Vol 7 | Issue 1 | January-June 2021 | page: 19-21 | Bishnu Pokharel, Rosan Prasad Shah Kalawar, Ashish Kumar Goyal
Author: Bishnu Pokharel , Rosan Prasad Shah Kalawar , Ashish Kumar Goyal
 Department of Orthopaedics, BPKIHS, Dharan, Nepal.  Department of Orthopaedics and Joint Replacement Surgery, Indrparastha Apollo Hospitals, Sarita Vihar, New Delhi, India.
Address of Correspondence
Dr. Ashish Kumar Goyal
Senior Registrar; Department of Orthopaedics and Joint Replacement Surgery Indrparastha Apollo Hospitals, Sarita Vihar, New Delhi, India.
Introduction: Rupture of the anterior cruciate ligament (ACL) is a common injury in active people and one of the most common knee injuries in sports. Foreign body granuloma with concomitant infection is a rare complication in ACL surgery. Very few cases have been reported on it. We present a young patient with a chronic discharging sinus at a surgical site on the tibia in a diabetic patient and its successful management.
Case Report: A thirty-two-year-old male presented to us with a persistent discharging sinus at the surgical site following an Anterior Cruciate Ligament (ACL) reconstruction two years back. Since then, he developed wound infection at the incision site created for graft harvesting, which kept on discharging sero-purulent discharge even with several antibiotics and local dressing courses. There was no stiffness or instability in the knee. We did a follow-up arthroscopic evaluation of the joint and debridement of the wound. A portion of hamstring graft and non-absorbable suture with unhealthy granulation tissues were found subcutaneously during the surgery. A partially resorbed bioscrew with unhealthy granulation tissue was observed in the tibial tunnel. After thorough debridement of the site, the wound completely healed.
Conclusion: Surgical site infection and foreign body granuloma should be considered and treated accordingly if the patient presents with persistent discharging sinus at the surgical site in ACL reconstruction
Keywords: Anterior cruciate ligament reconstruction, ACL, Surgical site infection, Tibial tunnel.
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|How to Cite this article: Pokharel B, Kalawar RPS, Goyal AK | Chronic Tibial Tunnel Infection Following ACL Reconstruction: A Case Report and Review of The Literature | Trauma International | January-June 2021; 7(1): 19-21.|
Vol 7 | Issue 1 | January-June 2021 | page: 15-18 | Divyesh V. Bukalsaria, Sachin Kale, Prakash D. Samant, Arvind Vatkar, Sanjay Dhar, Prasad Chaudhari
Author: Divyesh V. Bukalsaria , Sachin Kale , Prakash D. Samant , Arvind Vatkar , Sanjay Dhar , Prasad Chaudhari 
 Department of Orthopaedic Surgery, D Y Patil Medical College and Research Centre, Navi Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Divyesh Vinod Bukalsaria,
Resident Physician, Department of Orthopaedic Surgery, D Y Patil Medical College and Research Centre, Navi Mumbai, Maharashtra, India.
Compound fracture-dislocations of proximal carpal bones are very rare. We report a 54-year-old male, laborer, who sustained a compound Gustilo Anderson type III-A dorsal wound with trans styloid, trans-scaphoid, peri-lunate dislocation with an extensor tendon injury. The patient underwent primary scaphoidectomy with Lunocapitate fusion with extensor tendon repair. On follow-up after 3 months, the patient had partial recovery of range of motion around the wrist without any significant discomfort.
Keywords: Compound fracture-dislocation, Primary proximal row carpectomy, Trans-styloid trans scaphoidperilunate dislocation
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13. Yao, Yu-Cheng, et al. “Lunocapitate Fusion with Scaphoid Excision for the Treatment of Scaphoid Nonunion Advanced Collapse or Scapho-Lunate Advanced Collapse Wrist.” Journal of the Chinese Medical Association, vol. 80, no. 2, 2017, pp. 117–120., doi:10.1016/j.jcma.2016.10.001
|How to Cite this article: Bukalsaria DV, Kale S, Samant PD, Vatkar A, Dhar S, Chaudhari P | Acute Scaphoidectomy and Lunocapitate Fusion for the Surgical Treatment of Compound Trans Styloid, Trans-Scaphoid, Peri-Lunate Fracture-Dislocation with Extensor Tendon Injury | Trauma International | January-June 2021; 7(1): 15-18.|
Vol 7 | Issue 1 | January-June 2021 | page: 12-14 | Neetin P Mahajan, Prasanna Kumar GS, Pranay Kondewar, Kishor Jadhav
Author: Neetin P Mahajan , Prasanna Kumar GS , Pranay Kondewar , Kishor Jadhav 
 Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Prasanna Kumar GS,
Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.
Introduction: Multi-fragmentary patellar non-union is rare and it causes functional disability in patients. The purpose of studying this case is to present an unusual patella multi-fragmentary non-union and discuss its management.
Case presentation: We present a case of a 25-year-old male patient presented with pain and instability and decreased movements of the right knee since last 1 year. The patient had a history of trauma for which he was operated at the local hospital. X-ray and CT scan of the right knee was suggestive of the non-union of the right patella with three main fragments. We managed with open reduction and internal fixation using CC screw, cerclage and tension band wiring. At one-year follow up, the patient is having a clinical and radiological union of non-union with good functional outcome.
Conclusion: Combination of cannulated cancellous screw, cerclage and tension band wiring provides stable fixation in the multi-fragmentary patellar non-union, helps in early mobilisation which in turn helps in getting good functional outcome and prevents implant-related complications.
Keywords: Non-union; Multi-fragmentary patella; Internal fixation; Fixation failure.
