IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Severe
patellofemoral arthritis secondary to patellofemoral
malalignment
treated by Fulkerson osteotomy plus tricortical
bone graft. A retrospective cohort of 45 knees.
Ideal Indications Meniscus Repair KNEE INJURY COMMON SPORTS INJURY
HOW TO DEAL SPORTS INJURY
RETURN TO SPORTS AFTER KNEE INJURY
BEST KNEE SURGEON DOCTOR IN JAIPUR
#aclsurgeryjaipur #aclsurgeryhindia #aclsurgerytaekwondo
Acl reconstruction in jaipur | Acl reconstruction in taekwondo | Acl injury in football player surgery | Acl reconstruction surgery in football | acl surgery | Acl surgery ke baad physiotherapy | Acl surgery in jaipur | acl surgery recovery | Best acl surgeon in jaipur | Best ligament doctor in hindi | Best acl surgeon in india | Meniscus repair surgery in jaipur | Sports injury doctor | Acl injury in football players | Acl injury in taekwondo | acl tear | Best knee surgeon in jaipur
#allinsideacl #internalbrace #drrajatjangir #bestaclsurgeon #aclexpert #bestkneesurgeon
To Know more about ACL Injury, Click the links below:
1. ACL surgery 7 different Techniques we do at our center - "Not single technique best for all"
https://youtu.be/oWkIr8IXvr8
2. Everything about ACL Injury tear surgery in Hindi I
https://youtu.be/bqpjkAkwZ14
3. Best Screw for ACL tear surgery in Hindi
https://youtu.be/1LGpU1NHiIs
4. ACL Injury Tear Surgery Recovery : All your questions & queries solved by Dr.Rajat Jangir
https://youtu.be/SIAPWiMbOqs
5. Partial ACL Tear Surgery or not ! ACL आधा टूटा हो तो क्या करें ?
https://youtu.be/NEJRPKskJTI
6. 5 Symptoms of ACL Injury tear इंजरी के पांच लक्षण ?
https://youtu.be/EXpgy19Jxzw
7. PRP injection therapy in Partial ACL TEARs
https://youtu.be/qyG1EYgS87E
Dr.RAJAT JANGIR(Asso Prof.)
Senior Consultant Arthroscopy and Joint Replacement
(Specialist in Shoulder Knee Hip Surgery)
Ligament and Joints Clinic
67/34 Mansarovar Jaipur
Whatsapp: shorturl.at/gnAEP
Appointment: +91 8104855900
Email: ligamentsurgeon@gmail.com
Google Page: https://g.page/KNEE-Shoulder-SURGERY?...
Facebook: https://www.facebook.com/Ligamentandj...
* Vast experience and specialisation in the field of Arthroscopy and sports surgery.
* M.S. orthopaedics from BJ Medical College, Civil hospital, Ahmedabad
* Fellowship in Arthroscopy and Sports injury with Prof Joon Ho Wang at Samsung Medical Center, South Korea
* Diploma in Sports Medicine from InternationaI Olympic Committee
* Invited as Athlete Medical Doctor at Rio Olympic 2016
* Done Rajasthan's first "All Inside Physeal Preserving ACL reconstruction" in 13 year old Athlete
Dr.Rajat is rated as one of the best orthopedic surgeon with with excellence in Knee Shoulder Arthroscopy surgeries as replacements'
Short Term Analysis of Clinical, Functional Radiological Outcome of Total Kne...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Severe
patellofemoral arthritis secondary to patellofemoral
malalignment
treated by Fulkerson osteotomy plus tricortical
bone graft. A retrospective cohort of 45 knees.
