ABSTRACT
In the human body, ascorbic acid (AA) is known for its potent antioxidant and reducing properties and also plays a vital role in supporting the growth of bones and cartilage. It has been used extensively in orthopedic surgery. Ongoing studies under the umbrella of ascorbic acid research investigate its impact on bone and tendon physiology, as well as its influence on joint replacement and postoperative pain. The majority of both laboratory and human studies link the usage of ascorbic acid to enhanced bone health and improved tendon healing. Recent literature suggest that ascorbic acid administration may have a positive impact on the outcome of orthopedic procedures. On the other hand, controversy exists regarding the efficacy of ascorbic acid in reducing the incidence of complex regional pain syndrome. In brief, the effectiveness of ascorbic acid in enhancing orthopedic procedure outcomes remains a subject of ongoing investigation. Although certain studies have hinted at the potential positive influence of ascorbic acid on these outcomes, further research is required to validate its effectiveness and ascertain the ideal dosage and method of administration for maximizing its anticipated advantages. To establish the efficacy of ascorbic acid in improving orthopedic procedure outcomes, rigorous human trials of high quality are imperative. The aim of this review was to provide an overview of ascorbic acid's utilization in orthopedic practices and to pinpoint prospective areas for future research.
ABSTRACT
The giant cell tumor of the tendon sheath (GCTTS) is a benign nodular tumor that is found on the tendon sheath of hands and feet. It is the second most common tumor of the hand, next only to ganglion cysts. Several hypotheses were formulated about the etiological factors of these tumors, but still, there is not a common opinion on etiology, prognostic factors, and recurrence rate. We report a case of GCTTS in a young male where a lesion was identified in his left thumb. Although marginal excision is the treatment of choice, it is often difficult to perform due to the location and the strict adherence of the tumor to the tendon or neurovascular bundles. The primary issue with the treatment lies in its elevated recurrence rates. Apart from cases of incomplete excision, there is a lack of consensus regarding the impact of other risk factors on the likelihood of recurrence.
ABSTRACT
Introduction: Chondrosarcoma (CHS) of the toes is very rare and the involvement of phalanges is extremely rare. The osteolytic destruction of this tumor severely affects limb function and carries the risk of distant metastasis. These tumors are removed surgically to minimize local recurrence and distant metastases, maximize limb function with better prognosis. The main objective of this report is to present the case of a CHS that invaded the phalanx of the left great toe and formed a large phalangeal mass with osteolytic destruction of the distal bone. Case Report: This case report includes a 60-year-old man suffering from swelling of his left great toe for 2 years, with pain and swelling for 6 months. Serial hematological, radiological and tumor investigations were done. Magnetic resonance imaging revealed a well-defined peripherally enhancing multilobulated soft-tissue mass with central necrotic component involving the entire proximal phalanx of left great toe extending to distal phalanx and head of first metatarsal. The patient was planned for operative intervention due to the possibility of invasion into the adjacent bones. The tumor was excised and sent for histopathological examination, which was reported as Grade 2 CHS (PT, Nx, and Mx) and was S100 positive. The patient has been followed-up for 5 months. Results: There were no signs of local recurrence or distant metastasis on radiological investigations or clinical assessment during follow-ups. Conclusion: CHS occurring in toes is extremely rare. In this case, extensive surgical resection of the large low-grade CHS was safe and effective.
ABSTRACT
Diffuse Large B-Cell Lymphoma (DLBCL) of bone is a rare presentation of Non-Hodgkin Lymphoma (NHL), which remains asymptomatic or present late in clinical course as bone pain or pathological fracture. We report a case of a 15-year-old male child presenting with diffuse joint pain and swelling over his left shoulder and elbow, associated with B symptoms. Radiological examination revealed lytic lesions in multiple bones along with collection along the left iliopsoas and hip joint, suggestive of infective etiology. The diagnostic dilemma was resolved on biopsy, which confirmed DLBCL involving bones and soft tissue.
ABSTRACT
INTRODUCTION: Hemiarthroplasty is considered to be the treatment of choice for femoral neck fractures in elderly, however there is no consensus to support the choice between unipolar or bipolar hemiarthroplasty. Several studies found that patients with bipolar hemiarthroplasty had a better outcome of pain, a higher rate of return to the pre-injury state, and a greater range of hip motion. Some studies have demonstrated equal hip functional outcome between unipolar and bipolar hemiarthroplasty, but unipolar hemiarthroplasty was favoured due to its lower cost. The purpose of this study was to compare the functional and radiological outcome of cemented unipolar vs modular bipolar hemiarthroplasty in displaced femoral neck fracture in elderly patient population. METHODS: It is a prospective randomized study, with 44 patients in each group. Elderly Patients (>60 years of age) with traumatic displaced femoral neck fractures were included in the study. Cemented unipolar or modular bipolar hemiarthroplasty was performed in the respective patient groups using posterior or anterolateral approach. Functional outcome evaluation was done by Harris Hip Score and radiological outcome evaluation was done for acetabular erosion. The data was entered in MS EXCEL spread sheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 20.0 (IBM, Chicago). RESULTS: The mean age in the unipolar and bipolar group was 67.2 and 66.1 years respectively. The average follow-up period was 20.1 and 22.3 months in the unipolar and bipolar group respectively. Mean operating time was significantly more in the modular bipolar group (78.3 minutes) compared to the unipolar group (67.3 minutes). Two patients (4.5%) had acetabular erosion in each group. Mean Harris Hip score at 3 months follow-up was significantly higher (p value <0.05) in bipolar group (75.8±4.2) than the unipolar group (77.7±2.9). However, subsequent follow-ups at 6 months (80.9±2.8, 82.0±2.5, p value >0.05) 12 months (83.1±2.2, 83.2±1.2, p value >0.05) and 24 months (85.5±2.4, 85.2±2.8, p value >0.05) did not show any significant difference between the two groups. The incidence of general complications was 34% in bipolar and 20.4% in unipolar hemiarthroplasty group. CONCLUSION: Functional outcome in terms of Harris Hip Score are better in the bipolar group at 3 months follow up but there was no significant difference in the functional outcome between the two groups at 6, 12 and 24 months follow up. The operative time for unipolar is lower and statistically significant compared to bipolar hemiarthroplasty of the hip.
