I am a Consultant Orthopaedic Surgeon with special interest in minimal invasive management of Sports injuries of Shoulder, wrist, Knee and ankle joints and expertise in Joint replacement and Orthopaedic Trauma.
Introduction: Distal tibia fractures often caused by high energy axial compressive, direct bendin... more Introduction: Distal tibia fractures often caused by high energy axial compressive, direct bending or low energy rotation forces. These fractures constitute less than 7% of all the tibial fracture and less than 10% of all lower extremity fractures. Management of distal tibia fracture is challenging because of its subcutaneous location with precarious blood supply, proximity to the ankle joint and associated soft tissue injury. Numerous features are responsible for this, but perhaps none are as difficult as the accompanying soft tissue injury that is frequently present. They are associated with gross swelling, skin injury and blisters because of subcutaneous location. Skin condition determines the timing of surgery. The aim of treating the fracture is to preserve normal mechanical axis, ensure joint stability and restore a near full range of motion. This is a difficult task to accomplish in each and every case as we face compromised soft tissue condition and variable bone quality. Av...
Background: Fractures of proximal humerus are common and debilitating injuries increasing seen in... more Background: Fractures of proximal humerus are common and debilitating injuries increasing seen in the elderly population [1]. Neer classification remains most widely used today [7]. Optimal treatment of three-or four-part fractures of proximal part of the humerus in elderly patients is controversial. However, recent advances in fracture fixation technology has led to development of fixed angle locked plates (PHILOS) that maintain angular stability under load [18]. Methods: This retrospective study included 41 patients aged > 18 years with fractures of the proximal humerus, including two-, three-, and four-part fractures, treated by open reduction and internal fixation with PHILOS plating. Patients were functionally evaluated based on subjective (35 points) and objective (65 points) parameters as per the Neer scoring system. Results: All these operated patients were followed up for 12-18 months. Functional outcome based on the Neer scoring system showed 32 patients had good outcome scores (78%) which include excellent and satisfactory result, whereas 9 patients had poor outcome scores (22%) which include unsatisfactory and failure results, out of which 4 patients had avascular necrosis and were treated with Shoulder Hemiarthroplasty, 4 patients presented with varus malunion and treated with Osteotomy and revision plating and 1 patient underwent implant removal and physiotherapy. Conclusion: Proximal humerus locking plate is a preferred option for management of in all types of Neer's fracture types of proximal humerus and fracture dislocation of proximal humerus. The present study concludes that it is a promising implant working by a dual mechanism i.e. a buttressing effect laterally and inferomedial support by locking screws, which prevent varus displacement of proximal fragment and thus it provides a good functional outcome in proximal humerus fractures. However, complications are not uncommon with PHILOS plates. And therefore, a thorough understanding of fracture morphology using pre-operative planning with 3D CT scan, sound surgical techniques and proper plate positioning is necessary to achieve good functional outcomes.
Impact factor and focuses to publish informative articles in all the fields of orthopaedics and b... more Impact factor and focuses to publish informative articles in all the fields of orthopaedics and bone research. The journal focuses on every issue relevant to clinical and experimental research with regard to musculoskeletal disorders. Journal scope likewise incorporates information related to both surgical and nonsurgical methods to treat musculoskeletal trauma, sports injuries, degenerative diseases. The journal has a mission to exchange ideas concerned with the symposium of orthopaedics, traumatology, rheumatology, arthroscopy, bone tumors and different broad orthopaedics related themes. Indexations https://actascientific.com
INTRODUCTION Osteoarthritis (OA) is an important cause of chronic pain and disability worldwide a... more INTRODUCTION Osteoarthritis (OA) is an important cause of chronic pain and disability worldwide among the elderly population. 1 OA is a very common problem in the older population and affects almost 5% of people over 65 years of age. 2-4 As population ages, disease progresses, it leads to deteriorating quality of life with pain, loss of mobility and functional independence. The general increase in life expectance means increase in number of people affected with OA. It affected more than 10 million people in India and there is increase in numbers by more than 8% annually and it's a major health problem worldwide. Osteoarthritis is the second most common rheumatologic problem and it is the most frequent joint disease with a prevalence of 22% to 39% in India. 5,6 OA is more common in women than men, but the prevalence increases dramatically with age. 5,7,8 Nearly, 45% of women over the age of 65 years have symptoms while radiological evidence is found in 70% of those over 65 years. 7-9 OA of the knee is a major cause of mobility impairment, particularly among females. 7,8 OA was ABSTRACT Background: Osteoarthritis of knee (OA Knee) is one of the most common form of joint disease and affects everyone in different proportion with aging. To reduce the burden on society and improve the productive life various modalities of treatment are suggested. Our goal was to find out how much Intra Articular Hyaluronic acid injection (I/A HA inj.) is effective and safe. Methods: We have done a retrospective single blind study on 60 patients of OA Knee according to ACR Criteria, Grade I and II, who were treated with I/A HA inj. of a single brand. They were followed up up to 3 year after last injection and clinical assessment done based on VAS Scale and WOMAC Score. Results: Out of 60 patients who have been given I/A HA injection, patients below age of 50 and ACR Grade I OA Knee, responded well with injection. However patients above age of 50 and ACR Grade II OA Knee responded poorly and require some other form of treatment as early as 1 month after stopping injection. Conclusions: Though OA Knee is a degenerative disease which requires long term follow up to justify use of I/A HA injection, We believe that in early cases of OA Knee and Patients below age of 50 years, this treatment modality can work well and may prolong active life and delay surgical intervention and hence cost benefit ratio justifies use of this treatment modality.
