Editorial 2023

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 01 | Dr. Nicholas Antao, Dr. Ashok Shyam

DOI: 10.13107/jcorth.2022.v08i01.546

Author: Dr. Nicholas Antao [1], Dr. Ashok Shyam [2]

[1] Department of Orthopaedics, Hill Way Clinic, Hill N Dale Building, 4th Floor, Hill Road, Bandra West, Mumbai, Maharashtra, India.

[2] Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehablitation, Pune, India.

Address of Correspondence
Dr. Nicholas Antao,
Head of Department of Orthopaedics, Holy Spirit Hospital, Mahakali Road, Andheri (E), Mumbai – 400093, Maharashtra, India.
E-mail: narantao@gmail.com


Our last WIROC-22 issue was mainly on paediatrics articles from a well written, accepted and acclaimed symposium on “Office Orthopaedics in Paediatrics” This issue contains thought provoking articles that were not covered earlier in that symposium.

Whereas anterior knee pain in adults is quite complex, similar pain in the paediatrics age can be quite perplexing. A well written article here will help you to gather your thoughts and make precision diagnosis.
Any deformity in the child is quite disabling and depressing for the parent that they very keen to get treatment to correct the same as early as possible. Can you imagine the agony of the parent when their child has such a deformity congenital or acquired and they would be very keen to do everything on earth to free the child of the same? The role of braces is well discussed in this issue and will be very helpful in guiding them to avoid their fear.
Flat feet are a common entity often worrying the parent, that their ward is not walking properly, complaining about pain while walking, running or the shoes get worn out fast. The most information given in the article is to understand the difference between rigid flat feet and correctible flat feet and the associated tight tissues and joints to be notably corrected.
CTEV is a common congenital deformity of the feet and the evolution of Ponsetti’s method with Pirani’s score helps you to understand deeper into the problem and the knowledge how to correct the deformity through serial manipulation and plastering. The author has described the method very succinctly.
We all know how difficult is to get rid of pain of gouty arthritis with allopathic medicine and even surgical methods often do not give the desired results to make patient pain-free of the ailment. A multicentric study revealed that herbal therapy is more effective than allopathic therapy is very interesting and informative. Another multicentric review on non-operative treatment of early osteoarthrosis is interesting is indeed very interesting with Orthobiologics playing a major role in defining the its role and how effective it can be in the initial stages.
We are happy that this issue has multicentric study reviews which is very encouraging and the most important factor to take indexing of the journal to a higher level.
All of us are aware of how much the COVID took the toll of medical and para medics life, inter personal relationships, workplace issue and various other problems in the management of this pandemic. The article Burnout in COVID-19 residency highlighted the innumerable problems and issues the resident faced in tackling the pandemic. They concluded that the educators should consider pertinent instruction and interventions during the process of instructing resident doctors which is vital to save the life of the patient, resident, paramedics and better management of the patient and the burn out. An interesting, rare case report on giant cell tumor of the tendon sheath is very informative.

Finally, the article on prevention of sports injuries is an eye opener to counsel patients with sports injuries to prevent further deterioration of the injury.


Dr. Nicholas Antao,

Dr. Ashok Shyam.

How to Cite this article: Antao N, Shyam A. Editorial. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):01.


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Gout Arthritis Progression in Treatment with Herbal Therapy: A Systematic Review

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 02-07 | I Putu Arya Agung Pratama, I Wayan Subawa

DOI: :10.13107/jcorth.2023.v08i01.547

Author: I Putu Arya Agung Pratama [1] I Wayan Subawa [2]

[1] Department of Orthopedics, General Practitioner, Faculty of Medicine Udayana University, Denpasar, Bali, Indonesia,
[2] Department of Orthopedics and Traumatology, General Hospital Prof. dr. IGNG Ngoerah, Faculty of Medicine Udayana University, Denpasar, Bali, Indonesia.

Address of Correspondence
Dr. I Putu Arya Agung Pratama,

Faculty of Medicine, Udayana University, Denpasar, Bali.

