Asian Journal of Orthopaedic Research <p style="text-align: justify;"><strong>Asian Journal of Orthopaedic Research</strong>&nbsp;aims to publish&nbsp;high-quality&nbsp;papers (<a href="/index.php/AJORR/general-guideline-for-authors">Click here for Types of paper</a>) on all aspects of&nbsp;Orthopaedic&nbsp;research. This journal facilitates the research and wishes to publish papers as long as they are technically correct, scientifically motivated. The journal also encourages the submission of useful reports of negative results. This is a quality controlled,&nbsp;OPEN&nbsp;peer-reviewed, open access INTERNATIONAL journal.</p> Asian Journal of Orthopaedic Research en-US Asian Journal of Orthopaedic Research Outcome of Paediatric Femoral Shaft Fractures Treated with Titanium Elastic Nailing- A Prospective Study <p><strong>Background: </strong>Conservative management has always been used for paediatric fractures. However surgical management has shown outstanding results. Closed reduction and titanium elastic nailing is one of the procedures that is used for management of paediatric injuries. We undertook this study to see the outcome paediactric fractures treated with Titanium Elastic Nailing.</p> <p><strong>Methods: </strong>A prospective study conducted at Krishna institute of medical sciences, Karad. 30 children with femoral fracture managed with TENS were included in this study. Patients were followed up till 12 months post-operatively for limb length discrepancy, pelvic asymmetries, rotational deformity, axial angulation, and hip and knee range of motion (ROM). Scoring criteria for TEN By Flynn et al. [11] was used and results were classified as excellent, satisfactory or poor</p> <p><strong>Results: </strong>There were 19 boys and 11 girls in this study. The mean duration of surgery was 50 min. Radiological union was achieved in average time of 7 weeks. Full weight bearing was achieved in a meantime of 7 weeks. As per the Flynn et al. [11] criteria the results were excellent in 24 patients, successful in 5, and poor in 1 patient. One patient had varus angulation, 3 patient had entry site irritation and 2 had limb length discrepancy.</p> <p><strong>Conclusion: </strong>The TENS is an efficient and acceptable form of treatment in selected cases of femoral diaphyseal fractures in children.</p> Sandip Patil Chitresh Mehta Subhasish Das Ismail Pandor ##submission.copyrightStatement## 2021-02-15 2021-02-15 1 6 The Effect of Covid-19 on Orthopaedic Residents’ Education, Skills and Mental Health: A Resident’s Perspective <p><strong>Background:</strong> The Coronavirus Disease-2019 (COVID-19) was first detected in Wuhan, China, in November 2019. Orthopaedic residents have faced many challenges during this pandemic and this study aims to set forth the issues and concerns faced by residents that have been neglected in the current scenario of the pandemic. We did an online survey among the orthopaedic residents of North India to know how COVID-19 has affected their training, skills and mental health and what measures they have in their mind to tackle these problems.</p> <p><strong>Methods:</strong> A 43-question web based survey was conducted among orthopaedic residents enrolled in various medical colleges of North India from 1<sup>st</sup> October, 2020 to 31<sup>st</sup> October, 2020. Orthopaedic residents irrespective of their year of residency from North Indian states were included in the survey. The data collected from the resident’s feedback was calculated as frequencies and proportions. Correlation between different variables was calculated using pearson method.</p> <p><strong>Results:</strong> 150 residents (76.92%) contributed in this survey. 93.3% of residents informed that the number of face to face classes have decreased during this pandemic. 43.33% have informed that they have been or going to be redeployed in COVID care wards. 96% of the residents were of the opinion that there was decrease in surgical exposure. 70.65% respondents were afraid of getting infected with COVID-19. Majority of residents (71.33%) were afraid that they would fail their final exams.</p> <p><strong>Conclusion:</strong> COVID-19 pandemic has significantly affected the personal and professional life of orthopaedic residents. They have been under a lot of stress due to various factors which needs to be addressed and solved on priority basis so that a healthier workforce is formed to fight against COVID-19 pandemic.</p> Mohit Singla Aditya Kaushal Riya Chopra Sanya Vermani ##submission.copyrightStatement## 2021-02-17 2021-02-17 7 21 Femoral Tunnel Three Approach Comparison for Double Bundle Anterior Cruciate Ligament Reconstruction <p><strong>Background: </strong>There is a lot of controversy surrounding the technique of femoral tunnel placement during reconstruction of anterior cruciate ligament. By our study we attempt to clarify the controversy by using three different techniques for femoral tunnel position with the same concept of tunnel creation and supported measurement data.