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Chyle leaks are uncommon complications after head and neck surgeries. Although uncommon, such a complication is noteworthy mention due to its perplexing diagnosis and management strategies. This scoping review aims to highlight and emphasize the diagnosis and management options proposed in the literature. A comprehensive search was performed in PubMed, Google Scholar, Cochrane Library, and Scopus databases and identified 617 articles that were reduced to 40 studies and reports after applying the eligibility criteria. Although numerous treatment options ranging from simple, conservative measures to invasive surgical procedures have been mentioned for low-output, high-output, and massive leaks, there is no concrete evidence on the best method. Thus, a combination of management options must be customized by case for optimum results.
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Background There is a lack of literature regarding the arthroscopic approach to a single-bundle anterior cruciate ligament (ACL) reconstruction using the quadrupled hamstring tendon graft in the north-eastern Indian population. Methodology A prospective, single-center study was planned for patients with ACL tears according to the eligibility criteria and with a defined surgical protocol. Patients were followed up from the preoperative period for at least one year, and knee function was evaluated using the International Knee Documentation Committee (IKDC) subjective knee score and the Lysholm knee score. Results A total of 29 patients were followed up for a mean of 14.6 months (12-22 months). The mean age of patients was 26.83 ± 7.50 years, with a male:female ratio of 4.8:1 and almost equal involvement of both knees. There was statistically significant improvement (p<0.001) in results in the Lachman test, anterior drawer test, pivot shift test, IKDC score, and Lysholm score. No intraoperative or postoperative complications were found in the present study. Discussion The study shows that arthroscopic anatomical single-bundle ACL reconstruction using quadrupled hamstring tendon grafts is a minimally invasive, safe, and effective procedure that provides anteroposterior and rotational stability and good to excellent functional outcomes.
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Aim: We performed a bibliometric analysis of top 100 systematic reviews (SR) and meta-analyses (MA) in orthopaedic literature and also evaluated articles with maximum average citation per year, which were unable to make up in the present top 100 cited list, but may have a promising future in the world of citations. Methods: This bibliometric study was performed by searching Web of Science database according to a specific search strategy by two independent authors according to eligibility criteria of the studies. Articles with more than 100 citations were eligible for analysis and were evaluated for following parameters: number of citations, journal name, publication date and year, first author, the total number of authors, average citations per year, methodological design of the study, geographic origin and institute associated. Inter-rater reliability was evaluated using Kappa coefficient. Results: The number of citations ranged from 1073 to 198 with a total citation count of 30,589. Inter-rater reliability came to out in the good agreement (Kappa value-0.8). There was visible up-gradation of the research from the 2000 year till today. Spine journal had the maximum articles (26) followed by Journal of Bone and Joint Surgery-America (12 articles). The topics "Spine" and "Sports Medicine" were the most frequently cited topics with 41 and 20 articles, respectively. USA has the maximum articles in the top 100 cited SR and MA. Based on the maximum average citations per year, 34 old articles were replaced in the list with the latest articles that have a bright future ahead and can be predicted to be in the top 100 cited SR and MA of Orthopaedics soon. Conclusion: This study recognizes those articles that have contributed significantly to the growth of knowledge and influenced clinical practices in orthopaedics. We believe that this will facilitate and encourage researchers and clinicians in their future research. Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-022-00604-9.
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Introduction: Hypokalemic periodic paralysis (HPP) is an important and a reversible but rare cause of paralysis. Periodic paralyses are of two types. The first one is primary which is also known as familial type and the second one is secondary periodic paralysis which is due to other underlying pathologies [1]. Important secondary causes can be categorized as metabolic, infectious and losses from the body, etc. [2]. HPP associated with bony abnormalities in form of spontaneous atypical fractures in femoral shaft with coxa vara is an unusual presentation. Case Report: Here is a case report of 26 year old lady who presented with pain in the proximal part of right thigh and weakness in both the upper and the lower limbs. She was diagnosed as familial HPP (FHPP) with atypical fracture of proximal third diaphysis of femur. Confirmation of the expected diagnosis was done with history, laboratory tests, and plain radiographs. Previously also, she had similar episode of weakness and opposite side femur atypical fracture. Conclusion: Association of atypical femur diaphysis fracture and FHPP is a rare presentation of an uncommon disease but should be kept in mind whenever treating any HPP patient. The patient complaining of pain in limbs should be taken seriously as atypical fractures are prone to be missed. In future, further genetic studies are required to establish this rare association.