E-mail: aryaagungpratama@gmail.com


Introduction: Gout is a common arthritis condition due to deposition of monosodium urate (MSU) and is closely related to hyperuricemia. The goal of gout treatment in the acute stage of gouty arthritis mainly focuses on relieving pain while slowing down or stopping progression and further gout flares in the chronic stage, ultimately improving joint function, and increasing the quality of life.

Materials and Methods: A literature search was carried out to determine potential studies for this review up to November 2022. The search was performed using the PubMed/MEDLINE, Cochrane Library, and Google Scholar databases including keywords that matched the MeSH rule and the term used for herbal therapy and gout arthritis.

Results: The search strategy generated several diverse literatures presenting a variety of randomized control trial of herbal therapy in gout arthritis patient. A total of eight studies were included in the review. Satisfactory pain relieve and decreasing of serum uric acid level were found in most of the studies. Decreasing of serum uric acid level statistically significantly found in six of the eight studies studied. Furthermore, significant fewer incident of adverse event found in four studies.

Conclusion: Herbal therapy or medication are potentially more effective than western medications or placebos at slowing the progression of pain, lowering blood uric acid levels, and preventing some adverse events in gout patients.

Keywords: Arthritis, gout, herbal therapy, progression, uric acid level.


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  9. Wang YG, Wang L, Li EZ, Li Y, Wang ZC, Sun XF, et al. Chuanhu anti-gout mixture versus colchicine for acute gouty arthritis: A randomized, double-blind, double-dummy, non-inferiority trial. Int J Med Sci 2014;11:880-5.
  10. Yu XN, Wu HY, Deng YP, Zhuang GT, Tan BH, Huang YZ, et al. Yellow-dragon Wonderful-seed Formula” for hyperuricemia in gout patients with dampness-heat pouring downward pattern: A pilot randomized controlled trial. Trials 2018;19:551.
  11. Xie Z, Wu H, Jing X, Li X, Li Y, Han Y, et al. Hypouricemic and arthritis relapse-reducing effects of compound tufuling oral-liquid in intercritical and chronic gout: A double-blind, placebo-controlled, multicenter randomized trial. Medicine (Baltimore) 2017;96:e6315.
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How to Cite this article: Pratama IPAA, Subawa IW. Gout Arthritis Progression in Treatment with Herbal Therapy: A Systematic Review. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):02-07.

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Invasive Non-Arthroplasty Treatment Options for Knee Osteoarthritis: Review

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 08-17 | Rohan G Reddy, YuChia Wang, Ryan Scully, Savyasachi C Thakkar

DOI: :10.13107/jcorth.2023.v08i01.549

Author: Rohan G Reddy [1], YuChia Wang [2], Ryan Scully [3], Savyasachi C Thakkar [4]

[1] Orthopaedic Research Collaborative (ORC); Johns Hopkins University, Baltimore, Maryland, United States, ,
[2] Orthopaedic Research Collaborative (ORC);Department of Orthopaedic Surgery, Eastern Virginia Medical School, Norfolk, Virginia, United States,
[3] Orthopaedic Research Collaborative (ORC); Department of Orthopaedic Surgery, Naval Hospital Camp Pendleton, Oceanside, California, United States,

[4] Orthopaedic Research Collaborative (ORC); Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, United States.

Address of Correspondence
Dr. Rohan G Reddy,

Johns Hopkins University, Baltimore, Maryland, United States.

E-mail: rreddy19@jhu.edu


Introduction: Knee osteoarthritis (KOA) is one of the most common joint diseases in the world, such that there exists a variety of treatment methods, ranging from conservative treatments such as physical therapy and weight loss to total replacement of the diseased joint. Invasive non-arthroplasty treatment methods are growing in popularity and this review aims to explore the current literature. Better understanding of these alternatives could allow orthopedic surgeons and primary care providers to offer poor arthroplasty candidates meaningful symptomatic relief.

Materials and Methods: A literature review using PubMed, Google Scholar, and SCOPUS was performed to examine the following invasive non-arthroplasty treatment options: Corticosteroid injections (CS), viscosupplementation, platelet-rich plasma injections, stem cell injections, ozone therapy, prolotherapy, radiofrequency nerve ablation (RFA), arthroscopy, and osteotomy. Articles with complete data on the outcomes following these treatment methods were included in the study.