Ideal Indications Meniscus Repair KNEE INJURY COMMON SPORTS INJURY
HOW TO DEAL SPORTS INJURY
RETURN TO SPORTS AFTER KNEE INJURY
BEST KNEE SURGEON DOCTOR IN JAIPUR
#aclsurgeryjaipur #aclsurgeryhindia #aclsurgerytaekwondo
Acl reconstruction in jaipur | Acl reconstruction in taekwondo | Acl injury in football player surgery | Acl reconstruction surgery in football | acl surgery | Acl surgery ke baad physiotherapy | Acl surgery in jaipur | acl surgery recovery | Best acl surgeon in jaipur | Best ligament doctor in hindi | Best acl surgeon in india | Meniscus repair surgery in jaipur | Sports injury doctor | Acl injury in football players | Acl injury in taekwondo | acl tear | Best knee surgeon in jaipur
#allinsideacl #internalbrace #drrajatjangir #bestaclsurgeon #aclexpert #bestkneesurgeon
To Know more about ACL Injury, Click the links below:
1. ACL surgery 7 different Techniques we do at our center - "Not single technique best for all"
https://youtu.be/oWkIr8IXvr8
2. Everything about ACL Injury tear surgery in Hindi I
https://youtu.be/bqpjkAkwZ14
3. Best Screw for ACL tear surgery in Hindi
https://youtu.be/1LGpU1NHiIs
4. ACL Injury Tear Surgery Recovery : All your questions & queries solved by Dr.Rajat Jangir
https://youtu.be/SIAPWiMbOqs
5. Partial ACL Tear Surgery or not ! ACL आधा टूटा हो तो क्या करें ?
https://youtu.be/NEJRPKskJTI
6. 5 Symptoms of ACL Injury tear इंजरी के पांच लक्षण ?
https://youtu.be/EXpgy19Jxzw
7. PRP injection therapy in Partial ACL TEARs
https://youtu.be/qyG1EYgS87E
Dr.RAJAT JANGIR(Asso Prof.)
Senior Consultant Arthroscopy and Joint Replacement
(Specialist in Shoulder Knee Hip Surgery)
Ligament and Joints Clinic
67/34 Mansarovar Jaipur
Whatsapp: shorturl.at/gnAEP
Appointment: +91 8104855900
Email: ligamentsurgeon@gmail.com
Google Page: https://g.page/KNEE-Shoulder-SURGERY?...
Facebook: https://www.facebook.com/Ligamentandj...
* Vast experience and specialisation in the field of Arthroscopy and sports surgery.
* M.S. orthopaedics from BJ Medical College, Civil hospital, Ahmedabad
* Fellowship in Arthroscopy and Sports injury with Prof Joon Ho Wang at Samsung Medical Center, South Korea
* Diploma in Sports Medicine from InternationaI Olympic Committee
* Invited as Athlete Medical Doctor at Rio Olympic 2016
* Done Rajasthan's first "All Inside Physeal Preserving ACL reconstruction" in 13 year old Athlete
Dr.Rajat is rated as one of the best orthopedic surgeon with with excellence in Knee Shoulder Arthroscopy surgeries as replacements'
Short Term Analysis of Clinical, Functional Radiological Outcome of Total Kne...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Proximal fibular osteotomy - What is the evidence?Dr Saseendar MD
Proximal fibular osteotomy has been proposed as a simple and inexpensive alternative to high-tibial osteotomy and unicondylar knee arthroplasty and may be useful for low-income populations that cannot afford expensive treatment methods. However, there is no consensus existing regarding the mechanism by which it acts nor the outcome of this procedure. This study was performed to analyze the available evidence on the benefits of proximal fibular osteotomy and to understand the possible mechanisms in play. There are various mechanisms that are proposed to individually or collectively contribute to the outcomes of this procedure, and include the theory of non-uniform settlement, the too-many cortices theory, slippage phenomenon, the concept of competition of muscles, dynamic fibular distalization theory and ground reaction vector readjustment theory. The mechanisms have been discussed and future directions in research have been proposed. The current literature, which mostly consists of case series, suggests the usefulness of the procedure in decreasing varus deformity as well as improving symptoms in medial osteoarthritis. However, large randomised controlled trials with long-term follow-up are required to establish the benefits of this procedure over other established treatment methods.
Proximal Fibular Osteotomy for Knee Osteoarthritis - What is the evidence?Dr Saseendar MD
Proximal Fibular Osteotomy for Knee Osteoarthritis - What is the evidence?
