Journal of Orthopedic Education

This short communication sought to establish the need for clinical prediction rules (CPR) and/or clinical decision rules (CDR) in evaluation and management of upper quadrant orthopaedic conditions such as fractures and soft tissue injuries. There was one study on cervical spine fractures, one on whiplash-associated disorders, one on thoracic injuries, one on lateral epicondylalgia and one on carpal tunnel syndrome. There were no studies on shoulder and on other common orthopaedic conditions of the upper quadrant which essentiates future research in this area. 

Keywords: Clinical Examination; Orthopaedic Examination; Clinical Orthopaedics; Traumatic Conditions.

Chronic patella tendon rupture is a rare disabling injury that is technically difficult to repair. Bone avulsions of the patellar tendons or pure ruptures of the quadriceps and patellar tendons are usually caused by indirect forces and sometimes by penetrating injuries. We are presenting a case of old patella tendon rupture which also had other co morbidities of tibial fracture & partial patellectomy.This case had classic symptoms of old patella tendon rupture.We did repaired this case with help of semitendinosus & gracilis graft. Patient did recovered well in post operative phase with good physiotherapy. In most of cases old patella tendon rupture is associated with other systemic diseases or it is itself due to old neglected injury. In this case old rupture is associated with previous patella & tibia fractures with partial patellectomy.It shows that even after old partial patellectomy & old operated tibia fracture with interlocking nail,patella tendon can be repaired & patient can lead normal life. 

Keywords: Old Patella Tendon Rupture; Parial Patellectomy; Semitendinosus and Gracilis Graft.

 Fibrous dysplasia, a condition in which the skeleton fails to develop normally, is characterized by fibroblastic stroma and immature bone. Bowing of the long bones occurs frequently and stress fractures often result. Shepherd’s crook deformity of hip is a characteristic feature of fibrous dysplasia. The goal of its treatment is to obtain normal walking ability and relieve pain due to pathologic fracture secondary to the deformity; however, correction of the deformity is a surgical challenge. We present 2 cases of Shepherd’s Crook deformity treated with corrective osteotomy and a 95 degree Hip screw. Both cases showed good bone healing and no recurrent deformity. The gross deformities were corrected, and both patients were pain-free after operation.

Keywords: Corrective Osteotomy; 95 Degree Hip Screw; Fibrous Dysplasia; Shepherd’s Crook Deformity.

Friedreich gene Romberg test. which ataxia presents We is an present a child who came with complaints of progressive autosomal with ataxic gait, absent tendon reflexes, extensor plantar response and positive recessive disorder, due to expansion of trinucleotide ataxia ofrepeat gait since in Frataxin the age of 10 years and was diagnosed to have Friedreich ataxia. They have associated cardiomyopathy and endocrine abnormality like diabetes and hypothyroidism. 

Keywords: Areflexia; Friedreich Ataxia; Extensor Plantar Response; Romberg’s Sign; Trinucleotide Repeat.

A caused by excessive external rotation and hyperextension of the arm in the overhead direction. Anterior dislocation of the shoulder with fracture of the greater tuberosity is rarely associated with nterior post-traumatic dislocation of the shoulder is the most common type of dislocation and is brachial plexus palsy.The treatment given is Closed reduction of shoulder joint under anaesthesia and shoulder immobilization.

Keywords: Shoulder; Anterior Dislocation; Fracture of the Greater Tuberosity; Plexus Injury.

The objective of this review article was to Get an insight into the role of exercise in LEP, along an evidence-informed approach of overview of current literature.There were studies comparing exercises as adjunct compared with other related conservative treatments either given alone or in combination. Specific stretching upon identifying ECRB, ED, ECRL or FCR muscle dysfunction, and a combination of concentric and eccentric strengthening with Cyriax physiotherapy of deep transverse friction massage and Mill’s manipulation may be attempted for use in a comprehensive rehabilitative approach for LEa.The evidence for exercise therapy is equivocal, and considering fewer adverse events and better functional restoration in people with LEa, exercises are a viable, feasible and a cost-effective treatment adjunct to be used in combination with other conservative treatment methods for pain relief, grip strength and functional status.

Keywords: Upper Extremity Soft Tissue Injuries; Sports Injuries; Elbow Tendinopathy; Orthopaedic Rehabilitation.

Carpal tunnel syndrome (CTS) is the clinical manifestation of compression of median nerve in the volar aspect of wrist leading to sensory, motor and autonomic dysfunction in the hands. This review article outlined the evidence for exercise therapy in CTS to identify the type, dosage and prescription in this population. The presented evidence includes many studies on splinting versus nerve/ tendon gliding exercises, one study on nerve slider techniques, one study on aerobic exercises, one study on carpal tunnel decompression exercises and one study on upper extremity flexibility, strength, and circulatory exercises for people with CTS. Insufficient evidence and inconsistent findings limit our conclusions and provision of definitive recommendations in this population. 

Keywords: Carpal Tunnel Syndrome; Entrapment Neuropathy; Hand Rehabilitation; Orthopaedic Rehabilitation.

Background: modalities for cartilage tissue regeneration. The aim of this study is to study the effect intra-articular platelet rich plasma injections in knee Osteoarthritis (OA). Autologous Platelet-Rich Plasma (PRP) has been advocated as one the recent treatment Methods: Twenty-five patients with mild to moderate osteoarthritis of knee were given single injection of freshly prepared autologous PRP in the affected knee. The Results were evaluated on the basis of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire and Visual Analog Scale (VAS) before treatment and 3 weeks, 8 weeks, 16 weeks and 24 weeks after treatment. Results: Statistically significant improvement in all WOMAC parameters and VAS scores were noted in the patients. The beneficial effects lasted for 24 weeks of follow-up with slight deterioration at 24thweek. Conclusion: Intra-articular injection of Autologous Platelet rich plasma provides Pain relief and improves function in patients with mild to moderate knee osteoarthritis. 

Tutilities like tele consultation, tele surgery, tele education, tele monitoring, tele pharmacy, tele nursing etc. Improved technology and use of low cost simple gazettes have made it convenient to most of the elemedicine being an integrated part of clinical practice in today’s armamentarium, has several people. Tele surgery and tele education are branches of interest for surgeons. Tele education is not only confined to the theory related skills but it is also useful for learning surgical skill. Trainee residents have a vast opportunity of learning and improving the surgical skills without actually waiting for the surgery especially in emergency procedures where senior consultant may not be present all the times and a skilled hand is required to perform the procedures in trauma patients. Tele surgery plays an important in this scenario, by keeping a video library resident can learn surgical skills by recorded videos and also he can transmit these to senior consultant to get expert’s opinion either intra operatively or post operatively. We present a simple, low cost, spectacle mounted and user friendly device for video recording which has several advantages over traditionally used video recorders. 

Keywords: Tele Education; Trauma; Video Recording.