Results: CSs showed strong efficacy in providing short-term pain relief, while viscosupplementation and platelet-rich plasma have shown to be effective in long-term management as well. Aside from the more common injectable treatment options, newer options such as stem cell injection and ozone therapy have shown clinical efficacy while prolotherapy and RFA are still early-stage treatment options. Still, further studies are required to better assess these emerging therapies. Operatively, arthroscopic surgery has shown to be minimally effective while osteotomy demonstrated effective pain and functional improvement.

Conclusion: Multiple therapeutic options exist for invasive management of KOA to a different degree of effectiveness and efficacy. We have analyzed the outcomes of multiple invasive non-arthroplasty treatment options for KOA. This review can better inform patients and surgeons of the pros and cons of different KOA treatment methods. Newer conservative options may have positive clinical implications but will require further investigation. Operative alternatives to arthroplasty can provide symptomatic relief but may increase the associated risk and complexity should the need for arthroplasty ever arises.

Keywords: Total knee arthroplasty, injections, radiofrequency nerve ablation, arthroscopy, osteotomy.


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  78. Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Does obesity and nicotine abuse influence the outcome and complication rate after open-wedge high tibial osteotomy? A retrospective evaluation of five hundred and thirty three patients. Int Orthop 2014;38:55-60.
  79. Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Outcome after high tibial open-wedge osteotomy: A retrospective evaluation of 533 patients. Knee Surg Sports Traumatol Arthrosc 2013;21:170-80.
  80. Salzmann GM, Ahrens P, Naal FD, El-Azab H, Spang JT, Imhoff AB, et al. Sporting activity after high tibial osteotomy for the treatment of medial compartment knee osteoarthritis. Am J Sports Med 2009;37:312-8.
  81. Schuster P, Geßlein M, Schlumberger M, Mayer P, Mayr R, Oremek D, et al. Ten-year results of medial open-wedge high tibial osteotomy and chondral resurfacing in severe medial osteoarthritis and varus malalignment. Am J Sports Med 2018;46:1362-70.
  82. Dugdale TW, Noyes FR, Styer D. Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res1992;274:248-64.
  83. Kosashvili Y, Safir O, Gross A, Morag G, Lakstein D, Backstein D. Distal femoral varus osteotomy for lateral osteoarthritis of the knee: A minimum ten-year follow-up. Int Orthop 2010;34:249-54.
  84. Coventry M. Osteotomy about the knee for degenerative and rheumatoid arthritis. J Bone Joint Surg Am 1973;55:23-48.
  85. Buda R, Castagnini F, Gorgolini G, Baldassarri M, Vannini F. Distal femoral medial closing wedge osteotomy for degenerative valgus knee: Mid-term results in active patients. Acta Orthop Belg 2017;83:140-5.


How to Cite this article: Reddy RG, Wang Y, Scully R, Thakkar SC. Invasive Non-arthroplasty Treatment Options for Knee Osteoarthritis: Review. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):08-17.

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Burnout in COVID-19 Residency

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 18-24 | Sachin Kale, Pratik Dhabalia, Ajit Chalak, Abhiraj Patel, Abhineet Chand, Sonali Das

DOI: :10.13107/jcorth.2023.v08i01.551

Author: Sachin Kale [1], Pratik Dhabalia [1], Ajit Chalak [1], Abhiraj Patel [1], Abhineet Chand [1], Sonali Das [1]

[1] Department of Orthopaedics, DY Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Abhiraj Patel,

Department of Orthopaedics, DY Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India.

E-mail: abhirajpatel15@gmail.com


Introduction: Burnout is a syndrome denoting the outcome of chronic work stress which has not been managed successfully. Burnout has only sometimes been at the forefront of studies in healthcare, where patient care and management have received more attention. This study focuses particularly on burnout of residents and healthcare workers during the COVID-19 pandemic that has changed the working environment.

Material and Methods: Questionnaires in the form of surveys have been used to receive feedback regarding work experience within the bubble of isolation and high patient load unique to COVID-19 pandemic. A full and complete analysis of the research is provided after the definition, description, and measurement of burnout are given.