knee osteoarthritis, knee surgery, total knee replacement, osteoarthritis, knee pain, elderly,
https://kneesurgrelatres.biomedcentral.com/articles/10.1186/s43019-019-0016-0
Calcaneal Lengthening Using Bone Substitute Graft for Neurological Flatfoot T...CrimsonPublishersOPROJ
Calcaneal Lengthening Using Bone Substitute Graft for Neurological Flatfoot Treatment by Mario Lampropulos* in Crimson Publishers: Orthopedic Research and Reviews Journal
PCL Posterior Cruciate Ligament Knee Injury: Is it Benign I Dr.RAJAT JANGIR JAIPUR
#aclsurgeryjaipur #aclsurgeryhindia #aclsurgerytaekwondo
Acl reconstruction in jaipur | Acl reconstruction in taekwondo | Acl injury in football player surgery | Acl reconstruction surgery in football | acl surgery | Acl surgery ke baad physiotherapy | Acl surgery in jaipur | acl surgery recovery | Best acl surgeon in jaipur | Best ligament doctor in hindi | Best acl surgeon in india | Meniscus repair surgery in jaipur | Sports injury doctor | Acl injury in football players | Acl injury in taekwondo | acl tear | Best knee surgeon in jaipur
#allinsideacl #internalbrace #drrajatjangir #bestaclsurgeon #aclexpert #bestkneesurgeon
To Know more about ACL Injury, Click the links below:
1. ACL surgery 7 different Techniques we do at our center - "Not single technique best for all"
https://youtu.be/oWkIr8IXvr8
2. Everything about ACL Injury tear surgery in Hindi I
https://youtu.be/bqpjkAkwZ14
3. Best Screw for ACL tear surgery in Hindi
https://youtu.be/1LGpU1NHiIs
4. ACL Injury Tear Surgery Recovery : All your questions & queries solved by Dr.Rajat Jangir
https://youtu.be/SIAPWiMbOqs
5. Partial ACL Tear Surgery or not ! ACL आधा टूटा हो तो क्या करें ?
https://youtu.be/NEJRPKskJTI
6. 5 Symptoms of ACL Injury tear इंजरी के पांच लक्षण ?
https://youtu.be/EXpgy19Jxzw
7. PRP injection therapy in Partial ACL TEARs
https://youtu.be/qyG1EYgS87E
Dr.RAJAT JANGIR(Asso Prof.)
Senior Consultant Arthroscopy and Joint Replacement
(Specialist in Shoulder Knee Hip Surgery)
Ligament and Joints Clinic
67/34 Mansarovar Jaipur
Whatsapp: shorturl.at/gnAEP
Appointment: +91 8104855900
Email: ligamentsurgeon@gmail.com
Google Page: https://g.page/KNEE-Shoulder-SURGERY?...
Facebook: https://www.facebook.com/Ligamentandj...
* Vast experience and specialisation in the field of Arthroscopy and sports surgery.
* M.S. orthopaedics from BJ Medical College, Civil hospital, Ahmedabad
* Fellowship in Arthroscopy and Sports injury with Prof Joon Ho Wang at Samsung Medical Center, South Korea
* Diploma in Sports Medicine from InternationaI Olympic Committee
* Invited as Athlete Medical Doctor at Rio Olympic 2016
* Done Rajasthan's first "All Inside Physeal Preserving ACL reconstruction" in 13 year old Athlete
Dr.Rajat is rated as one of the best orthopedic surgeon with with excellence in Knee Shoulder Arthroscopy surgeries as replacements'
Computer Navigated Medial Opening Wedge High Tibial Osteotomy- Review of Lite...CrimsonPublishersOPROJ
Computer Navigated Medial Opening Wedge High Tibial Osteotomy- Review of Literature by Kunal Dhurve* in Crimson Publishers: Orthopedic Research and Reviews Journal
Describes current options for treatment of arthritis including stem cell treatments, Platelet Rich Plasma, hyaluronic and steroid injections as well as arthroscopy and joint replacement.
Dr. Goradia with G2 Orthopedics and Sports Medicine in Glen Allen, VA reviews advances in knee replacement surgery that are helping more patients live pain free.
Finite Element Analysis of Osteosynthesis Miniplate for the Reconstruction of...UniversitasGadjahMada
In the last two decades, the use of osteosynthesis miniplate has been growing to aid the healing process and reconstruction of fractured mandibular bone. In principle, the plate is used to provide stable fixation of the fractured bone tissue during the healing process and reconstruction. Based on earlier studies, it is noted that arrangements and geometry of the osteosynthesis miniplate played a critical role in determining the stability of the fractured mandibular bone, as well as the miniplate. In this research, a simulation with finite element method (FEM) was carried out to investigate the influence of the number of holes in an osteosynthesis miniplate on the stability of fractured mandibular bone and the corresponding miniplate after the implantation. For this purpose, a set of osteosynthesis miniplate with three different configurations was taken for simulation using a three-dimensional (3D) model of mandibular bone generated from the patient through computed tomography (CT). The result of the simulation showed that all the miniplates with three configurations tested were stable enough to prevent movement of fractured mandibular bone. Moreover, fixation with a pair of miniplates having four screw holes demonstrated the desired result; as indicated by the lowest value of displacement, pressure on the bone surface and pressure on the miniplate.
