yadav G, Patel SA, Ramesh A, Nema S, Ramalingam T

Malays Orthop J, 2023 Jul;17(2):7-12.
PMID: 37583529 DOI: 10.5704/MOJ.2307.002

INTRODUCTION: Anatomical femoral tunnel placement is critical for anterior cruciate ligament reconstruction (ACLR). Tunnel placement may vary with different surgical techniques. The aim of this study was to compare the accuracy of femoral tunnel placement between the Anteromedial (AM) and Anterolateral (AL) visualisation portals on post-operative CT scans among a cohort of ACLR patients.
MATERIALS AND METHODS: This cross-sectional study was conducted from January 2018 to March 2020 after obtaining ethics clearance. Patients who went for arthroscopic ACLR in our institute were divided into an AM (group 1) and an AL (group 2) based on the visualisation portal for creating the femoral tunnel and a 3D CT scan was done. The femoral tunnel position was calculated in deep to shallow and high to low direction using the Bernard Hertel grid. Femoral tunnel angle was measured in the 2D coronal image. Statistical analysis was done with the data collected.
RESULTS: Fifty patients with an average age of 26.36 (18-55) years ±7.216 SD were enrolled in the study. In this study, the AM technique was significantly more accurate (p<0.01) than the AL technique in terms of femoral tunnel angle. Furthermore, the deep to the shallow position was significantly (p= 0.018) closer to normative values, as determined by the chi-square test. The chances of error in tunnel angle in femoral condyle are 2.6 times greater in the AL technique (minimal clinical difference).
CONCLUSION: To conclude, in ACLR the anteromedial visualisation portal can facilitate accurate femoral tunnel placement compared to the anterolateral visualisation portal.
Fulltext Pachydermodactyly does not need rheumatologic work-up

Sinha NK, Ling SP, Nema SK, Pai DR

J Postgrad Med, 2013 Oct-Dec;59(4):335-6.
PMID: 24346401 DOI: 10.4103/0022-3859.123182
Fulltext Congenital humeroradial synostosis: a case report

Nema S, Vyas G, Sirsikar A, Bhoj PK

Malays Orthop J, 2012 Jun;6(SupplA):41-2.
PMID: 25279074 MyJurnal DOI: 10.5704/MOJ.1211.010

We present here a unique case of humeroradial synostosis. These anomalies are due to longitudinal failure of differentiation. Approximately 150 cases of humeroradial synostosis have been reported worldwide, the majority of which are familial in nature or associated with syndromes. The case presented here involves an infant aged 1½ months, born with bilateral humeroradial synostosis without familial or syndromic association. To the best of our knowledge, no such case has been reported in Asia.
Fulltext Improving the Accuracy of Corrective Osteotomy for Congenital Radio Ulnar Synostosis using the Axis of Rotation of the Forearm as a Guide

Gandhi S, Dalei TR, Nema SK, Rathod A, Jagadevan M

Malays Orthop J, 2023 Mar;17(1):40-44.
PMID: 37064637 DOI: 10.5704/MOJ.2303.006

INTRODUCTION: Despite several techniques for corrective osteotomy in congenital radioulnar synostosis (CRUS) the published literature lacks a guide for radiographic planning and rationale for the site and level of the osteotomy. The primary objective of this study is to report a technique of radiographically controlled corrective osteotomy using the axis of rotation of the forearm in CRUS.
MATERIALS AND METHODS: Children with CRUS underwent corrective osteotomy based on radiographic planning; the extent of rotational correction and functional outcomes were assessed at a mean of 27 months after the operation.
RESULTS: Seven forearms in six children of an average of 6.25 years were assessed for correction and functional outcomes. The average pre-operative pronation deformity was 71.5°. The average correction achieved was 64°. At follow-up, there were five excellent and two good functional outcomes. All children could perform daily tasks besides eating with hand and personal hygiene.
CONCLUSION: Radiographic determination of the osteotomy sites by the method described is effective, consistent, and reproducible in achieving optimal functional outcomes in congenital radioulnar synostosis.