Results: According to a review of the burnout literature, burnout affects medical students, residents, and practicing doctors, with prevalence rates ranging from 28% to 45% for each group. First-year residency during the COVID-19 pandemic, in particular, is plagued with unmanageable burnout symptoms and a depleted support system. Burnout among residents is said to be caused by time demands, a lack of control, poor work organization, naturally challenging employment settings, and interpersonal connections. Workplace solutions might take the form of burnout education, workload adjustments, diversifying job roles, stress management training, mentorship, emotional intelligence seminars, and training in emotional intelligence. In addition, developing interpersonal and professional relationships, meditation, therapy, and exercise are examples of self-directed behavioral, social, and physical activities..

Conclusion: Educators should consider including pertinent instructions and interventions during the process of instructing resident doctors. In addition, they should actively become aware of burnout. Early detection aids in better management of burnout.

Keywords: burnout, COVID-19, residency, work-life balance.


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How to Cite this article: Kale S, Dhabalia P, Chalak A, Patel A, Chand A, Das S. Burnout in COVID-19 Residency. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):18-24.

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When all is not good – managing an adolescent with Osgood Schlatter disease

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 25-31 | Tushar Agarwal, Pooja Suratwala

DOI: 10.13107/jcorth.2023.v08i01.557

Author: Tushar Agarwal [1], Pooja Suratwala [2]

[1] Aastha Hospital, 65 Balasinor Society, SV Road Kandivali West, Mumbai 67 India,
[2] Clinical Fellow Paediatric Orthopaedics, Aastha Hospital, Kandivali, India.

Address of Correspondence
Dr. Tushar Agrawal,

Aastha Hospital, 65 Balasinor Society, SV Road Kandivali West, Mumbai 67, India.
E-mail: drtusharagrawal@gmail.com


Anterior knee pain in children above 10 years of age is a part of every orthopaedic surgeon OPD practice. Osgood-Schlatter disease is the most common cause in skeletal of immature athletic children. It is a condition, in which the patellar tendon insertion on the tibial tuberosity becomes inflamed. It tends to occur more commonly in boys and it occurs in the second decade of life ( 10-15 years). It is a self limiting condition and and occurs secondary to repetitive extensor mechanism stress activities such as jumping and sprinting. OSD is a clinical diagnosis, and only radiographic evaluation may be done to confirm the diagnosis. Pain level dictates overall treatment, and management includes symptomatic treatment with ice and NSAIDs, as well as activity modification. & relative rest from inciting activities in association with lower extremities stretching exercises. In this paper we discuss the etiology, presentation, evaluation, and management of osgood schlatter disease.

Keywords: osgood Schlatter disease , osteochondritis, anterior knee pain.


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  5. Green DW, Sidharthan S, Schlichte LM, Aitchison AH, Mintz DN. Increased posterior tibial slope in patients with Osgood-Schlatter disease: A new association. Am J Sports Med 2020;48:642-6.
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  8. Kadirhan O, Fatihoglu E. Magnetic resonance imaging findings in Osgood Schlatter disease: Acase report. Curr Res MRI 2022;1:50-1.
  9. Siddiq MA. Osgood-Schlatter disease unveiled under high-frequency ultrasonogram. Cureus 2018;10:e3411.
  10. Neuhaus C, Appenzeller-Herzog C, Faude O. A systematic review on conservative treatment options for OSGOOD-Schlatter disease. Phys Ther Sport 2021;49:178-87.
  11. Topol GA, Podesta LA, Reeves KD, Raya MF, Fullerton BD, Yeh HW. Hyperosmolar dextrose injection for recalcitrant Osgood-Schlatter disease. Pediatrics 2011;128:e1121-8.
  12. Weiss JM, Jordan SS, Andersen JS, Lee BM, Kocher M. Surgical treatment of unresolved Osgood-Schlatter disease: Ossicle resection with tibial tubercleplasty. J Pediatr Orthop 2007;27:844-7.
  13. Tsakotos G, Flevas DA, Sasalos GG, Benakis L, Tokis AV. Osgood-Schlatter lesion removed arthroscopically in an adult patient. Cureus 2020;12:e7362.
  14. Fujita K, Nakase J, Yoshimizu R, Kimura M, Kanayama T, Tsuchiya H. Bursoscopic ultrasound-guided ossicle resection for Osgood-Schlatter disease. Arthrosc Tech 2022;11:e841-6.
  15. Pihlajamäki HK, Mattila VM, Parviainen M, Kiuru MJ, Visuri TI. Long-term outcome after surgical treatment of unresolved Osgood-Schlatter disease in young men. J Bone Joint Surg Am 2009;91:2350-8.
  16. Circi E, Atalay Y, Beyzadeoglu T. Treatment of Osgood-Schlatter disease: Review of the literature. Musculoskelet
    Surg 2017;101:195-200.
  17. Corbi F, Matas S, Álvarez-Herms J, Sitko S, Baiget E, Reverter-Masia J, et al. Osgood-Schlatter disease: Appearance, diagnosis and treatment: A narrative review. Healthcare (Basel) 2022;10:1011.
How to Cite this article: Agarwal T, Suratwala P. When All Is Not Good – Managing an Adolescent with Osgood–Schlatter Disease. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):25-31.

