Applying a Hip Spica in a Child

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 27-29 | Darshan Kapoor, Sandeep V Vaidya

DOI: 10.13107/jcorth.2022.v07i02.521

Author: Darshan Kapoor [1], Sandeep V Vaidya [1,2]

[1] Department of Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India,
[2] Department of Orthopaedics, Pinnacle Orthocentre Hospital, Thane, Maharashtra, India.

Address of Correspondence
Dr. Sandeep V Vaidya,
Department of Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India.
E-mail: drsvvaidya@gmail.com

Abstract

Hip spica cast is a useful modality for the lower limb immobilization in children with hip and femur pathologies. Single, one and half, double limb spica cast may be applied depending on the indication. The position of hip immobilization is also dependent on the underlying pathology for which the spica is being applied. The inguinal region and knee are potential weak spots in a spica and these should reinforce during spica application. Potential complications include plaster sores, breakage, avascular necrosis of femoral head (in developmental dysplasia of hip), neurovascular compromise, and superior mesenteric artery syndrome (very rare). Careful attention to technique and vigilant after-care is necessary to prevent these complications.

Keywords: Hip spica cast, Pediatric femur fracture, Closed reduction, DDH

References

  1. Kumar SJ. Hip spica application for the treatment of congenital dislocation of the hip. J Pediatr Orthop 1981;1:97-9.
  2. Wan KL, Shanmugam R, Lee KY, Saw A. Comparing the mechanical strength of hip spica cast between a conventional and a new method of application. J Child Orthop 2016;10:387-94.
  3. Tisherman RT, Hoellwarth JS, Mendelson SA. Systematic. review of spica casting for the treatment of paediatric
    diaphyseal femur fractures. J Child Orthop 2018;12:136-44.
  4. Sargent MC. Single-leg spica cast application for treatment of pediatric femoral fracture. JBJS Essent Surg Tech
    2017;7:e26.

 

How to Cite this article: Kapoor D, Vaidya SV. Applying a Hip Spica in a Child. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):27-29.

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Wooden board technique for Hip Spica application in children

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 30-32 | Sandeep Patwardhan, Vivek Sodhai, Chaitrali Gundawar, Vishwajit Patil

DOI: 10.13107/jcorth.2022.v07i02.523

Author: Sandeep Patwardhan [1], Vivek Sodhai [1], Chaitrali Gundawar [1], Vishwajit Patil [1]

[1] Department of Pediatric Orthopedics, Sancheti Institute for Orthopedics and Rehabilitation, Pune, India.

Address of Correspondence
Dr. Sandeep Patwardhan,
Department of Pediatric Orthopedics, Sancheti Institute for Orthopedics and Rehabilitation, Pune, India.

References

  1.  Rachel DiFazio, Judith Vessey, Incidence of Skin Complications and Associated Charges in Children Treated With Hip Spica Casts for Femur Fractures
  2. Dirk Leu, M. Catherine Sargent, Spica Casting for Pédiatrie Femoral Fractures -A Prospective, Randomized Controlled Study of Single-Leg Versus Double-Leg Spica Casts by The Journal of Bone and Joint Surgery.
  3. Kumar SJ (1981) Hip spica application for the treatment of congenital dislocation of the hip. J Pediatr Orthop.
  4. Wheeless’Textbook of Orthopaedics- Hip spica cast.
  5. Hip spica nursing care guidelines by The Royal Children’s Hospital Melbourne.

 

How to Cite this article: Patwardhan S, Sodhai V, Gundawar C, Patil V. Wooden board technique for Hip Spica
application in children. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):30-32.

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Tutorial – The ABC of what to see on a hip X-ray of children

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 33-37 | Swapnil M Keny , Nihar Modi

DOI: 10.13107/jcorth.2022.v07i02.525

Author: Swapnil M Keny [1], Nihar Modi [2]

[1] Paediatric Orthopaedic Surgery, Sir H. N. Reliance Hospital, Mumbai, Maharashtra, India,
[2] Department of Orthopaedics, K. B. Bhabha Municipal General Hospital, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Swapnil M Keny,
Paediatric Orthopaedic Surgery, Sir H .N. Reliance Hospital, Mumbai, Maharashtra, India.
E-mail: peadortho@gmail.com

