Journal of Orthopedic Education

 The term “Patellar instability” encompasses not only symptomatic patellar instability but also dislocations as well as subluxations. The management of patellar instability requires a thorough understanding of the factors which are involved in providing patellar stability and the factors which cause instability. For assessing patellar instability various clinical examinations have been advocated. Reduction of patellar dislocation is an easy, safe and simple. Surgery is indicated in the presence of correctable and defined anatomical abnormalities. This is done only after adequate rehabilitation procedures have failed to help the patient regain functional control of their knees. Unfortunately none of these measures is specifically tailor made for patellar instability. The management of patellar instability continues to evolve and improve. Non operative management is still recommended for primary acute patellar dislocation. Once conservative options have failed the surgical management is specifically based on the underlying pathological condition. 

Keywords: Patellar Instability; Trochleoplasty; Medial Patellofemoral Ligament. 

Tibial fractures are common due to high energy injuries. The principles of treatment include the respect of the soft tissues and reduction of fracture fragments. There are various surgical fixation methods that can achieve these principles of treatment. Recognition of the particular fracture is important, as these guides the surgical approaches required in order to adequately stabilize the fracture. Three cases of compound fracture tibia are treated depending upon Gustilo types, are discussed here.

 Aim: To study the outcome of the various surgical modalities (DHS, PFN, Cemented bipolar arthroplasty) in the management of intertrochanteric fractures of femur in adults, compare the results, in various age groups, asses the complications encountered with each method. Materials and Methods: The present study consists of 50 adult patients with intertrochanteric fractures of femur treated with DHS, PFN and cemented bipolar prosthesis at department of Orthopaedics. Results: In this study of 50 patients, 14 were treated with PFN, 20 with DHS, 15 with bipolar hemiarthroplasty and 1 with other method. Intertrochanteric fractures common between 29-48 years and 49-78 years, shows bimodal age distribution. In young patients it was due to high velocity trauma, fall from height being the common mechanism of injury. Slip and fall was common mechanism in elderly. It was more common in females due to post menopausal osteoporosis. Associated injuries were more common in high velocity trauma. Early surgery increases patients comfort, facilitates nursing care, helps in early mobilization of patients and decreases hospital stay. Conclusion: In elderly patient with osteoporotic communited IT fracture, bipolar hemiarthroplasty is better option, Unstable, communited and reverse oblique IT fracture with good bone quality PFN is a better option. DHS is the still viable option in stable fractures and in unstable fracture with technical expertise, in improving fracture stability. 

Keywords: DHS; PFN; Cemented Bipolar Arthroplasty.

Background: Bone tumours are less commonly encountered lesions, and they pose a definite diagnostic challenge. Aims and Objective: The aims and objective of this study is to determine the incidence of bone tumours reported to the tertiary care rural teaching hospital and correlate various bone tumours with age and gender and anatomical location. Materials and Methods: A retrospective study of all bone lesions was done for 5 years from January 2013 to December 2017 in departments of Orthopedics, Radiology and Pathology at a tertiary care teaching hospital, central rural India. A total of 216 cases of different bone lesions were studied. Relevant history, clinical data, and radiological reports were obtained from the concerned departments. Results: The

Introduction: Calcaneal fractures usually occur by a fall from height when one lands on their feet. In this study we aimed to compare the functional outcome and radiological findings after treatment by steinmen pin (K-wire) and by plating method. Methodology: We designed a prospective study of all patients who were admitted and operated for calcaneum fractures in the Department of Orthopedics, Padmashree Dr. D. Y, Patil Medical College, Hospital & Research Centre, Navi Mumbai, Maharashtra from July 2015 till December 2017. Of the 30 cases, half received treatment with K-wire and the other half of the patients underwent plating. Baseline characteristics, pre- and post-operative Bohler’s and Gissane’s angles and complications were noted for all patients.

Background: It is only seven percent of all femoral fractures which constitutes distal femur a very low incidence of injury in population. The complexity of understanding the fractures and aim of anatomical reduction and internal fixation with early vigorous rehabilitation offer comparative results. Methodology: Twenty three consecutive patients with 20-80 years were included with AO/ OTA type A,B,C fracture patterns which were treated by locking plates and followed up upto one year and analysed with American Knee Score. Result: Mean age of 43years with 11 patients had RTA while 10 patients had fall at home. Hospital stay average was 7 days. Average flexion 40

 Background: Distal end radius fractures are the commonest fractures occurring in upper extremity that account for 17% of all upper limb injuries. Although it was described 184 years back controversies still exist regarding the best mode of treatment

 Introduction: Clavicle fracture is one of the commonest traumatic injuries around shoulder girdle due to its subcutaneous position.Despite the poor outcome like mal-union and non-union in severely displaced clavicle fracture cases traditionally non-operative management has been in practice. However, surgery can lead to accurate reduction, rigid fixation and quick pain relief with very few complications. Material and Methods: This was a prospective study which was carried out in the departments of orthopaedics in Rajshree Medical Research Institute, Bareilly from June 2017 to May 2018. Study population included fifty patients (50) of either sex above 18 years suffering from clavicle fracture. Results: Results of the current study showed that 80% cases of among clavicle fracture belonged to middle 3rd while 20% of cases belonged to lateral 3rd of clavicle.Plates and cortical screws were used to manage all the fracture of middle 3rd of clavicle. Further, majority of patients received locking compression plate (48%), followed by reconstruction plate (16%) and dynamic compression plate (16%). Twenty eight patients (56%) with middle third clavicle fracture treated with plate and screws while six patients (12%) with lateral 3rd clavicle patientshad excellent functional outcome. Conclusion: Clavicle fractures can be treated conservatively. However, there

may be specific indications which indicate necessity of surgical procedure like displaced lateral third clavicle fracture, displaced middle third clavicle fracture and comminuted. Longer period of immobilization untill union is required for the internal fixation methods as intramedullary fixation do not control rotation.A lesser period of immobilization is required for primary open reduction and internal fixation with plate and screws of fresh middle third clavicle fractures as it provides a more rigid fixation.

Keywords: Clavicle Fracture; Surgery; Functional Outcome; Complications.