Proximal fibular osteotomy - What is the evidence?Dr Saseendar MD
Proximal fibular osteotomy has been proposed as a simple and inexpensive alternative to high-tibial osteotomy and unicondylar knee arthroplasty and may be useful for low-income populations that cannot afford expensive treatment methods. However, there is no consensus existing regarding the mechanism by which it acts nor the outcome of this procedure. This study was performed to analyze the available evidence on the benefits of proximal fibular osteotomy and to understand the possible mechanisms in play. There are various mechanisms that are proposed to individually or collectively contribute to the outcomes of this procedure, and include the theory of non-uniform settlement, the too-many cortices theory, slippage phenomenon, the concept of competition of muscles, dynamic fibular distalization theory and ground reaction vector readjustment theory. The mechanisms have been discussed and future directions in research have been proposed. The current literature, which mostly consists of case series, suggests the usefulness of the procedure in decreasing varus deformity as well as improving symptoms in medial osteoarthritis. However, large randomised controlled trials with long-term follow-up are required to establish the benefits of this procedure over other established treatment methods.
Proximal Fibular Osteotomy for Knee Osteoarthritis - What is the evidence?Dr Saseendar MD
Proximal Fibular Osteotomy for Knee Osteoarthritis - What is the evidence?
knee osteoarthritis, knee surgery, total knee replacement, osteoarthritis, knee pain, elderly,
https://kneesurgrelatres.biomedcentral.com/articles/10.1186/s43019-019-0016-0
Calcaneal Lengthening Using Bone Substitute Graft for Neurological Flatfoot T...CrimsonPublishersOPROJ
Calcaneal Lengthening Using Bone Substitute Graft for Neurological Flatfoot Treatment by Mario Lampropulos* in Crimson Publishers: Orthopedic Research and Reviews Journal
PCL Posterior Cruciate Ligament Knee Injury: Is it Benign I Dr.RAJAT JANGIR JAIPUR
#aclsurgeryjaipur #aclsurgeryhindia #aclsurgerytaekwondo
Acl reconstruction in jaipur | Acl reconstruction in taekwondo | Acl injury in football player surgery | Acl reconstruction surgery in football | acl surgery | Acl surgery ke baad physiotherapy | Acl surgery in jaipur | acl surgery recovery | Best acl surgeon in jaipur | Best ligament doctor in hindi | Best acl surgeon in india | Meniscus repair surgery in jaipur | Sports injury doctor | Acl injury in football players | Acl injury in taekwondo | acl tear | Best knee surgeon in jaipur
#allinsideacl #internalbrace #drrajatjangir #bestaclsurgeon #aclexpert #bestkneesurgeon
To Know more about ACL Injury, Click the links below:
1. ACL surgery 7 different Techniques we do at our center - "Not single technique best for all"
https://youtu.be/oWkIr8IXvr8
2. Everything about ACL Injury tear surgery in Hindi I
https://youtu.be/bqpjkAkwZ14
3. Best Screw for ACL tear surgery in Hindi
https://youtu.be/1LGpU1NHiIs
4. ACL Injury Tear Surgery Recovery : All your questions & queries solved by Dr.Rajat Jangir
https://youtu.be/SIAPWiMbOqs
5. Partial ACL Tear Surgery or not ! ACL आधा टूटा हो तो क्या करें ?
https://youtu.be/NEJRPKskJTI
6. 5 Symptoms of ACL Injury tear इंजरी के पांच लक्षण ?
https://youtu.be/EXpgy19Jxzw
7. PRP injection therapy in Partial ACL TEARs
https://youtu.be/qyG1EYgS87E
Dr.RAJAT JANGIR(Asso Prof.)
Senior Consultant Arthroscopy and Joint Replacement
(Specialist in Shoulder Knee Hip Surgery)
Ligament and Joints Clinic
67/34 Mansarovar Jaipur
Whatsapp: shorturl.at/gnAEP
Appointment: +91 8104855900
Email: ligamentsurgeon@gmail.com
Google Page: https://g.page/KNEE-Shoulder-SURGERY?...