References

1. Donnelly MD, Lane F. Diagnostic Imaging: Pediatrics. 2nd ed. Salt Lake City, Utah: Amirsys Inc; 2011.
2. Donnelly MD, Lane F. Pediatric Imaging: The Fundamentals. 1st ed. Pennsylvania, United States: Saunders; 2009.
3. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, et al. Towards complete and accurate reporting of studies of diagnostic accuracy: The STARD initiative. AJR Am J Roentgenol 2003;181:51-5.
4. Tonnis D. Normal values of the hip joint for the evaluation of X-rays in children and adults. Clin Orthop Relat Res 1976;119:39-47.
5. Portinaro NM, Murray DW, Bhullar TP, Benson MK. Errors in measurement of acetabular index. J Pediatr Orthop 1995;15:780-4.
6. Agus H, Bicimoglu A, Omeroglu H, Tumer Y. How should the acetabular angle of Sharp be measured on a pelvic radiograph? J Pediatr Orthop 2002;22:228-31.
7. Humbert L, Carlioz H, Baudoin A, Skalli W, Mitton D. 3D Evaluation of the acetabular coverage assessed by biplanar X-rays or single anteroposterior X-ray compared with CT-scan. Comput Methods Biomech Biomed Engin 2008;11:257-62.
8. Stein-Wexler R, Wootton-Gorges SL, Ozonoff MB. Pediatric Orthopedic Imaging. Berlin, Germany: Springer; 2014.
9. Hefti F. Pediatric Orthopedics in Practice. Germany: Springer; 2015.

 

How to Cite this article: Keny SM, Modi N. Tutorial – The ABC of what to see on a hip X-ray of children. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):33-37.

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Moving toward Regional Anaesthesia for Spine Surgery – Need of the Hour

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 38-42 | Samidha Waradkar , Aaliya Mehmood , Saijyot Raut , Vishal Kundnani

DOI: 10.13107/jcorth.2022.v07i02.527

Author: Samidha Waradkar [1], Aaliya Mehmood [2], Saijyot Raut [3], Vishal Kundnani [4]

[1] Consultant Anesthesiology, at Lilavati Hospital and Research Centre, Mumbai, India,
[2] Senior Resident Anesthesiology at Lilavati Hospital and Research Centre, Mumbai, India,
[3] MS Ortho, Consultant Spine Surgeon at Spine Centre, Andheri and SL Raheja Hospital, Mahim, Mumbai, India,
[4] MS Ortho, Consultant Spine Surgeon at Lilavati Hospital and Research Centre, Mumbai, India.

Address of Correspondence
Dr. Aaliya Mehmood,
Flat 701, A-8, Al-Quba CHS, Millat Nagar, Andheri West, Mumbai 400053, India.
E-mail: aaliyamehmood@hotmail.com

Abstract

Background: In the last few decades, many studies have been conducted on comparison between general anaesthesia (GA) versus spinal anaesthesia (SA) for lumbar spine surgeries and each have reported discrepancies between the two methods of induction with equivalent pros and cons; ultimately failing to state a final conclusive method. With the ongoing COVID pandemic, and the fear of aerosol generation associated with GA; our focus has shifted on regional anesthesia completely, as it is been proven safer and more hassle-free to conduct during these challenging times.

Materials and Methods: A similar case study was conducted with 178 patients posted for lumbar spine procedures under the same surgeon. Wherein, 86 received GA and 92 SA. Appropriate statistical analysis was applied to identify differences in blood loss, operative time, time from entering the operating room (OR) until incision, time from bandage placement to exiting the OR, total anesthesia time, PACU time, and total hospital stay. Secondary outcomes of interest included incidence of postoperative spinal hematoma and death, incidence of paraparesis, paraplegia, paraesthesia, post-Dural puncture headache, signs of meningism, urinary retention, and other perioperative complications among the SA patients.

Results: SA was associated with significantly lower operative time, blood loss, total anaesthesia time, time from entering the OR until incision, time from bandage placement until exiting the OR. SA was also associated with shorter stay in the PACU, and overall lesser total duration of hospital stay. None of the 92 patients in SA group needed conversion to GA or had an episode of high/complete sympathetic blockade. No incidences of paraparesis or paraplegia, or episodes of persistent post-operative paraesthesia or weakness, Bagai (vasovagal) syncope, PONV, post-op meningism, post-dural puncture headache, spinal hematoma, intraoperative dural Cerebrospinal Fluid leak or post-op fistula, were noted. There were two incidences of failed spinal which were easily managed with a lower dose repeat SA. Overall better post-op analgesia and higher patient and surgeon satisfaction compared to GA was observed.