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Non Standard Deviation – Managing angular deformities around the knee in young age

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 32-37 | Binoti Sheth

DOI: 10.13107/jcorth.2023.v08i01.559

Author: Binoti Sheth [1]

[1] Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India.

Address of Correspondence
Dr. Binoti Sheth, MS, DNB, FCPS, D. Orth.
Professor and Head of Unit, Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General
Hospital, Sion, Mumbai, India.
E-mail: binotisheth@yahoo.com


Angular deformities around the knee in children are common presentations in day to day practice. While some of the deformities are physiological that need careful observation, the others are pathological and need timely medical or surgical intervention. Systematic evaluation of the deformity is the first step in making the correct decision about the management. The right choice of treatment, the correct timing and perfect execution of the technique are necessary for optimum outcome. This article describes the aetiology, clinicoradiological evaluation and management of angular deformities around the knee in children.

Keywords: Knee, Angular deformity, Children.


  1. SeleniusP., Vankka E.: The development of the tibiofemoral angle in children J. Bone Joint Surg Am.1975, 57:259-261.
  2. Valentino Coppa, Mario Marinelli: Coronal plane deformity around the knee in the skeletally immature population: A review of principles of evaluation and treatment World Journal of Orthopaedics 2022, May 13(5):427-443.
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  7. Eltayeby HH, Lobst CA. Hemiepiphysiodesis using tension band plates: does the initial screw angle influence the rate of correction? J. Child Ortho. 2019, Feb. 13(1): 62-66.
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How to Cite this article: Sheth B. Non Standard Deviation – Managing angular deformities around the knee in young agee. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):32-37.

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Bracing for Impact – Bracing in Adolescent Idiopathic Scoliosis

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 38-40 | Kshitij Chaudhary

DOI: 10.13107/jcorth.2023.v08i01.561

Author: Kshitij Chaudhary [1]

[1] Orthopaedic Spine Surgeon, Department of Orthopaedics, P.D. Hinduja National Hospital and Research Centre,
Mumbai, Maharashtra, India..

Address of Correspondence
Dr. Kshitij Chaudhary,
1417, OPD Building, PD hinduja Hospital and Research Center, Veer Savarkar Marg, Mahim, Mumbai, 400016, India.
E-mail: chaudhary.kc@gmail.com


Bracing plays a vital role in the non-operative treatment of adolescent idiopathic scoliosis (AIS), especially when detected early. Recent high-quality studies confirm that bracing can alter the natural progression of a curve, potentially preventing the need for surgery. The concept is based on the ability of external force to guide spine growth, which has been experimentally proven. However, bracing cannot straighten the spine; its primary goal is to halt the curve’s progression. The evidence for bracing is strong, with studies showing that approximately two-thirds of AIS curves can be controlled through bracing. However, there are concerns about the broad application of bracing indications, potentially leading to unnecessary treatment for some patients. Identifying the 25% of patients who will benefit from bracing remains a challenge. Bracing is most effective when applied to curves between 25-45° during the rapid growth phase, but compliance is crucial for success. The choice of brace type matters less than its quality and corrective effect. The practice of bracing requires a close orthotist-surgeon relationship, and follow-up visits are essential to monitor progress. Ultimately, bracing remains a valuable non-surgical option for AIS, but careful patient selection and close monitoring are necessary for optimal results.

