Elliotthardin0958
Hip fractures account for a large proportion of hospitalization among the trauma cases. Low cost, simple technique, easy removal, and high rate of the bone union makes extramedullary (EM) fixation techniques a preferred choice. A close-fit bone and plate are essential for the success of such implantation. Various studies have found femur morphometry being related to regional features and social differences. Most of the available commercial implants are developed based on the data of the Caucasian population.
In the herein study, a novel design, Double Oblique Device for Osteosynthesis of hip (DODO), is proposed while considering the regional morphometry of the Northeast (NE) population of India. This study employs finite element (FE) analysis to compare the biomechanical outcome of the new device with that of proximal femoral locking plate (PFLP) and variable angle dynamic hip screw (VA-DHS) on a femur having an Evans type-I intertrochanteric fracture.
The stress shielding was substantially high for the PFLP and VA-DHS in the distal bone fragment (lateral aspect) and for DODO in the femoral head. The difference in axial displacement between the post-implanted DODO-fixed femur and its respective intact femur was predicted to be almost the same as that of PFLP-fixed femur and its respective intact femur.
The computational results found the new device to be a viable alternative to the conventional plating techniques, especially for the NE population of India, and predicted better to comparable biomechanical characteristics.
The computational results found the new device to be a viable alternative to the conventional plating techniques, especially for the NE population of India, and predicted better to comparable biomechanical characteristics.
To evaluate the biomechanical behavior of a metaphyseal stem specifically designed for the fixation of Pauwels type-III femoral neck fractures using finite-element analysis.
Three different constructions were studied the dynamic hip screw with a superior anti-rotation screw (DHS + ARS), multiple cannulated screws in an inverted triangle configuration (ASNIS), and the Metaphyseal Nailing System (MNS), a new implant developed by the authors. Vertical and total displacement, localized and total maximum and minimum principal, and the Von Mises peak stresses were evaluated.
Results are shown for the DHS + ARS, ASNIS, and MNS models, respectively. Vertical displacement (mm) was 1.49, 3.63, and 1.90; total displacement (mm) was 5.33, 6.02, and 6.30; localized maximum principal (Mpa) was 2.77, 4.5, and 1.7; Total maximum principal (Mpa) was 126, 223, and 531; localized minimum principal (Mpa) was -1.8, -3.15, and -0.39; total minimum (Mpa) was -121, -449, and -245; and Von Mises peak stress (MPA) was 315.5, 326stress, allows to affirm that the main deforming force, the shear, in this fracture pattern, was considerably reduced and the low value of Von Mises obtained, consistent with an implant capable of making an effective load sharing.
The present study was aimed to study and develop in-depth understanding of the effect of the coronal angulation of sacral vestibule S2 on morphometry of sacral vestibule in north-west Indian population presenting to our institution, which will go a long way in planning to treat the posterior pelvic injuries with percutaneous screws, thereby reducing the morbidity associated with open fixation.
This study was conducted in the Department of Orthopaedics and Radiodiagnosis at Dr Rajendra Prasad Govt.Medical College, Kangra at Tanda over a period of one year. All the patients of the age > 18years and above submitting for either abdominal, lower spinal or non-orthopedic pathology of pelvic region, presenting for computed tomography to the Department of Radiodiagnosis were included in the study.
The coronal angulation of S2 vestibule ranged from 1° to 10° with a mean of 5.06° ± 2.77°. There was a weak relation between coronal angulation of S2 and age-groups 18-30years (
= 0.105;
= 0.186), 31-40years (
= 0.040;
= 0.715), 41-50years (
= - 0.085;
= 0.330), 51-60years (
= 0.119;
= 0.079), and > 60years (
= - 0.166;
= 0.605). There was non-significant difference in coronal angulation of S2 (
= 0.913) between males and females. https://www.selleckchem.com/products/ms-275.html There was a weak relation between interspinus distance with coronal angulation of S2 (
= 0.069;
= 0.090). There was no relation between height with coronal angulation of S2 (
= 0.019;
= 0.631).
The present study, the first of its kind in the north-western part of India arrived to help us anthropometric measurements of sacral vestibule, thereby, helping in development of local protocols for percutaneous fixation in sacral fracture.
The present study, the first of its kind in the north-western part of India arrived to help us anthropometric measurements of sacral vestibule, thereby, helping in development of local protocols for percutaneous fixation in sacral fracture.
The novel Oblique lumbar interbody fusion [OLIF] technique has been proposed as a solution to approach related complications of anterior lumbar interbody fusion [ALIF] and lateral lumbar interbody fusion [LLIF]. There exists no study concerning morphological evaluation of retroperitoneal oblique corridor for the Oblique lumbar interbody fusion (OLIF) technique in the Indian population. The aim of our study was (a) to measure magnetic resonance imaging (MRI) based anatomic parameters concerning OLIF operative windows from L2-L3 to L4-L5 level (b) to determine the feasibility of this technique following MRI-based morphometric evaluation in the Indian population.
We did retrospective MRI analysis of 307 consecutive patients following our exclusion criteria. Bare window, psoas major window and psoas major width were measured from axial T2 MRI image taken at mid disc level from L2-L3 to L4-L5 levels.