Introduction: Distal tibia fractures often caused by high energy axial compressive, direct bendin... more Introduction: Distal tibia fractures often caused by high energy axial compressive, direct bending or low energy rotation forces. These fractures constitute less than 7% of all the tibial fracture and less than 10% of all lower extremity fractures. Management of distal tibia fracture is challenging because of its subcutaneous location with precarious blood supply, proximity to the ankle joint and associated soft tissue injury. Numerous features are responsible for this, but perhaps none are as difficult as the accompanying soft tissue injury that is frequently present. They are associated with gross swelling, skin injury and blisters because of subcutaneous location. Skin condition determines the timing of surgery. The aim of treating the fracture is to preserve normal mechanical axis, ensure joint stability and restore a near full range of motion. This is a difficult task to accomplish in each and every case as we face compromised soft tissue condition and variable bone quality. Av...
Background: Fractures of proximal humerus are common and debilitating injuries increasing seen in... more Background: Fractures of proximal humerus are common and debilitating injuries increasing seen in the elderly population [1]. Neer classification remains most widely used today [7]. Optimal treatment of three-or four-part fractures of proximal part of the humerus in elderly patients is controversial. However, recent advances in fracture fixation technology has led to development of fixed angle locked plates (PHILOS) that maintain angular stability under load [18]. Methods: This retrospective study included 41 patients aged > 18 years with fractures of the proximal humerus, including two-, three-, and four-part fractures, treated by open reduction and internal fixation with PHILOS plating. Patients were functionally evaluated based on subjective (35 points) and objective (65 points) parameters as per the Neer scoring system. Results: All these operated patients were followed up for 12-18 months. Functional outcome based on the Neer scoring system showed 32 patients had good outcome scores (78%) which include excellent and satisfactory result, whereas 9 patients had poor outcome scores (22%) which include unsatisfactory and failure results, out of which 4 patients had avascular necrosis and were treated with Shoulder Hemiarthroplasty, 4 patients presented with varus malunion and treated with Osteotomy and revision plating and 1 patient underwent implant removal and physiotherapy. Conclusion: Proximal humerus locking plate is a preferred option for management of in all types of Neer's fracture types of proximal humerus and fracture dislocation of proximal humerus. The present study concludes that it is a promising implant working by a dual mechanism i.e. a buttressing effect laterally and inferomedial support by locking screws, which prevent varus displacement of proximal fragment and thus it provides a good functional outcome in proximal humerus fractures. However, complications are not uncommon with PHILOS plates. And therefore, a thorough understanding of fracture morphology using pre-operative planning with 3D CT scan, sound surgical techniques and proper plate positioning is necessary to achieve good functional outcomes.
Impact factor and focuses to publish informative articles in all the fields of orthopaedics and b... more Impact factor and focuses to publish informative articles in all the fields of orthopaedics and bone research. The journal focuses on every issue relevant to clinical and experimental research with regard to musculoskeletal disorders. Journal scope likewise incorporates information related to both surgical and nonsurgical methods to treat musculoskeletal trauma, sports injuries, degenerative diseases. The journal has a mission to exchange ideas concerned with the symposium of orthopaedics, traumatology, rheumatology, arthroscopy, bone tumors and different broad orthopaedics related themes. Indexations https://actascientific.com
INTRODUCTION Osteoarthritis (OA) is an important cause of chronic pain and disability worldwide a... more INTRODUCTION Osteoarthritis (OA) is an important cause of chronic pain and disability worldwide among the elderly population. 1 OA is a very common problem in the older population and affects almost 5% of people over 65 years of age. 2-4 As population ages, disease progresses, it leads to deteriorating quality of life with pain, loss of mobility and functional independence. The general increase in life expectance means increase in number of people affected with OA. It affected more than 10 million people in India and there is increase in numbers by more than 8% annually and it's a major health problem worldwide. Osteoarthritis is the second most common rheumatologic problem and it is the most frequent joint disease with a prevalence of 22% to 39% in India. 5,6 OA is more common in women than men, but the prevalence increases dramatically with age. 5,7,8 Nearly, 45% of women over the age of 65 years have symptoms while radiological evidence is found in 70% of those over 65 years. 7-9 OA of the knee is a major cause of mobility impairment, particularly among females. 7,8 OA was ABSTRACT Background: Osteoarthritis of knee (OA Knee) is one of the most common form of joint disease and affects everyone in different proportion with aging. To reduce the burden on society and improve the productive life various modalities of treatment are suggested. Our goal was to find out how much Intra Articular Hyaluronic acid injection (I/A HA inj.) is effective and safe. Methods: We have done a retrospective single blind study on 60 patients of OA Knee according to ACR Criteria, Grade I and II, who were treated with I/A HA inj. of a single brand. They were followed up up to 3 year after last injection and clinical assessment done based on VAS Scale and WOMAC Score. Results: Out of 60 patients who have been given I/A HA injection, patients below age of 50 and ACR Grade I OA Knee, responded well with injection. However patients above age of 50 and ACR Grade II OA Knee responded poorly and require some other form of treatment as early as 1 month after stopping injection. Conclusions: Though OA Knee is a degenerative disease which requires long term follow up to justify use of I/A HA injection, We believe that in early cases of OA Knee and Patients below age of 50 years, this treatment modality can work well and may prolong active life and delay surgical intervention and hence cost benefit ratio justifies use of this treatment modality.
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