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|How to Cite this article: Mahajan NP, Prasanna Kumar GS, Kondewar P, Jadhav K | Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management- A Rare Case Report | Trauma International | January-June 2021; 7(1): 12-14.|
Vol 7 | Issue 1 | January-June 2021 | page: 05-11 | Brijesh Sharma, Vipul Agrawal, Rajendra Kumar Shakunt, Chandra Prakash Pal, Mayur Gupta, Rohit Yadav
Author: Brijesh Sharma , Vipul Agrawal , Rajendra Kumar Shakunt , Chandra Prakash Pal , Mayur Gupta , Rohit Yadav 
 Department of Orthopaedics, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Address of Correspondence
Dr. Mayur Gupta,
Department of Orthopaedics, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Background: Unstable or severely comminuted and intra-articular fractures of distal radius represent traumatic high energy injuries. Prospective study to evaluate the results of external fixation of such fractures was conducted from January 2017 to January 2020 in the Department of Orthopaedics. The aim of this study is to identify the results of external fixation of unstable fractures of distal radius and find out the best treatment options for such fractures under different clinical conditions by comparing the results for open and close fractures and analysis of similar studies.
Materials and Methods: 50 cases of unstable distal radius fractures, including 25 patients with open fractures and 25 patients with close fractures, were treated by external fixation. The patients had mean age of 33 years with 3:2 male female ratio. The fracture was anatomically reduced and fixed with external fixator. The mean follow up was of 24 months.
Results: Final assessment was done at 6 months postoperative follow up using the Sarmiento’s modification of Lindstrom criteria for radiological outcome, showing excellent to good results in 60% cases among open fracture group and 80% cases among close fracture group , Mayo Wrist Score for functional outcome showing excellent to good results in 52% cases among open fracture group and 76% cases among close fracture group. Long term assessment done using Jakim’s scoring system (for clinicoradiological correlation) at 24 months follow-up for all 50 patients, showed excellent to good results in 88% patients. Analysis of similar studies shows external fixation to be the most rewarding treatment option for varied clinical presentations of unstable fractures of distal radius.
Conclusions: Outcome at 6 months is significantly better in close fracture group as compared to open fracture group showing that good soft tissue cover is necessary for functional fracture healing. The long-term outcome in majority of the patients (44 cases) was excellent to good showing reliability of biological ligamentotaxis under various clinical presentations as suggested by analysis of similar studies. This treatment of choice leads to clinically rewarding functional, anatomical and radiological outcomes in unstable distal radius fractures.
Keywords: External fixation, ligamentotaxis, Distal radius.
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|How to Cite this article: Sharma B, Agrawal V, Shakunt RK, Pal CP, Gupta M, Yadav R | Prospective Evaluation of The Results of External Fixation of Unstable Fractures of Distal Radius- A Comparison Between Open and Close Fractures and an Analysis of Similar Studies | Trauma International | January-June 2021; 7(1): 05-11.|
Vol 7 | Issue 1 | January-June 2021 | page: 01-04 | Karuna Shankar Dinkar, Rohit Yadav, Arjun Uppal, Chandra Prakash Pal, Mayur Gupta
Author: Karuna Shankar Dinkar , Rohit Yadav , Arjun Uppal , Chandra Prakash Pal , Mayur Gupta 
 Department of Orthopaedic Surgery, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Address of Correspondence
Dr. Chandra Prakash Pal,
Professor and Head Dept. of orthopedics, S. N. Medical College, Agra, Uttar Pradesh, India.
Introduction- The incidence of inter-trochanteric fracture in the elderly is rising because of increased age and with low bone mineral density. The presence of osteoporosis in inter-trochanteric fractures is important because the fixation of the proximal fragment depends entirely on the quality of the cancellous bone present. The surgical stabilization of inter-trochanteric fractures remains a persistent challenge. The purpose of this study is to study the effectiveness and drawbacks of one such newer intramedullary device, Proximal Femoral Nail Antirotation in the management of inter-trochanteric fractures.
Material and method- Patients who underwent PFNA for inter-trochanteric fractures at a tertiary care center Agra, who have given written and informed consent. Patients fitting into inclusion criteria would form the study group. Data collected by interviews, observation of clinical and radiological findings and assessment of function done using Harris hip score.
Results- The study comprised 24 patients, with a mean age of mean age 63 years who suffered fracture inter-trochanteric femur, due to either trivial fall (75%) or RTA (17%) and managed by cephalomedullary nailing using Proximal Femoral Nai Antirotation at our center. The majority of the patients had the quality of reduction; the Majority of patients took 12 to 22 weeks for union with mean union time of 14 weeks. Patients were asked to follow up routinely, with post-operative follow up ranging from a minimum of 11 months to 18 months. At the final follow up following results obtained according to Harris Hip Score, were 55% patients excellent, 30.50% patients good, 12% patients fair, 2.50% patients poor.
Conclusions- The inter-trochanteric fracture in elderly patients treated with cephalomedullary nailing using proximal femoral nail-anti-rotation, which has the biomechanical advantage of the helical blade providing bone compaction, increasing surface area and better anchorage in the femoral head, which showed favorable outcome by retarding rotation and varus collapse and prevents medialization by acting as a central pillar.
Keywords- Inter-trochanteric fractures; Proximal femoral nail A2; Harris Hip Score.
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|How to Cite this article: Dinkar KS, Yadav R, Uppal A, Pal CP, Gupta M | To Evaluate The Outcome of Proximal Femoral Nail A2 in Management of Inter-trochanteric Fractures of Femur in Elderly | Trauma International | Jauary-June 2021; 7(1): 01-04.|
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