Facebook: https://www.facebook.com/Ligamentandj...
* Vast experience and specialisation in the field of Arthroscopy and sports surgery.
* M.S. orthopaedics from BJ Medical College, Civil hospital, Ahmedabad
* Fellowship in Arthroscopy and Sports injury with Prof Joon Ho Wang at Samsung Medical Center, South Korea
* Diploma in Sports Medicine from InternationaI Olympic Committee
* Invited as Athlete Medical Doctor at Rio Olympic 2016
* Done Rajasthan's first "All Inside Physeal Preserving ACL reconstruction" in 13 year old Athlete
Dr.Rajat is rated as one of the best orthopedic surgeon with with excellence in Knee Shoulder Arthroscopy surgeries as replacements'
Computer Navigated Medial Opening Wedge High Tibial Osteotomy- Review of Lite...CrimsonPublishersOPROJ
Computer Navigated Medial Opening Wedge High Tibial Osteotomy- Review of Literature by Kunal Dhurve* in Crimson Publishers: Orthopedic Research and Reviews Journal
Describes current options for treatment of arthritis including stem cell treatments, Platelet Rich Plasma, hyaluronic and steroid injections as well as arthroscopy and joint replacement.
Dr. Goradia with G2 Orthopedics and Sports Medicine in Glen Allen, VA reviews advances in knee replacement surgery that are helping more patients live pain free.
Finite Element Analysis of Osteosynthesis Miniplate for the Reconstruction of...UniversitasGadjahMada
In the last two decades, the use of osteosynthesis miniplate has been growing to aid the healing process and reconstruction of fractured mandibular bone. In principle, the plate is used to provide stable fixation of the fractured bone tissue during the healing process and reconstruction. Based on earlier studies, it is noted that arrangements and geometry of the osteosynthesis miniplate played a critical role in determining the stability of the fractured mandibular bone, as well as the miniplate. In this research, a simulation with finite element method (FEM) was carried out to investigate the influence of the number of holes in an osteosynthesis miniplate on the stability of fractured mandibular bone and the corresponding miniplate after the implantation. For this purpose, a set of osteosynthesis miniplate with three different configurations was taken for simulation using a three-dimensional (3D) model of mandibular bone generated from the patient through computed tomography (CT). The result of the simulation showed that all the miniplates with three configurations tested were stable enough to prevent movement of fractured mandibular bone. Moreover, fixation with a pair of miniplates having four screw holes demonstrated the desired result; as indicated by the lowest value of displacement, pressure on the bone surface and pressure on the miniplate.
Fracture healing and reasons for non unionL Prakash
Man doesn’t heal fractures, Nature does, What happens to animals with fractures??
When was the first metal put in the human body?
Why occasionally fractures don’t heal despite multiple surgeries?
Is there any absolute indication for internal fixation??
I have tried to answer these and other questions in this paper
Hoffa's Fracture: Diagnosis, management & New Classification System by BAGARI...Vaibhav Bagaria
Hoffa's Fracture - coronal split fracture of distal femur, its diagnosis, management strategy, a new classification and tips and tricks of management. First described Hoffa, a new classification system by Bagaria et al helps plan the surgery for these tricky fracture. The most crucial step is not to miss these fractures in ER.
MENISCUS REPAIR I Dr.RAJAT JANGIR JAIPUR
#aclsurgeryjaipur #aclsurgeryhindia #aclsurgerytaekwondo
Acl reconstruction in jaipur | Acl reconstruction in taekwondo | Acl injury in football player surgery | Acl reconstruction surgery in football | acl surgery | Acl surgery ke baad physiotherapy | Acl surgery in jaipur | acl surgery recovery | Best acl surgeon in jaipur | Best ligament doctor in hindi | Best acl surgeon in india | Meniscus repair surgery in jaipur | Sports injury doctor | Acl injury in football players | Acl injury in taekwondo | acl tear | Best knee surgeon in jaipur
#allinsideacl #internalbrace #drrajatjangir #bestaclsurgeon #aclexpert #bestkneesurgeon
To Know more about ACL Injury, Click the links below:
1. ACL surgery 7 different Techniques we do at our center - "Not single technique best for all"
https://youtu.be/oWkIr8IXvr8
2. Everything about ACL Injury tear surgery in Hindi I
https://youtu.be/bqpjkAkwZ14
3. Best Screw for ACL tear surgery in Hindi
https://youtu.be/1LGpU1NHiIs
4. ACL Injury Tear Surgery Recovery : All your questions & queries solved by Dr.Rajat Jangir
https://youtu.be/SIAPWiMbOqs
5. Partial ACL Tear Surgery or not ! ACL आधा टूटा हो तो क्या करें ?
https://youtu.be/NEJRPKskJTI
6. 5 Symptoms of ACL Injury tear इंजरी के पांच लक्षण ?
