Open Access Case Study

Boxers Fracture Treated with Antegrade Prebent K Wire Vs Conservative Management in Young Adults

Sandip Patil, Sapan Vora, Rohan Chavan

Asian Journal of Orthopaedic Research, Page 1-6

Introduction: A prospective study of boxer's fracture treated with antegrade prebent K wire and conservatively in young adults.

Materials and Methods: In Krishna Institute of Medical Science Karad Satara from July 2017 to July 2019, 20 patients of 5th metacarpal neck fracture were studied, 10 were treated with antegrade prebent K wire and 10 treated conservatively were selected, children younger than 15 yrs and fracture involving articular surface were excluded.

Observation: Boxers fracture are 20% of fracture encountered in hand majority of patients are male with right hand involvement majority of cases were due to hitting an hard object with closed fist.

Conclusion: Percutaneous fixation with prebent K wire in antegrade direction gives better results as compared to conservative management which is usually associated with shortening and angular deformities.

Open Access Original Research Article

Functional Outcome of Surgical Management of Fracture Both Bone Forearm in Adults Using Locking Compression Plate (LCP)

Anubhav Rijal, Santosh Thapa

Asian Journal of Orthopaedic Research, Page 7-12

Background: The forearm has a complex architecture consisting of 2 mobile relatively parallel bones radius and ulna, which provide a stable link between elbow and wrist joint. Anatomic reduction and internal fixation of these fractures is usually required to restore forearm rotation, elbow and wrist motion, grip strength. The objective of the study is to know the functional outcome, union time and complications of treating diaphyseal fractures both bones forearm with locking compression plates.

Methods: A prospective study was done among 30 patients presenting to department of Orthopaedics in a tertiary referral centre who were diagnosed clinically and radiologically as both bone forearm fracture and those meeting the criteria of the study. The patients were treated with open reduction and internal fixation with locking compression plate and the results was evaluated on the basis of fracture union, range of motion and complications.

Results: The study showed excellent elbow range of motion in 60% cases and satisfactory outcome in 40% of cases while range of motion of forearm was excellent in 83.3% of cases and satisfactory in 16.7% cases. Sixteen patients achieved union at 16 weeks, two cases united           before 24 weeks and in one patient union were achieved after 24 weeks. Minimum union time was found to be 16 weeks and maximum time was 25 weeks. Mean union time was found to be 16.8 weeks.

Conclusion: Open reduction and internal fixation with Locking Compression Plate provides excellent functional outcome.

Open Access Original Research Article

Tarsometatarsal Lisfranc Injuries: A Diagnostic Challenge

Nitin Patil, Amit Garud, S. V. Goutam, Sandeep Shirahatti

Asian Journal of Orthopaedic Research, Page 13-21

Introduction: Lisfranc injuries are often difficult to diagnose and treat causing long term disability without proper management. Lisfranc injuries refer to bony or ligamentous compromise of the tarsometatarsal and intercuneiform joint complex. Improper treatment of these fractures might lead to negative outcomes such as soft tissue necrosis, posttraumatic arthritis and arch abnormalities. This study aims to help in diagnosis and treatment of tarsometatarsal Lisfranc injuries.

Materials and Methods: Study comprises of 10 patients diagnosed with Lisfranc injury. All of them were treated with open reduction and internal fixation. Post-operatively, all patients were assessed using AOFAS midfoot scale for outcome after the surgery and scores were recorded at each follow up and final results were evaluated after 1 year of surgery.

Observation and Results: Mean AOFAS midfoot score was 82 at the end of one year. Majority of the patients had AOFAS score of more than 80. Majority of patients had B2 type of fracture according to Meyerson Classification.

Conclusion: Anatomical reduction is the key for the treatment of lisfranc injuries, therefore, open reduction and internal fixation is necessary to provide good outcome.

Open Access Original Research Article

Does Weather Conditions Influence the Epidemiology of Paediatric Orthopedic Trauma in Southern Nigeria?

J. E. Asuquo, I. E. Abang, E. O. Okokon, C. O. Anisi, O. A. Lasebikan, B. J. Asuquo, O. O. Adegbehingbe

Asian Journal of Orthopaedic Research, Page 22-29

Introduction: Trauma is a major cause of morbidity and mortality worldwide in the paediatric age group. It is a global problem of public health significance. The aim of this study is to describe the influence of weather on the pattern of paediatric orthopedic trauma in Southern Nigeria.

Methods: Trauma victims below the age of 18 years who presented in the accident and emergency department of University of Calabar Teaching Hospital and National Orthopedic Hospital, Enugu over a period of 12 months were enrolled in the study. A total of two hundred and twelve patients were included in the study.

Results: There were 129 male patients in the study which represented approximately 61% of the participants. The mean age of study participants was 97.28±57.88 months, with a range of (4-216) months. A greater proportion of study participants, 86(42.6%) were in primary school. Falls constituted approximately 54% of the cause of injury followed by domestic causes which made up 29.1%. Most injuries (58%) occurred in the home settings followed by roadways or playfields (29%). Injury occurred more in the evenings (36.5%), during dry seasons (75.3%), and the second term of the academic session (50.8%). The mean pediatric trauma score was 5.36 and 99.4% of the victims had mild Glasgow coma score. About 71% of these trauma victims were brought directly to the tertiary health facility, 73.1% completed treatment and were discharged, but five patients (2.4%) died during the study period.

Conclusion: Paediatric orthopedic trauma occurs mostly during the dry season due to evening falls at home. Most injuries are severe but do not involve loss of consciousness.

Open Access Review Article

The Effectiveness of Stabilization Exercises in Treating Patients with Chronic Low Back Pain: A Systematic Review

Sultan A. Alzubeidi, Abdurrahman A. Alfawaz, Mohammad Y. Algharawi, Abdulrhman S. Alrashidi, Marwan A. Alamrani, Ali B. Alsayed

Asian Journal of Orthopaedic Research, Page 30-46

Background: Chronic low back pain is one of the biggest health problems around the world. It is considered as one of the main causes of disability, high medical expenses and absenteeism. Chronic low back pain can be treated indifferent ways. However, the efficacy of most of these treatments has not been studied so medical intervention for chronic low back pain varies widely. Stabilization exercise is one form of physiotherapy treatment recommended in some guidelines. However, there is an argument about the effectiveness of this intervention.

Objective: This systematic review aimed to investigate the effectiveness of stabilization exercises on patients with chronic low back pain and disability.

Study Design: Systematic Review.

Search Strategy: An online research through the electronic databases, such as Ovid, Medline, CINHAL, Google Scholar, Cochrane library, Pedro database and Pub med was conducted. Citation searches within studies, as well as online tracking of references were also conducted in this review.

Mean of Analysis: The Pedro scale was used to assess the quality of the included randomized controlled trials, where studies which scored equal to or more than 5/10 were considered as a high quality studies. In addition, a simple qualitative analysis was performed to analyze data and give accurate results.

Main Results: Twenty studies met the inclusion criteria. Seventeen studies were randomized controlled studies; one was a study case series, one a cohort study, and one a comparative study. The most outcome measures among the studies were pain (numerical pain rating scale, visual analogue scale and short-form McGill pain scale) and disability (Ronald & Morris disability questionnaire and Oswestry disability questionnaire). The results show significant changes between the studies in terms of pain and disability. However, there is moderate evidence about effectiveness of the stabilization exercises for long term sufferers (>6 months).

Conclusion: Using stabilization exercises on patients with chronic low back pain is helpful to reduce pain and disability. However, there is no preference for this intervention over other physiotherapy interventions.

Recommendation: High quality studies are needed to investigate the efficacy of this intervention for long term.