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Agrawal, Nitish
- Functional Outcome of Burk Schaffer’s Approach for PCL Tibial Avulsion Fracture Fixed with Cancellous Screw
Abstract Views :322 |
PDF Views:106
Authors
Satyen Joshi
1,
Nikhil Challawar
2,
Nitish Agrawal
3,
Bhalchandra Prabhakar Bhalerao
3,
Ameya Kulkarni
3,
Yogesh Rathod
3
Affiliations
1 Associate Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
3 P.G. Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
1 Associate Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
3 P.G. Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik − 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 6, No 2 (2019), Pagination: 183-188Abstract
Background: Posterior Cruciate Ligament (PCL) is the main posterior stabilizer of the knee. Injuries of the PCL are rare. Isolated PCL disruption most commonly occurs as avulsion at its tibial insertion as compared with its femoral origin or as a mid-substance tear. In PCL bony avulsion, fixation of the avulsed fragment with cancellous screw is a recommended procedure. Objective: To evaluate efficacy of Burk Schaffer’s approach in treatment of PCL tibial avulsion fracture with cancellous screw and evaluation of functional results according to Tegner Lysholm score. Material and Methods: We included 30 patients (Male 26 and Female 4) operated for isolated PCL avulsion from tibia during the period from 2015 to 2017. Patients were evaluated clinically by posterior drawer test, radiologically by X-ray and using functional scale of Tegner-Lysholm. MRI was advised for suspected other ligaments and meniscal injuries. All cases were operated with 4mm cannulated screw fixation by Burk and Schaffer approach. Results: Mean Tegner Lysholm score of 30 patients was 95.37 after 6 months of surgery, which was excellent. After 3 months 75% has grade 0 posterior drawer test, 12.5% has grade 1 and 12.5% has grade 2 laxity. Conclusion: Approach by Burk and Schaffer is safer and easier than the classical one. Open reduction and fixation with cannulated screw for tibial avulsion of PCL gives good functional outcome.Keywords
Burk and Schaffer’s Approach, Posterior Cruciate Ligament (PCL) Avulsion Fractures, Tegner Lysholm Score.Full Text
References
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- David J, Deehan MD, Leo A, Pinczewski FRACS. Arthroscopic reattachment of an avulsion fracture of thetibial insertion of the posterior cruciate ligament. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 2001; 17(4):422-25. https://doi.org/10.1053/jars.2001.21841. PMid: 11288019.
- Hughston JC. The posterior cruciate ligament in knee joint stability. J. Bone Joint Surg. Am. 1954; 54:1045-46.
- Seitz H, Schlenz I, Pajenda G, Vécsei V. Tibial avulsion fracture of the posterior cruciate ligament: K-wire or screw fixation? A retrospective study of 26 patients. Arch. Orthop. Trauma Surg. 1997; 116:275-78. https://doi.org/10.1007/BF00390052. PMid: 9177803.
- Dhillon MS, Singh HP, Nagi ON. Posterior cruciate ligament avulsion from the tibia: Fixation by a posteromedial approach. Acta. Orthop. Belg. 2003; 69:162-67.
- Veselko M, Saciri V. Posterior approach for arthroscopic reduction and antegrade fixation of avulsion fracture of the posterior cruciate ligament from the tibia with cannulated screw and washer. Arthroscopy. 2003; 19:916-21. https://doi.org/10.1016/S0749-8063(03)00748-5.
- Fu YP, Hang CM, Fam HQ. Treatment of posterior cruciate ligament avulsion fracture using anchor system combined with cannulated screw. J. Pract. Orthop. 2011; 17:73-4.
- Chen W, Tang D, Kang L, Ding Z, Sha M, Hong J. Effects of micro endoscopy-assisted reduction and screw fixation through a single mini-incision on posterior cruciate ligament tibial avulsion fracture. Arch. Orthop. Trauma Surg. 2012; 132:429-35. https://doi.org/10.1007/s00402-011-1426-y. PMid: 22080931.
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- Khatri K, Sharma V, Lakhotia D, Bhalla R, Farooque K. Posterior cruciate ligament tibial avulsion treated with open reduction and internal fixation through the burks and schaffer approach. Malays. Orthop. J. 2015; 9:2-8. https://doi.org/10.5704/MOJ.1507.004. PMid: 28435601, PMCid: PMC5333651.