Conclusion: SA is effective for use in patients undergoing elective lumbar spine surgeries and very efficient alternative technique to GA. SA offers efficient OR functioning with decreasing overall operation theatre time and shown to be the more convenient anesthetic choice in the perioperative setting.

Keywords: Spinal Anaesthesia, Regional Anaesthesia, Covid-19, Spine Surgery, Lumbar Discectomy, Fast Track Anaesthesia, Aerosol Generation

References

1. Demirel CB, Kalayci M, Ozkocak I, Altunkaya H, Ozer Y, Acikgoz B. A prospective randomized study comparing perioperative outcome variables after epidural or general anesthesia for lumbar disc surgery. J Neurosurg Anesthesiol. 2003;15:185–192.
2. De Rojas JO, Syre P, Welch WC. Regional anesthesia versus general anesthesia for surgery on the lumbar spine: a review of the modern literature. Clin Neurol Neurosurg. 2014;119:39–43.
3. Pflug AE, Halter JB. Effect of spinal anesthesia on adrenergic tone and the neuroendocrine responses to surgical stress in humans. Anesthesiology. 1981;55:120–126
4. Rodgers A, Walker N, Schug S, McKee A, Kehlet H, van Zundert A, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ. 2000;321(7275):1493.
5. McLain RF, Bell GR, Kalfas I, Tetzlaff JE, Yoon HJ. Complications associated with lumbar laminectomy: a comparison of spinal versus general anesthesia. Spine (Phila Pa 1976). 2004;29:2542–2547.
6. McLain RF, Tetzlaff JE, Bell GR, Uwe-Lewandrowski K, Yoon HJ, Rana M. Microdiscectomy: spinal anesthesia offers optimal results in general patient population. J Surg Orthop Adv. 2007;16:5–11.
7. Available at: https://www.nysora.com/techniques/neuraxial-and-perineuraxial-techniques/spinal-anesthesia/
8. Scott NB, Kehlet H. Regional anaesthesia and surgical morbidity. Br J Surg. 1988;75(4):299–304.
9. Attari MA, Mirhosseini SA, Honarmand A, Safavi MR. Spinal anesthesia versus general anesthesia for elective lumbar spine surgery: a randomized clinical trial. J Res Med Sci. 2011;16:524–529.
10. Brown MJ. Anesthesia for elective spine surgery in adults. 2015. Available from: https://www.uptodate.com/contents/anesthesia-forelective-spine-surgery-in-adults. Accessed July 26, 2017.
11. Modig J, Karlstrom G. Intra- and post-operative blood loss and haemodynamics in total hip replacement when performed under lumbar epidural versus general anaesthesia. Eur J Anaesthesiol. 1987;4(5):345–55.
12. Urwin SC, Parker MJ, Griffiths R. General versus regional anaesthesia for hip fracture surgery: a meta-analysis of randomized trials. Br J Anaesth. 2000;84(4):450–5.
13. Indelli PF, Grant SA, Nielsen K, Vail TP. Regional anesthesia in hip surgery. Clin Orthop Relat Res. 2005;441:250–5.
14. Sakura S. Epidural anesthesia and spinal anesthesia in the elderly. Masui. 2007;56(2):130–8. [In Japanese].
15. Kao FC, Tsai TT, Chen LH, et al. Symptomatic epidural hematoma after lumbar decompression surgery. Eur Spine
J. 2015;24:348–357.

 

How to Cite this article: Waradkar S, Mehmood A, Raut S, Kundnani V. Moving toward Regional
Anesthesia for Spine Surgery – Need of the Hour. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):38-42.

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Clinical Profile of Congenital Clasped Thumb: A Case Series

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 43-51 | Bhaskaranand Kumar, Ashwath M Acharya, Himanshu R Prasad, S M Venugopal

DOI: :10.13107/jcorth.2022.v07i02.529

Author: Bhaskaranand Kumar [1], Ashwath M Acharya [2], Himanshu R Prasad [3], S M Venugopal [1]

[1] Department of Orthopaedics, Balaji Institute of Surgery, Research and Rehabilitation for the Disabled, Tirupati, Andhra Pradesh, India,
[2] Department of Hand Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India,
[3] Department of Orthopaedic Surgeon, Sunshine Hospital, Hyderabad, Telangana, India.