Keywords: Brace, Adolescent idiopathic scoliosis.


  1. Weinstein SL, Dolan L A, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic scoliosis. New England J Med 2013;369(16):1512-1521.
  2. Nachemson AL. Long-term effect of brace treatment on nonoperated immature idiopathic scoliosis followed to skeletal maturity. Spine 1995;20(12):1363-1367.
  3. Winter RB, Lonstein JE, Denis F, Johnson L. Scoliosis: etiology, diagnosis, and natural history. J Pediatric Ortho 1983;3(4):341-351.
  4. Karol LA, Johnston CE, Browne RH, Madison M, Birch J. Bracing as a treatment for adolescent idiopathic scoliosis: a prospective cohort study. J Pediatric Ortho 2008;28(7):753-759.
  5. Aronsson DD, Stokes IA. Nonfusion treatment of adolescent idiopathic scoliosis by growth modulation and remodeling. J Pediatr Orthop. 2011;31(1 Suppl):S99-106.
How to Cite this article: Chaudhary K. Bracing for Impact – Bracing in Adolescent Idiopathic Scoliosis. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):38-40.

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Foot Falls – Managing Flatfeet in Children and Adolescents

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 41-46 | Ranjit Deshmukh

DOI: 10.13107/jcorth.2023.v08i01.563

Author: Ranjit Deshmukh [1]

[1] Consultant Orthopaedic Surgeon, Blooming Buds Paediatric Orthopaedics Department, Deenanath Mangeshkar
Hospital, Pune, Maharashtra, India.

Address of Correspondence
Dr. Ranjit Deshmukh,
Consultant Orthopedic Surgeon, Blooming Buds Paediatric Orthopaedics Department, Deenanath Mangeshkar
Hospital, Pune, Maharashtra, India.
E-mail: drranjitdeshmukh@gmail.com


Flat feet are rarely symptomatic in children. The reason for consultation is usually parental anxiety and peer pressure. Majority of the patients and their parents needs to be treated with assurance. The clinical assessment of the foot must however be performed systematically in order to detect signs of symptomatic flat feet that are detected early and treated within time. Asymptomatic flexible flat feet constitute the majority of these feet and need to be assessed for a tight tendo achilles. Feet with a tight tendo achilles are most likely to become symptomatic and may need some form of treatment. The treatment is primarily conservative however in exceptional circumstances joint sparing osteo tomies of the feet are recommended Evaluation of the foot should detect any signs of a rigid flat foot. The cause of rigidity if established early can be addressed to prevent long term morbidity.

Keywords: :Flexible Flatfoot, Rigid Flatfoot Achilles tendon contracture, Foot Osteotomies.


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  17. MacKenzie AJ, Rome K, Evans AM. The efficacy of nonsurgical interventions for pediatric flexible flat foot: A critical review. J Pediatr Orthop 2012;32:830-4.
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  19. Dobbs MB, Purcell DB, Nunley R, Morcuende JA. Early results of a new method of treatment for idiopathic congenital vertical talus. J Bone Joint Surg Am 2006;88:1192-200.
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  22. Gantsoudes GD, Roocroft JH, Mubarak SJ. Treatment of talocalcaneal coalitions. J Pediatr Orthop 2012;32:301-7.
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How to Cite this article: Deshmukh R. Foot Falls – Managing Flatfeet in Children and Adolescents. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):41-46.

