Proximal Fibular Osteotomy: A Novel Technique for Management of Medial Compartment Knee Osteoarthritis

For medial compartment knee OA, which is usually seen in the age group 40-50 years, total knee replacement is not recommended ideally. Hence, for these patients, there is need of a new procedure which would be safe, effective & affordable. Objective: The aim of this study is to evaluate the early benefits of proximal fibular osteotomy (PFO) in medial compartment knee OA. Methods: Total 50 patients (70 knees) with medial compartment OA included in this study from march 2017 to august 2017. All patients were managed by PFO and followed-up prospectively for minimum upto 12 months. Visual analogue scale to assess knee pain, American knee society score (AKSS) to evaluate knee functions and medial/lateral joint space ratio were used for radiological assessment. Statistical analysis done by using SPSS 20.0 software.. Results: All patients observed significant relief in knee pain after PFO. AKSS and medial/lateral joint space ratio improved significantly postoperatively. Most of the patients showed increased walking distance post-operatively. Conclusion: This study concludes that PFO is a safe & effective method for the management of medial compartment knee OA. It relieves knee pain significantly and improves knee joint function

Severe Hallux Varus; an Uncommon Deformity —A Case Report and Review of Literature.

Hallux varus is relatively uncommon and few cases have been reported in the orthopedic literature. In this article, we report the case of a 63 years old, female patient with severe hallux varus deformity, associated with deformity of other toes. Here we describe the case report of hallux varus managed by surgical intervention at our tertiary care hospital in Mumbai, India.

Macrodystrophia Lipomatosa- A Rare Congenital Anomaly: A Case Report and Review of Literature.

Macrodystrophia lipomatosa is a rare presentation and only few cases are reported in scientific literature. We report a case of Macrodystrophia lipomatosa in a 7 year young girl from a tertiary care hospital Mumbai. Case presentation: A 7 year old female was presented to outpatient department with progressive enlargement of right lower limb with increase in size of right great toe since birth. On clinical examination there was non tender fluctuant soft tissue swelling with good functional limb. Scannogram showed reduction of the medial compartment of right knee joint and the right lower limb length was slightly longer compared to the left side with presence of soft tissue swelling on medial distal thigh and knee region. MRI showed un-encapsulated subcutaneous fatty tissue involving the entire right lower limb along its medial aspect up to the great toe with fatty infiltration of the vastus medialis muscle suggestive of macrodystrophia lipomatosa. Arterial and venous colour Doppler study of right lower limb was normal. Conclusion: Macrodystrophia lipomatosa is a rare congenital, non hereditary condition with localized macrodactyly and proliferation of mesenchymal element and marked increase in fibroadipose tissue. X-ray and MRI are investigation of choice. Doppler study shows normal vascularity.

Pattern of Orthopaedic Injuries Among Patients Attending the Emergency Department in a Tertiary Care Hospital – An Analytical Study.

Introduction: Th is study was aimed at analyzing the pattern of Orthopaedic injuries among patients attending the Emergency department in a tertiary care hospital. Retrospective study was conducted in the Department of Orthopaedics, Teerthanker Mahaveer Medical College & Research Centre. Methods: Th e record analysis of injured patients seen at the emergency department over a 12 months period from June 2012 to may 2013 was done. Th e data was analyzed with special reference tothepattern of Orthopaedic injuries. Results: A total of 1110 records of injured patients that attended the emergency department were analyzed. Study showed that themajority of victims were in the age group of 11-44 years (n=909, 81.89 percent). 71.09 percent (n=789) were males and 28.9 percent (n=321) were females. Road traffi c accident was the most common cause of injuries being responsible for 59.72 percent, (n=663) followed by fall from height (22.5 percent, n=247). Study revealed that the most common presentation of injuries was fracture (68.64 percent, n=762) and the most common site was lower limbs in 48.16 percent cases, (n=367). Next most common site was upper limbs (28.08 percent, n=214) followed by pelvic fracture (10.01 percent, n=77), spine fractures (8.26 percent, n=63), facial fracture (2.88 percent, n=22) & Ribs fracture (2.49 percent, n=19). Th ere were 71.65 percent cases (n=546) of simple fracture and 28.34 percent cases (n=216) ofthecompound fracture. Th ere were 3.87 percent cases (n=43), of various dislocations, shoulder dislocation being the most common. Crush injury was seen in 7.5 percent cases. Most commonly associated visceral injury wasthehead injury in 17.20 percent cases (n=191). Conclusion: Fractures were the most common pattern of Orthopaedic injuries, frequently associated with head injuries. Research in to appropriate strategies for prevention of injuries, especially RTA is required in tertiary care hospitals.