Address of Correspondence
Dr. Ashwath M Acharya,
Department of Hand Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal – 576 104, Karnataka, India.
E-mail: anmacharya@gmail.com

Abstract

Purpose: :Congenital clasped thumb is a rare deformity and not much has been described in literature about it. The aim of this study was to evaluate clinical profile of congenital clasped thumb, examine peroperative pathoanatomy, and evaluate the results of the treatment of such cases.

Methods: A prospective study on 57 patients [106 hands] was done and their data recorded from the medical case records. A thorough clinical and radiological assessment was performed. Patients were classified using the Tsuyuguchi classification. Splinting program was initially started and patients not responding to it and those older than 10 years underwent contracture release, joint stabilization, and local flap cover with or without tendon transfers. All patients were assessed by Gilbert’s grading after 1 year.

Results: There were 43 males and 14 females. The average age was 33 months [range 0–21 years]. At presentation, 51% [54/106] of hands were classified as severe with syndromic pattern [Type III]. About 61% [35/57] of the patients presented at the age <5 years and 21% after 10 years including three adults. About 41% of these patients [23/57] had a history of consanguinity and 27% [15/57] had a family history of a similar or associated congenital deformity. Splinting program showed excellent results in type I. An a-la-Carté release of soft tissues, joint stabilization with K-wire, and ligament reconstruction with local flap cover gave good to excellent results in 73% of our patients. Nine patients had features of web creep at first web space.

Conclusion: Congenital clasp thumb showed a strong genetic predisposition. There was no difference between type II and type III variants with respect to the pathoanatomy, treatment protocol, operative procedures, and results. Splinting program in mild deformity and surgical correction with reconstruction in more severe cases gave satisfactory results.

Keywords: Congenital adducted thumb, congenital clasped thumb, first web space contracture.

References

  1.  Abdel-Ghani H, El-Naggar A, Hegazy A, Hanna A, Tarraf Y, Temtamy S. Characteristics of patients with congenital clasped thumb: A prospective study of 40 patients with the results of treatment. J Child Orthop 2007;1:313-22.
  2. Kozin S. Deformities of the thumb. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS editors. Green’s Operative Hand Surgery. 7th ed. 7th ed. Philadelphia, PA: Elsevier; 2017. p. 1289-337.
  3. Tsuyuguchi Y, Masda K, Kawabata H, Kawai H, Ono K. Congenital clasped thumb: A review of forty-three cases. J Hand Surg Am 1985;10:613-8.
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  5. Verhagen JM, Schrander-Stumpel CT, Blezer MM, Weber JW, Schrander JJ, Rubio-Gozalbo ME, et al. Adducted thumbs: A clinical clue to genetic diagnosis. Eur J Med Genet 2013;56:153-8.
  6. McCarroll HR, Manske PR. The windblown hand: Correction of the complex clasped thumb deformity. Hand Clin 1992;8:147-59.
  7. Lin SC, Hung TH, Hsu HY, Lin CG, Chiu HY. A simple splinting method for correction of supple congenital clasped thumbs in infants. J Hand Surg Br 1999;24:612-4.
  8. Zlotolow DA, Tiedeken NC. Reorientation osteotomy for the atypical clasp thumb in children with arthrogryposis. Tech Hand Up Extrem Surg 2014;18:165-9.
  9. Mahmoud M, Abdel-Ghani H, Elfar JC. New flap for widening of the web space and correction of palmar contracture in complex clasped thumb. J Hand Surg Am 2013;38:2251-6.
  10. Wood VE, Biondi J. Treatment of the windblown hand. J Hand Surg Am 1990;15A:431-8.
  11. Caroli A, Zanasi S. First web-space reconstruction by Caroli’s technique in congenital hand. deformities with severe thumb ray adduction. Br J Plast Surg 1989;42:653-9.
  12. Brand PW. The hand. In: Campbell’s Operative Orthopaedics. 4th ed. St Louis: CV Mosby Co.
  13. Buck-Gramcko D. Congenital Malformations of the Hand and Forearm. Vol. 141. London: Churchill Livingstone; 1998.
  14. Ezaki M, Oishi SN. Index rotation flap for palmar thumb release in arthrogryposis. Tech Hand Up Extrem Surg 2010;14:38-40.

 

How to Cite this article: Kumar B, Acharya AM, Prasad HR, Venugopal SM. Clinical Profile of Congenital Clasped Thumb: A Case Series. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):43-51.