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The Boon in a toxin : Injection Botulinum Toxin for Spasticity management in Children with Cerebral Palsy

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 47-50 | Chasanal Rathod

DOI: 10.13107/jcorth.2023.v08i01.565

Author: Chasanal Rathod [1]

[1] Department of Orthopedics, SRCC Children’s Hospital, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Chasanal Rathod,
Department of Orthopedics, SRCC Children’s Hospital, Mumbai, Maharashtra, India.
E-mail: chasanal@gmail.com


  1. Multani I, Manji J, Hastings-Ison T, Khot A, Graham K. Botulinum toxin in the management of children with cerebral palsy. Paediatr Drugs 2019;21:261-81.
  2. Car H, Bogucki A, Bonikowski M, Dec-Ćwiek M, Drużdż A, Koziorowski D, et al. Botulinum toxin type-A preparations are not the same medications-basic science (Part 1). Neurol Neurochir Pol 2021;55:133-40.
  3. Sätilä H. Over 25 years of pediatric Botulinum toxin treatments: What have we learned from injection techniques, doses, dilutions, and recovery of repeated injections? Toxins (Basel) 2020;12:440.
  4. Graham HK, Aoki KR, Autti-Ramo I, Boyd RN, Delgado MR, Gaebler-Spira DJ, et al. Recommendations for the use of botulinum toxin type A in the management of cerebral palsy. Gait Posture 2000;11:67-79.
  5. Reeuwijk A, Van Schie PE, Becher JG, Kwakkel G. Effects of botulinum toxin type A on upper limb functions in children with cerebral palsy: A systematic review. Clin Rehabil 2006;20:375-87.
  6. Schroeder AS, Berweck S, Lee SH, Heinen F. Botulinum toxin treatment in children with cerebral palsy-a short review of different injection techniques. Neurotox Res 2006;9:189-96.
  7. Kinnett D. Botulinum toxin Ainjections in children: Technique and dosing issues. Am J Phys Med Rehabil 2004;83(Suppl 10):S59-64.
  8. Fehlings D, Rang M, Glazier J, Steele C. An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy. J Pediatr 2000;137:331-7.
  9. Jefferson RJ. Botulinum toxin in the management of cerebral palsy. Dev Med Child Neurol 2004;46:491-9.
  10. Read FA, Boyd RN, Barber LA. Longitudinal assessment of gait quality in children with bilateral cerebral palsy following repeated lower limb intramuscular botulinum toxin-Ainjections. Res Dev Disabil 2017;68:35-41.


How to Cite this article: Rathod C. The Boon in a Toxin: Injection Botulinum Toxin for Spasticity Management in Children with Cerebral Palsy. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):47-50.

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Setting the Standard of Care – Ponseti Casting for Club Feet

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 51-52 | Ashish S. Ranade, Bharati Deokar-Sharma

DOI: 10.13107/jcorth.2023.v08i01.567

Author: Ashish S. Ranade [1], Bharati Deokar-Sharma [2]

[1] Blooming Buds Centre for Pediatric Orthopaedics, Deenanath Mangeshkar Hospital and Research Centre, Pune,
Maharashtra, India,
[2] Department of Orthopaedics, Symbiosis Medical College for Women and Hospital, Pune, Maharashtra, India.

Address of Correspondence
Dr. Ashish S. Ranade,
Blooming Buds Centre for Pediatric Orthopaedics, Deenanath Mangeshkar Hospital and Research Centre, Pune,
Maharashtra, India.
E-mail: ranadea2@gmail.com


  1. Ponseti IV. Congenital Clubfoot: Fundamentals of Treatment. 2nd ed. Oxford: Oxford University Press; 1996.
  2. Ponseti IV. Common errors in the treatment of congenital clubfoot. Int Orthop 1997;21:137-41.
  3. Milbrandt T, Kryscio R, Muchow R, Walker J, Talwalkar V, Iwinski H. Oral sucrose for pain relief during clubfoot casting: Adouble-blinded randomized controlled trial. J Pediatr Orthop 2018;38:430-5.
  4. Youn SB, Ranade AS, Agarwal A, Belthur MV. Common Errors in the Management of Idiopathic Clubfeet Using the Ponseti Method: A Review of the Literature. Children (Basel). 2023 Jan 12;10(1):152.


How to Cite this article: Ranade AS, Sharma BD. Setting the Standard of Care – Ponseti Casting for Club Feet. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):51-52.

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