https://youtu.be/EXpgy19Jxzw
7. PRP injection therapy in Partial ACL TEARs
https://youtu.be/qyG1EYgS87E
Dr.RAJAT JANGIR(Asso Prof.)
Senior Consultant Arthroscopy and Joint Replacement
(Specialist in Shoulder Knee Hip Surgery)
Ligament and Joints Clinic
67/34 Mansarovar Jaipur
Whatsapp: shorturl.at/gnAEP
Appointment: +91 8104855900
Email: ligamentsurgeon@gmail.com
Google Page: https://g.page/KNEE-Shoulder-SURGERY?...
Facebook: https://www.facebook.com/Ligamentandj...
* Vast experience and specialisation in the field of Arthroscopy and sports surgery.
* M.S. orthopaedics from BJ Medical College, Civil hospital, Ahmedabad
* Fellowship in Arthroscopy and Sports injury with Prof Joon Ho Wang at Samsung Medical Center, South Korea
* Diploma in Sports Medicine from InternationaI Olympic Committee
* Invited as Athlete Medical Doctor at Rio Olympic 2016
* Done Rajasthan's first "All Inside Physeal Preserving ACL reconstruction" in 13 year old Athlete
Dr.Rajat is rated as one of the best orthopedic surgeon with with excellence in Knee Shoulder Arthroscopy surgeries as replacements'
Posterolateral corner injuries of knee joint Samir Dwidmuthe
Missed posterolateral corner injuries of knee joint is a common cause for failure of ACL and PCL reconstruction only next to malpositioned tunnels.
Isolated PLC injuries are uncommon, making up <2% of all acute knee ligamentous injuries. Covey JBJS 2001
Incidence of PLC injuries associated with concomitant ACL and PCL disruptions are much more common (43% to 80%). Ranawat JAAOS 2008
A recent (MRI) analysis of surgical tibialplateau fractures demonstrated an incidence of PLC injuries in 68% of cases. Gardner JOT 2005
Take home message
PLC injuries to be ruled out in every case of ACL& PCL rupture.
Neurovascular integrity to be checked in every case.
Grade I & II can be managed conservatively.
Grade III Acute- Repair.
Grade III Chronic- Anatomic PLC recon.
Beware of varus knee alignment.
An Examination of Effectuation Dimension as Financing Practice of Small and M...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Does Goods and Services Tax (GST) Leads to Indian Economic Development?iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Childhood Factors that influence success in later lifeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Customer’s Acceptance of Internet Banking in Dubaiiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumer Perspectives on Brand Preference: A Choice Based Model Approachiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Student`S Approach towards Social Network Sitesiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Broadcast Management in Nigeria: The systems approach as an imperativeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study on Retailer’s Perception on Soya Products with Special Reference to T...iosrjce
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Corrective Surgery for Malunited Tibial Plateau Fracture
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 11 Ver. I (Nov. 2015), PP 19-22
www.iosrjournals.org
DOI: 10.9790/0853-141111922 www.iosrjournals.org 19 | Page
Corrective Surgery for Malunited Tibial Plateau Fracture
Dr. Anand Sr1
, Dr.Bellad SH2
, Dr.raghavendra MS3 ,
MMCRI, Mysore
1
senior Resident, 2
assistant professor, 3
junior Resident
I. Introduction
Tibial plateau fractures continue to be a challenge for the orthopaedic surgeons. Restoration of normal
anatomy is the goal and results are dependent on timely intervention, good surgical technique and soft tissue
condition . Preventing malunion is one of the major hurdle of treating tibial plateau fractures. Joint depression ,
angular malunion in coronal or saggital plane are commonly seen consequently, malunion will lead to
instability and functional disability at knee joint. Prevalence of post traumatic osteoarthritis after tibial plateau
fractures estimated to be 30%1
.In such cases corrective surgery is necessary to improve functional status. The
surgical approach and technique will depend on the direction and amount of the deformity, the presence of
preexisting implants and the condition of the soft tissue. Corrective surgery for such cases are always
challenging , strategy is to restore joint congruency and enhance stability through osseous alignment2
. We
would like to share our experience of treating such fractures in our institute
II. Materials And Methods
Patients with malunion of the intraarticular tibial plateau fracture irrespective of age and sex in adults
were included in the study from 2003 -2009. We operated 12 cases ( 8 male and 4 female patients) during this
period, with mean age of 43(range 36 - 58) . All neglected cases, cases with failed fixation going for malunion
were considered for study. Time of Injury to corrective surgery was (range from 3 to 12 months) with an
average 6 months, in that 60% were below 6 months. We had 4 medial condyle malunion, 3 lateral condyle
malunion, 2 bicondylar Schatzker type V, Vl going for mal union with one with varus ,and another with valgus
deformity,1 case of mal union with subluxation of knee with ligamentous instability. Depending on the age,
quality of bone and amount of displacement and depression of the malunited fragments, different surgical
options like, A). Osteotomy through fracture site / reconstruction / fixation/ bone grafting. B). Extra articular
open wedge osteotomy/ bone grafting. C) Reconstructing articular surface procedure were implemented5
.
