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   Table of Contents - Current issue
January-June 2022
Volume 1 | Issue 1
Page Nos. 1-44

Online since Monday, January 23, 2023

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Osteoporosis: A narrative review of diagnosis and treatment p. 1
Dheeraj , Nirmal Kumar, Kavya Ronanki, Ravi Kant
Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue, with a subsequent increment in bone fragility and susceptibility to fracture. It is the most common metabolic bone disorder. It is a common condition affecting one in three women and one in five men over 50, resulting in substantial morbidity, excess mortality, and health and social services expenditure. Osteoporosis is undertreated and underrecognized, considering the silent nature of the disease. Therefore, it is essential to develop strategies for early detection, prompt prevention, and treatment of osteoporosis in both men and women. This paper reviews the risk factors associated with osteoporosis, diagnostic approach, investigation, and management. This should include multidynamic lifestyle changes to reduce bone loss and decrease the risk of falls and identify and treat secondary causes of bone loss and specific treatment for osteoporosis. Hormone replacement therapy, raloxifene, bisphosphonates, calcium and Vitamin D, calcitonin, and parathyroid hormone have all been shown to improve bone density and decrease the risk of fracture in specific situations. Treatment must be tailored to the individual patient to ensure compliance and optimize the potential benefits.
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Plate osteosynthesis: Newer tools and recent updates p. 8
Ganesh Singh Dharmshaktu, Ishwar Singh Dharmshaktu, Naveen Agarwal, Anant Agarwal
Plate osteosynthesis involves open reduction and internal fixation of fractures with plate application abiding various principles of fixation. The conventional plates currently in widespread use are dynamic compression plate, tubular pates, and locking compression plates. There have always been modifications and advancements in implant development and the plates have also undergone various updates. Many of these developments are in vogue but many are in their primary stages. The newer technical developments and newer implants enrich the surgical armamentarium and address a critical issue in their usage and application. As part of the continuous professional development, working knowledge of key recent advances and new implant development is important for a relevant orthopedic practice.
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Notable resources for assistance in the research and scholarly publication journey: A brief overview p. 15
Ganesh Singh Dharmshaktu, Tanuja Pangtey
Research journey is an arduous process for beginners, but consistent learning and efforts make one better every time. Regular study of core principles of research and publication process coupled with persistent writing and submission is key to gaining experience and planning robust studies later. While the guidance of seniors or seasoned researchers is important asset, but the absence of it should not dampen enthusiasm. Various educational resources exist to serve the purpose of continuous professional development and improve knowledge regarding scholarly publication. A self-directed learning is also of paramount importance, and various educational contents are available on the Internet worth a visit. Recent trends in the world of scholarly publication are a perennial process and adherence to stringent research practices is a key element of a study well done. A general review of a few common resources which may help increase our knowledge regarding research process, are described here for the educational purpose of postgraduate students and for revision purposes for experienced researchers.
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A new diagnostic and therapeutic method for the conservative management of sciatica: A randomized placebo-controlled trial p. 21
Vivek Malik, Varun Kumar Agarwal
Background: The term “Sciatica” is commonly used for describing nerve pain in the leg which is caused due to the irritation or compression of the sciatic nerve. It is a source of disability and can interfere with the physical occupation aspect. Estimates for the lifetime incidence of sciatica range from 13% to 40%. Two common nonsurgical interventions used are physical therapy and epidural steroid injections. Pain is regulated by a subset of voltage-gated sodium channels, (NaV1.3, NaV1.7, NaV1.8, and NaV1.9). For this character of sodium channels in neurological pain, a peripheral nerve block is an upcoming treatment other than conventional treatment options such as steroid injections or opioids, analgesics. Methods: We conducted a randomized placebo-controlled trial in which after the application of injection we compared Visual Analog Scale Score, subjective satisfaction scale, straight leg raise (SLR) test preinjection and postinjection at 10 min, 1 week, and at 1 month. Results: In our study, a total of 92 patients were taken for the study: 66 patients in drug mixture group and 26 patients in the placebo group. The present study showed relief from pain up to the maximum follow-up period of 1 month; it also showed improvement in the SLR and also a better patient satisfaction, without any complications. Conclusion: In conclusion, peripheral sodium-channel block can be considered as a diagnostic as well as an option for short-term relief from pain in the patient suffering from sciatica, allowing physiotherapy, and rehabilitation exercises.
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Use of trochanteric femoral nail system in the management of un-united proximal femoral fracture: A case report on surgical technique p. 26
Saroj Sah, Mohit Dhingra
The mode of fixation of proximal femur fracture has evolved immensely. Inspite of use of number of implants the failure of fixation is reported to be between 5 to 14%. The fixation failure is mainly due to loss of fixation in the proximal femur. Quality of bone is the major factor for loss of fixation. Here in our study we present a case report where trochanteric femoral nail advanced system has been used for fixation of proximal femur which had compromised bone quality and had undergone multiple surgeries. We here have highlighted the methodology for use of this implant and along with peroperative experiences.
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Pathological fracture due to the aneurysmal bone cyst involving a large segment of radius diaphysis in an adolescent: A case report and 5-year follow-up p. 29
Ganesh Singh Dharmshaktu, Ishwar Singh Dharmshaktu, Naveen Agarwal
A cystic lesion of the long bones occasionally presents with a pathological fracture. Various etiologies are described, and the aneurysmal bone cyst (ABC) is an uncommon lesion in the forearm bones. Usually, ABC involves the metaphyseal region as an eccentric expansile lesion and its presence in diaphysis is rare. Involvement of a large segment of a long bone is a very uncommon presentation for any cystic lesion including ABC. Fracture resulting in the settings of ABC with an extensive diaphyseal involvement is a rare and challenging presentation. We describe relevant details pertaining to a case of a 13-year-old female involving a large segment of the radial diaphysis that was managed operatively and finally diagnosed as ABC. She had good outcome in the follow-up of 5 years, and no postoperative complication or recurrence was noted.
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Uniplanar monorail fixator for knee arthrodesis in triple deformity, an effective technique p. 32
Arun Chaudhary Kurmi, Roop Bhusan Kalia, Sajid Ansari, Souvik Paul
Limb reconstruction system (LRS) is a preferred method of choice for limb lengthening as well as to achieve the optimum level of compression in arthrodesis, thus enhancing primary bone healing. The case of a 30-year-old female diagnosed with triple deformity of the right knee due to advanced tubercular arthritis underwent left knee arthrodesis with uniplanar bilateral LRS fixator after 2 years of illness. The patient had an optimal fusion in the postoperative period with satisfactory outcomes regarding pain and mobilization. There are lots of cases of tubercular knee that might land into advanced tubercular arthritis. Such cases can have this sort of surgical management as an effective means.
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Sequential bilateral total hip arthroplasty for osseous ankylosed hips with severe flexion deformity in a teenage girl – A case report and review of literature p. 37
Sajid Ansari, Balgovind S Raja, Souvik Paul, Roop Bhushan Kalia
Total hip arthroplasty (THA) in an ankylosed hip is a challenging procedure, especially in the presence of severe flexion deformity. The outcome of surgery largely depends on the surgical technique apart from the degree of the change that occurs in the muscles and soft tissues at the hip from long immobilization, and considerable postoperative rehabilitation is necessary. The complications in these cases are also higher than primary THA for nonankylosed hips. We report a case of a young teenage girl with both hips fused in severe flexion deformity. Surgical technique is described in detail, and pertinent literature is reviewed.
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Herpes zoster radiculopathy: A lesson in physical examination p. 43
Ganesh Singh Dharmshaktu, Naveen Agarwal, Ishwar Singh Dharmshaktu
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