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Prospective Study of Attitude of MBBS Doctors toward Violence against Doctors

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 52-58 | Sachin Kale, Sunil H Shetty, Arvind Vatkar, Sushmit Singh, Pramod Bhor, Raja Ganesh Rayudu

DOI: 10.13107/jcorth.2022.v07i02.531

Author: Sachin Kale [1], Sunil H Shetty [1], Arvind Vatkar [2], Sushmit Singh [1], Pramod Bhor [3], Raja Ganesh Rayudu [1]

[1] Department of Orthopedics, Dr. D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India,
[2] Spinal Fellow Queens Medical Centre, Nottingham, United Kingdom,
[3] Department of Orthopedics, Terna Medical College Navi Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Raja Ganesh Rayudu,
Dr. D. Y. Patil University-School of Medicine, Navi Mumbai, Maharashtra, India.
E-mail: rajaganesh70@gmail.com

Abstract

Introduction: It is perceived that about 75% of doctors have faced some kind of violence at work, which is similar to the rates from other countries in the continent. A substantial proportion of doctors are in peril as they are victims of violence by their patients or relatives, which often is unreported.

Methodology:A structured study questionnaire was designed and prepared in the form of “Google Forms.”

Results: Student doctors tackling such abuse are known to develop psychological stress at most times; and come about with high functioning depression, fear, and post-traumatic stress disorders at such a preliminary stage of their practice. From this study, we explored that how doctors from being genuinely praised for their altruistic work to having faced social stigma and abuse.

Conclusion: We intent to fortify doctors to tackle this emerging issue for the safety of physicians. Drawing inference from the literature and graphical analysis, a sustainable way to alleviate duress on doctors would be ameliorating public health-care services and thus the quality of life. To fathom this issue and to tackle interludes of violence against doctors, it is of paramount importance that as a society, we concede this as a public health and safety challenge.

Keywords: Doctors, psychological stress, violence

References

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  2. Pitcher G. BMA survey finds one-third of doctors attacked physically or verbally in 2007. Ethics, Health and Safety, HR STRATEGY, Latest News, Occupational Health, Stress, Wellbeing. 2008 Jan 10 .
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  10. Nagpal N. Incidents of violence against doctors in India: Can these be prevented? Natl Med J India 2017;30:97-100; 2017.
  11. available at: https://www.mospi.gov.in/documents/213904/8 48928/annual_report_2020_21_eng.pdf/d448c47a-fa4e-17c5-7a34-e8fe3063b06a?t=1613993557446; 2020. 

 

How to Cite this article: Kale S, Shetty SH, Vatkar A, Singh S, Bhor P, Rayudu RG. Prospective Study of Attitude of MBBS Doctors toward Violence against Doctors. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):52-58.

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Comparative Evaluation of Clinical and Ultrasound Examination in Neonatal Hip Screening for the Detection of Developmental Dysplasia of the Hip – A Hospital-Based Cross-Sectional Study

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 59-65 | Viveksheel Kashyap, Rajeev Reddy Kikkuri, Anmol Mittal, Karri Sandeep Reddy, Richa Singhal

DOI: 10.13107/jcorth.2022.v07i02.533

Author: Viveksheel Kashyap [1], Rajeev Reddy Kikkuri [2], Anmol Mittal [3], Karri Sandeep Reddy [2], Richa Singhal [4]

[1] Department of Orthopaedics, Paras HMRI Hospital, Patna, Bihar, India,
[2] Department of Orthopaedics, Sunshine Hospitals, Telangana, Hyderabad, India,
[3] Department of Orthopaedics, J.N. Medical College, KLE University, Belgaum, Karnataka, India,
[4] Department of Pediatrics, Safdarjung Hospital, New Delhi, India.

Address of Correspondence
Dr. Rajeev Reddy Kikkuri,
Department of Orthopaedics, Sunshine Hospitals, Telangana, Hyderabad, India.
E-mail: rajeevkikkuri@gmail.com

Abstract

Background: During infancy, among developmental abnormalities of the hip joint, a broad-spectrum anomaly is developmental dysplasia of the hip (DDH). To examine this abnormality, no standardized screening protocol is available. Clinical examination is most frequently followed, and in doubtful cases, ultrasound (US) examination is used to confirm the diagnosis.

Aims: The present study aims to compare the sensitivity and specificity of clinical to US examination in neonatal hip screening to detect DDH.