Correction of the deformity restoring mechanical axis was executed .post operatively mobilization
started after 48 hrs,and non wt bearing for 10 -12 wks advised. Patients were followed up for mean duration of
54 months (range 24 to 72months).post operatively functional assessment of knee done using lysholm scoring
systemand results were analysed
2. Corrective Surgery for Malunited Tibial Plateau Fracture
DOI: 10.9790/0853-141111922 www.iosrjournals.org 20 | Page
Sl no Age/sex category Follow up
months
Post operative functional score remarks
1 54/m Cat 1 66 90 -------
2 38/f “ “ 70 84 -------
3 58/m “ “ 55 88 -------
4 50/m “ “ 42 90 -------
5 40/m Cat 2 74 86 -------
6 46/f “ “ 52 80 -------
7 47/m “ “ 70 80 -------
8 44f Cat3 36 84 -------
9 36/f “ “ 48 78 -------
10 38/m Cat 4 64 86 Wound healing
delayed
11 40/m “ “ 46 88
12 40/m Cat 5 24 78 Mild persistant
instability
Lysholm Knee Scale7
Limp (5 Points)
None 5 _____
Slight or periodic 3 _____
Severe and constant 0 _____
Support (5 Points)
Full Support 5 _____
Cane or crutch 3 _____
Weight Bearing impossible 0 _____
Stair Climbing (5 points)
No problems 5 _____
Slightly impaired 3 _____
One step at a time 2 _____
Unable 0 _____
Squatting (5 Points)
No problem 5 _____
Lightly impaired 3 _____
Not past 90 degrees 2 _____
Unable 0 _____
Walking, Running and Jumping
Instability (30 Points)
Never giving way 30 _____
Rarely gives way except
for athletic or other
severe exertion 25 _____
Gives way frequently
during athletic events
or severe exertion 0 ______
Occasionally in daily activities 10 ____
Often in daily activities 5 _____
Every step 0 _____
Swelling (10 Points)
None 10 _____
With giving way 7 ______
On severe exertion 5 _____
On ordinary exertion 2 _____
Constant 0 _____
Pain (30 Points)
None 30 _____
Inconstant and slight
during severe exertion 25 _____
Marked on giving way 20 _____
Marked during severe exertion 15 ____
Marked on or after walking
more than 1 ¼ miles 10 _____
Marked on or after walking
less than 1 ¼ miles 5 _____
Constant and severe 0 _____
Atrophy of thigh (5 Points)
None 5 _____
1-2 cm 3 _____
> 2 cm 0 _____
TOTAL _______
Grading the Tegner Lysholm Knee Scoring Scale
<65 Poor 65-83 Fair 84-90 Good >90 Excellent
Surgical technique; 2,3,5,6
Malunion medial condyle treated with osteotomy /elevation / tricortical graft from iliac crest- medial
open wedge osteotomy with fixation
Lateral condyle malunion with / without valgus deformity treated with lateral open/closed wedge
osteotomy with fixation, proximal fibular ostetomy/superior tibio fibular disruption.