The mean bare window size was largest at L2-L3 (1.39cm) level followed by L3-L4 and L4-L5 level (1.28 and 0.6re window. In our opinion, this level may be better suited for OLIF approach in the elderly Indian population, especially for surgeons who are beginning to attempt this technique in their surgical practice. Preoperative MRI evaluation for the OLIF is important to assess its feasibility, as there exists significant age and gender differences in the Indian population for anatomic parameters concerning OLIF operative windows from L2-L3 to L4-L5 levels.
The online version contains supplementary material available at 10.1007/s43465-021-00393-7.
The online version contains supplementary material available at 10.1007/s43465-021-00393-7.
Failure of a well-executed Bankart repair in non-contact athletes is difficult to predict and its management is a lesser investigated area with uncertain outcome in terms of return to sports (RTS). This study analyses effectiveness of revision Bankart repair with remplissage for failed Bankart repair in non-contact athletes, focusing on time and level of RTS.
Fifty-five consecutive non-contact athletes with evidence of instability after primary arthroscopic Bankart repair having glenoid loss < 25% and off-track Hill-Sachs lesion were included in the study according to algorithm mentioned. All cases underwent revision arthroscopic Bankart repair with remplissage and followed-up for 24months. Rowe, UCLA, WOSI and Quick-DASH scores were recorded preoperative and at 24months. RTS was allowed after unilateral seated shot-put test.
Out of 55 cases, 6 were excluded because of poor tissue quality, 7 were lost to follow-up. Forty-two cases with a mean age of 28.2 ± 5.2years were included. Mean duration between primary surgery and failure was 7.3 ± 1.4months with a mean 1.9 redislocations. The mean Rowe, WOSI, UCLA, Quick-DASH scores improved from 37 to 89, 39.3 to 83.7%, 18.4 to 30.5, 45.3 to 18.7 at 24months. Thirty-five cases could RTS in a mean time 15.4 ± 1.4months. Out of seven cases who could not RTS, four had instability, one had pain and two voluntarily quit sports.
Revision Bankart repair with remplissage is a feasible option for failed primary Bankart repair in non-contact athletes who have glenoid bone loss < 25% with off-track Hill-Sachs.
Level IV.
Level IV.
The coronoid process plays a key-role in preserving elbow stability. Currently, there are no radiographic indexes conceived to assess the intrinsic elbow stability and the joint congruency. The aim of this study is to present new radiological parameters, which will help assess the intrinsic stability of the ulnohumeral joint and to define normal values of these indexes in a normal, healthy population.
Four independent observers (two orthopaedic surgeons and two radiologists) selected lateral view X-rays of subjects with no history of upper limb disease or surgery. The following radiographic indexes were defined trochlear depth index (TDI); anterior coverage index (ACI); posterior coverage index (PCI); olecranon-coronoid angle (OCA); radiographic coverage angle (RCA). Inter-observer and intra-observer reproducibility were assessed for each index.
126 subjects were included. Standardized lateral elbow radiographs (62 left and 64 right elbows) were obtained and analysed. The mean TDI was 0.46 ± 0.06 (0.3-1
Elbow bony stability relies primarily on the high anatomic congruency between the humeral trochlea and the ulnar greater sigmoid notch. No practical tools are available to distinguish different morphotypes of the proximal ulna and herewith predict elbow stability. The aim of this study was to assess inter-observer reproducibility, evaluate diagnostic performance and determine responsiveness to change after simulated coronoid process fracture for three novel elbow radiographic indexes.
Ten fresh-frozen cadaver specimens of upper limbs from human donors were available for this study. Three primary indexes were defined, as well as two derived angles Trochlear Depth Index (TDI); Posterior Coverage Index (PCI); Anterior Coverage Index (ACI); radiographic coverage angle (RCA); olecranon-diaphisary angle (ODA). Each index was first measured on standardized lateral radiographs and subsequently by direct measurement after open dissection. Finally, a type II coronoid fracture (Regan and Morrey classification) was cponsiveness of these parameters to a pathological condition. Furthermore, combining TDI and ACI in a regression model equation allowed to identify simulated fractures with high sensitivity and specificity. The newly proposed indexes are, therefore, promising tools to improve diagnostic accuracy of coronoid fractures and show potential to enhance perioperative diagnostic also in cases of elbow instability and stiffness.
Basic science study.
The newly proposed indexes are promising tools to improve diagnostic accuracy of coronoid fractures as well as to enhance perioperative diagnostic for elbow instability and stiffness.
The newly proposed indexes are promising tools to improve diagnostic accuracy of coronoid fractures as well as to enhance perioperative diagnostic for elbow instability and stiffness.
The aim of our study was to project the A1-pulley of the thumb onto the total thumb length to enable its complete division with and without direct sight.
The study involved 50 hands from adult human cadavers. The proximal and distal borders of the A1-pulley were measured with reference to the first metacarpophalangeal joint (MCPJ). The length of the thumb was defined as the interval between the first carpometacarpal joint (CMCJ) and the apex of the thumb. The length of the pulley is calculated proportionally with reference to the line between the first CMCJ and apex of the thumb.
Approximated by computing 95% confidence intervals, the pulley can be expected to lie in an area between 34.0% (proximal border) and 57.8% (distal border) alongside this line.
Percutaneous and minimally-invasive division of the A1-pulley needs to be performed between 34.0 and 57.8% of the length between the first CMCJ and apex of the thumb.
Percutaneous and minimally-invasive division of the A1-pulley needs to be performed between 34.