</p> <p><strong>Methods: </strong>The creation of the femoral tunnel placement of double bundle ACL reconstruction was carried out using the behind remnant approach. The Transtibial approach was carried out for all primary Anterior Cruciate Ligament injury cases till December 2017. After that, from January 2018 to September 2018 we used the Trans-portal approach followed by which the Outside In approach was used from October 2018 to March 2019. We compared the tunnel position with a 3D reconstructed computer tomography image. We also analyzed through our study the length of each femoral tunnel and the distance between septum of every anteromedial and posterolateral tunnel.</p> <p><strong>Results: </strong>The aperture of the anteromedial bundle tunnel position in Transtibial method was higher and shallow as compared to that Trans-portal method. Also, the tunnel length in Trans-portal was shorter as compared to the Transtibial method and the Outside In approach.</p> <p><strong>Conclusion: </strong>There is a risk of antero-medial aperture position in Transtibial approach being high and shallow, whereas Trans-portal approach runs the risk of short tunnel length. Hence, we could conclude that it is important to apply any of the methods flexibly to each case as there is no data supporting a single best approach.</p> Clevio Desouza Abhinay Vadlamudi Amit Kale Girish Nathani ##submission.copyrightStatement## 2021-02-24 2021-02-24 22 29 A Retrospective Study of Non-operative Management of Distal Radial Fractures in an Indigenous Black Population <p><strong>Background:</strong> Operative fixation is increasingly used to treat distal radial fractures. However, non-operative management of these fractures is common, especially in developing countries. Although surgery results in better restoration of anatomy, it is unclear if this translates to a better function.</p> <p><strong>Aim:</strong> The study aims to assess patients' functional outcome after non-operative treatment of distal radius fractures.</p> <p><strong>Methods:</strong> This work was a five-year retrospective study involving 35 subjects treated for a distal radial fracture with non-operative methods. The pre-operative and post-operative distal radius radiographic parameters, DASH scores at 22-month follow-up and the Frykman class of the fractures were documented. The correlation between the Frykman classes and DASH scores and that between the post-operative radiographic parameters and DASH scores was assessed.</p> <p><strong>Results:</strong> All the distal radius parameters except the palmar tilt improved with non-operative treatment in this study. There were no significant differences in the mean DASH scores between those with acceptable and non-acceptable radiographic indices. The most frequent class of fracture in this study was Frykman class 1. The Frykman class showed a strong correlation with the DASH score, with an increasing class of injury having a higher DASH score, rho= .651, p-value = .001.</p> <p><strong>Conclusion:</strong> Non-operative management of distal radial fractures was associated with favourable DASH scores, even though most of the patients had at least one unacceptable radiographic parameter post-reduction.</p> K. A. Madu O. Ede C. C. Obi W. Anetekhai ##submission.copyrightStatement## 2021-03-19 2021-03-19 49 55 Total Knee Arthroplasty- A Review of Emerging Trends in Patient Management and Surgical Practices <p><strong>Background: </strong>Osteoarthritis is a chronic, multifactorial, degenerative disorder commonly seen in elderly with predominance for females above the age of 45yrs with largely unknown etiology. With the rising demand for TKA in the foreseeable future, our aim is to assess the emerging trends in patient management and surgical practices for TKA.</p> <p><strong>Material and Methods:</strong> A narrative review of current literature analyzing the patient characteristics, current practices in peri-operative management, methods to control blow loss, pain management and recent advances in TKA.</p> <p><strong>Results:</strong> Literature describes that the prevalence of osteoarthritis of knee along with average BMI and associated comorbidities are on the rise. Emphasis is being laid on blood preservation, including iron therapy, erythropoietin tranexamic acid, low pressure tourniquet, acute normovolemic hemodilution. Multimodal analgesia including pre-emptive analgesia, peri articular injections, peripheral nerve blocks play a major role in pain management. The use of artificial intelligence, Robotics, 3D printing and Computer assisted navigation in TKA in recent years shows a promising future.</p> <p><strong>Conclusion:</strong> Favorable outcomes have been observed with various blood preservation and pain management techniques. TKA remains the forefront of evolution of scientific innovation that have a great potential for refining the TKA alignment and biomechanical outcome to subsequently reduce the incidence of TKA revision and improve patient’s satisfaction. However, further Level 1 studies are required to assess the long-term outcomes.</p> Aditya Kaushal Akash Ghosh Rajendra Kumar Kanojia ##submission.copyrightStatement## 2021-03-08 2021-03-08 30 48