Bicondylar malnion with extra articular deformity surgically corrected by osteotomy of proximal tibial
metaphysis, cases with intra articular deformity corrected by inverted Y osteotomy/osteochondral grafts.
3. Corrective Surgery for Malunited Tibial Plateau Fracture
DOI: 10.9790/0853-141111922 www.iosrjournals.org 21 | Page
III. Results:
The clinical results were evaluated periodically with average 4 years (range, 2to 6 years). Tibiofemoral
angle as measured pre operatively on antero posterior radiographs ranged from 200
varus to 300
valgus.
Restoration of mechanical axis was done with mean deviation of around 30
. Depression of the tibial plateau as
measured preoperatively ranged from 5 to 24mm on an average of 14mm. Restoration of articular suface
obtained with 3mm (mean value) of depression. Ligamentous instability persisted in 2 cases, delayed wound
healing noticed in one case, Post operative ROM (mean 50
-1200
) achieved, mild persistant pain noticed in two
cases The comprehensively scoring assessment showed that an excellent result was achieved in 5 patients,
good in 5, and fair in 2, with an excellent and good rate of 83%; according to the Lysholm and Gillquist knee
joint function assessment 7
IV. Discussion:
Malunited tibial condyle may be a result of neglected cases treated with POP cast or native treatment
or inadequate reduction, early wt bearing, and collapse at fracture site . Indications for surgery are deformities of
the proximal tibia in all three planes, intraarticular malunions after unicondylar fractures, as well as residual
joint impaction in combination with ligamentous instability5
. Medial condyle fractures are more prone for
malunion than lateral condyle with intra articular deformity . where as bicondylar fractures will add to an extra
articular and rotational deformity. Surgical correction of such deformity will not be straight forward , cases may
require dual approach and planned multiple osteotomies, so plane of osteotomy depends on the duration and
site of malunion. Osteoporosis at mal united site will add to the burden of surgical correction and obtaining the
stable fixation. Owing to cancellous nature of bone all cases corrected with osteotomy and elevation has to be
supported with tricortical bone graft and stable fixation2,6
.When articular surface is lost surface reconstructing
procedures are mandatory using auto or allo graft. Cases with both intra and extra articular deformity may need
ring fixators for surgical correction5
. cases with ligamentous instability are most challenging where single plane
corrective osteotomy are contraindicated. Ligamentous reconstruction has to be done if significant instability
persists after corrective osteotomy but the results are yet to be analysed regarding such cases.Post traumatic
osteoarthritis with persistence of pain during movements commonly seen in severely depressed fractures with
significant intraarticular step. Postoperative early range of movement and physical therapy, non wt bearing
ambulation with functional brace for 10 to 12 wks are advised for better out come6
.Secondary reconstruction of
malunited intraarticular fracture can delay joint replacement and create a better condition for eventual
replacement2
.
V. Conclusion:
A planned surgical correction appropriate to degree of malunion and bone quality will give excellent
results and can prevent secondary arthritis, improve the joint congruency, stablity, reduction of pain and restore
joint moblity. We recommend this surgery in peoples of malunited fracture with high probablity of
success.Though procedure is technically demanding, proper plan and execution can be a definitive treatment to
get good functional outcome and delay primary arthroplasty for the same in future where post traumatic arthritis
is the sequelae.
4. Corrective Surgery for Malunited Tibial Plateau Fracture
DOI: 10.9790/0853-141111922 www.iosrjournals.org 22 | Page
References
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GM, Moojen TM J Bone Joint Surg Am. 2001 Feb;83-A(2):164-70.
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[4]. Opening-wedge osteotomy of the proximal tibia Acta Chir Orthop Traumatol Cech. 2005;72(5):308-12.
[5]. Malunion: proximal tibia - AO Surgery Reference www.aofoundation.org/. by RK Marti –
[6]. Correction of lateral tibial plateau depression and valgus malunion of the proximal tibia. Marti RK, Kerkhoffs GM, Rademakers
MV. Oper Orthop Traumatol. 2007 Mar;19(1):101-13
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[8]. New procedures for tightening knee collateral ligaments in conjunction with knee realignment osteotomy. Paley D, Bhatnagar J,
Herzenberg JE, Bhave A. Orthop Clin North Am. 1994 Jul;25(3):533-55.
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[12]. Principles of Deformity Correction Paley, D. Springer Verlag, New York, 2002