- Unstable Intertrochanteric Femur Fracture in Elderly Treated with Bipolar Hemiarthroplasty Versus Dynamic Hip Screw-A Prospective Comparative Study
Abstract Views :249 |
PDF Views:99
Authors
Sandeep Pangavane
1,
Nikhil Challawar
2,
Ameya Kulkarni
3,
Nimesh Nebhani
3,
Nitish Agrawal
3,
Bhalchandra Bhalerao
3
Affiliations
1 Professor and HOD, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
3 Post-Graduate Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
1 Professor and HOD, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
3 Post-Graduate Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik − 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 6, No 2 (2019), Pagination: 231-236Abstract
Introduction: Intertrochanteric fractures are one of the most common fractures in elderly population and have a huge impact on the health care system of the society. Objectives: The objective of our study was to compare functional outcome and complication rates of bipolar hemiarthroplasty to dynamic hip screw which is a established procedure for unstable intertrochanteric fracture femur. Materials and Methods: The present study included 50 patients over the age of 55 years, 25 undergoing bipolar hemiarthroplasty and 25 undergoing dynamic hip screw for unstable intertrochanteric fracture femur and their functional outcomes were compared with Harris hip score. Results: We found that the average Harris hip score was better for the bipolar hemiarthroplasty group than for the dynamic hip screw group at 6 months. Conclusion: Bipolar hemiarthroplasty is an effective alternative to dynamic hip screw for unstable intertrochanteric fractures in elderly patients as it has a good function outcome and lower complication rate. A larger randomized control trial has to be conducted to arrive at a conclusion.Keywords
Dynamic Hip Screw, Primary Bipolar Hemiarthroplasty, Unstable Inter-trochanteric Fractures.Full Text
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- Functional Outcome of Arthroscopic Reconstruction of Single Bundle Anterior Cruciate Ligament with 5 Strand Hamstring Autograft
Abstract Views :208 |
PDF Views:83
Authors
Nitin Wagh
1,
Brijbhushan Mahajan
2,
Bhalchandra Prabhakar Bhalerao
3,
Nitish Agrawal
3,
Nimesh Nebhani
3,
Yogesh Rathod
3
Affiliations
1 Associate Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
3 Former PG Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
1 Associate Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
3 Former PG Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 7, No 1 (2020), Pagination: 78-85Abstract
Background: Most commonly reconstructed ligament of knee is Anterior Cruciate Ligament that aims to halt or minimise the number of instability episodes 1. Testing with biomechanical parameters has shown that there is correlation between graft cross-sectional area and maximum load to failure 2. This study attempts to analyse the functional outcome of ACL reconstruction with 5 strands of hamstring autograft. Aims and Objectives: This study is based on hypothesis that larger graft will be stronger, stiffer providing better functional outcome. Materials & Methods: 35 Patients having ACL injury were treated at a tertiary care hospital; using a 5-strand hamstring graft, fixed with suspensory fixation at femoral side and aperture fixation at the tibial side. Cases were diagnosed with ACL on clinical examination & MRI. Tegner-lyshom score and International Knee Documentation Committee - Orthopaedic Scores (IKDC) is used post-operatively to grade the functional outcome of an ACL reconstruction. Results: Male predominance was observed in study subjects than female with left side slightly more commonly involved than right. Laterality didn’t influenced outcome. Graft diameter observed is 9mm in 68.6%, 8 mm and 10 mm was observed in 11.4% and 20% respectively. Lysholm score at baseline was 41.63 which increased progressively to 93.45 at the end of 9 months. The IKDC score at baseline was 32.5 which increased progressively to 83.45 at the end of 12 months. Superficial infections was seen in 8.6% while complaint of knee pain was given by 2.9% cases. Lachman test was positive in 2 (5.7%) cases. Conclusion: Five-strand graft offers very high strength and more length than the 4ST. It is useful in patients with ligamentous laxity, small tendons, or other stability risk factors.Keywords
ACL, Autograft, Graft Diameter, 5 StrandFull Text
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