Materials and Methods: This is a 1-year hospital-based cross-sectional study. Newborns who were referred to the Department of Orthopaedics with suspected DDH and examined by both clinical examination and US examination were included in the study. The Chi-square test and Fisher’s t-test were used for statistical analysis.

Results: Out of the 75 babies, referred two-thirds were girls. The mean age of the babies was 6.25 ± 3.50 days. The breech presentation was the common risk factor (85.33%) for DDH, and LSCS was the standard mode of delivery. Clinical diagnosis of DDH was positive among babies, more on the left side than the right side. Eight babies (10.67%) were diagnosed to have DDH based on Graf’s test using USG. Among them, 4 (50%) babies had a clinical diagnosis of DDH. The sensitivity of the clinical trial with USG as reference standard was 50%

Conclusion: Due to the lower sensitivity of clinical examination, USG screening should be done to detect DDH.

Keywords: Hip dislocation, infant, newborn, ultrasonography, mass screening

References

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25. Geertsema D, Meinardi JE, Kempink DR, Fiocco M, van de Sande M. Screening program for neonates at risk for developmental dysplasia of the hip: Comparing first radiographic evaluation at five months with the standard twelve week ultrasound. A prospective cross-sectional cohort study. Int Orthop 2019;43:1933-8.
26. Herring J. Developmental Dysplasia of the Hip. Tachdjian’s Pediatric Orthopaedics. Philadelphia, PA: WB Saunders; 2008.

27. Hegde D, Powers N, Nathan EA, Rakshasbhuvankar A. Developmental dysplasia of the hip in preterm breech infants. Arch Dis Child Fetal Neonatal Ed 2020;105:556-8.

28. Kumar RK, Shah P, Ramya AN, Rajan R. Diagnosing developmental dysplasia of hip in newborns using clinical screen and ultrasound of hips-An Indian experience. J Trop Pediatr 2016;62:241-5.

 

How to Cite this article: Kashyap V, Kikkuri RR, Mittal A, Reddy KS, Singhal R. Comparative Evaluation of Clinical and Ultrasound Examination in Neonatal Hip Screening for the Detection of Developmental Dysplasia of the Hip – A Hospital-Based Cross-Sectional Study. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):59-65.

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Financial Burden of COVID-19 on Orthopeadic Surgeons

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 66-72 | Sachin Kale, Sagar Soni, Sarang Aggarwal, Nikhil Reginald Isaacs, Ronak Mishra, Sankalp Shashwat, Suraj Doshi

DOI: 10.13107/jcorth.2022.v07i02.537

Author: Sachin Kale [1], Sagar Soni [1], Sarang Aggarwal [1], Nikhil Reginald Isaacs [1], Ronak Mishra [1], Sankalp Shashwat [1], Suraj Doshi [1]

[1] Department of Orthopaedic, Dr. D. Y. Patil University , School of Medicine Hospital and Research Centre, Nerul,
Navi Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Nikhil Reginald Isaacs,
Department of Orthopaedic, Dr. D. Y. Patil University , School of Medicine Hospital and Research Centre, Nerul,
Navi Mumbai, Maharashtra, India.
E-mail: nikhil-isaacs@hotmail.com

Abstract

Background: Coronavirus disease 2019 (COVID-19) has spread throughout the world, affecting people from all walks of life, including orthopedic doctors in India. We’ve We’ have seen a significant decrease in the number of patients. The study’s study’s goal was to determine the extent to which the epidemic has affected Indian orthopaedic practice.

Methods: An online survey of currently practicing Indian orthopaedic doctors was done. The study enlisted the help of 500 orthopaedic surgeons. A statistical analysis was performed to determine the relationship between the demographic profile of study participants and other orthopaedic practice characteristics.

Results: Maximum participants belonged to the age group of 30-–40 years (39.8%) and only 13.6% belonged to the age group of 51-–60 years. Approximately, 85.8% participants were married. Out of all, 86% participants were consultants and 14% were residents. Most of the participants (35.2%) have 5-–10 years of practice experience. Most of the participants were working in charity hospitals (31.4%) and very few of them (4.8%) were working in government hospitals.

Conclusion: Practicing orthopaedic surgeons working in the private sector and running their own (individual) hospitals and clinics have been the most badly afflicted in terms of earnings, while those working in the government sector and medical universities have been the least afflicted.

Keywords: Coronavirus disease 2019COVID-19, financial loss, orthopedic surgeons, clinical practice, World Health
Organization. WHO

References

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How to Cite this article: Kale S, Soni S, Aggarwal S, Isaacs NR, Mishra R, Shashwat S, Doshi S. Financial Burden of COVID-19 on Orthopeadic Surgeons. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):66-72.

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Prevention and Management of Sudden Cardiac Death in Athletes

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 73-77 | Alwar Thiagarajan, Ayyadurai Prakash, Gopalakrishnan Janani, Rao Vikram, Sivaraman Arumugam

DOI: 10.13107/jcorth.2022.v07i02.535

Author: Alwar Thiagarajan [1], Ayyadurai Prakash [1], Gopalakrishnan Janani [1], Rao Vikram [1], Sivaraman Arumugam [1]

[1] Centre for Sports Science, Department of Arthroscopy and Sports Medicine, Sri Ramachandra Institute of Higher
Education and Research, Chennai, Tamil Nadu, India.

Address of Correspondence
Dr. Ayyadurai Prakash,
Centre for Sports Science, Department of Arthroscopy and Sports Medicine, Sri Ramachandra Institute of Higher
Education and Research, Chennai, Tamil Nadu, India.
E-mail: prakashortho@outlook.com

Abstract

Sudden cardiac death (SCD) is the biggest challenge of all sports emergencies, as it is the leading cause of preventable deaths in both professional and recreational athletes. There is also an ongoing concern about COVID-19-associated cardiac pathology among athletes because myocarditis is an important cause of SCD during exercise. Hypertrophic cardiomyopathy represents 24% of SCD and Sudden Unexplained Death (normal heart at autopsy) represents 34% of SCD. To make sports participation safer, it is important to synergistically combine primary prevention of SCD by pre-participation identification of athletes affected by at-risk cardiomyopathies and secondary prevention with backup defibrillation of unpredictable sudden cardiac arrest on the field. The prompt application of an automated external defibrillator itself is associated with a greater likelihood of survival. With the advancement in the field of sports cardiology, the implantation of implantable cardioverter defibrillator has been promising in getting the athlete back on the field including in contact sports. Hence, knowledge of primary and secondary prevention is of great importance in reducing the incidence of SCD as well as improvising existing strategies.

Keywords: Athlete’s heart, preparticipation cardiac screening, on-field death, cardiac arrest, ECG changes.

References

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How to Cite this article: Thiagarajan A, Prakash A, Janani G, Vikram R, Arumugam S. Prevention and Management of Sudden Cardiac Death in Athletes. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):73-77.

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Incarcerated pes anserinus around a proximal tibial osteochondroma: a rare extra-articular Cause of locked knee

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 78-80 | Sachin Khemkar, Eknath Pawar, Vipul Shet, Mrinal Kambli, Nihar Modi, Mitali Mokashi

DOI: 10.13107/jcorth.2022.v07i02.539

Author: Sachin Khemkar [1], Eknath Pawar [1], Vipul Shet [1], Mrinal Kambli [1], Nihar Modi [1], Mitali Mokashi [1]

[1] Department of Orthopaedics, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Sachin Khemkar,
Department of Orthopaedics, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India.
E-mail: sachinkhemkar@gmail.com

Abstract

Background: Osteochondroma is the most common benign skeletal neoplasm and is found most often in long bones, especially in the distal femur and proximal tibia. They usually present as painless swelling near the joint and can be complicated by mechanical irritation, compression or injury of adjacent structures, fracture, malignant transformation, and post-operative recurrence. Locking of the knee refers to flexion of the knee without complete extension and passive extension is limited resulting in significant pain. Excision is a successful form of the treatment for symptomatic osteochondromas.

Case Report: A case of osteochondroma of the proximal tibia illustrates extra-articular cause of locked knee secondary to the incarceration of pes anserinus tendons by the lesion.

Conclusion: Surgical excision of the bilobed pedunculated posteromedial proximal tibia osteochondroma and restoration of the gracilis and semitendinosis to its normal anatomic position resulted in the complete resolution of symptoms.

Keywords: Osteochondroma, Locked knee, Pes anserinus

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How to Cite this article: Khemkar S, Pawar E, Shet V, Kambli M, Modi N, Mokashi M. Incarcerated Pes Anserinus Around a Proximal Tibial Osteochondroma: A Rare Extra-articular Cause of Locked Knee. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):78-80.

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