Stump Closure using Kirschner Wire – A Novel Technique

/0 Comments/in /by

Volume 6 | Issue 1 | Jan-April 2018 | Page  | Blessin S. Cherian, A.M. Georgekutty, Manesh Stephen

Authors: Blessin S. Cherian, A.M. Georgekutty, Manesh Stephen [?].

[1]Department of Orthopaedics, Ganga Hospital,
Mettupalayam Road, Coimbatore,Tamil Nadu

Address of Correspondence
Dr Blessin S. Cherian
Department of Orthopaedics, Ganga Hospital
313, Mettupalayam Road, Coimbatore – 641043
Tamil Nadu
E mail : blessincherian@yahoo.com

Abstract

We report the case of a 14 year old patient who underwent below knee amputation following rail accident. She was referred to our centre for wound care but there was gaping of stump which was not amenable to simple suturing. We used two K wires and stainless steel wires to apply traction to the wound. After serial tightening, once the edges were approximated it was sutured. Sutures were retained for three weeks and following suture removal the patient had a cosmetic and sensate stump. To the best of our knowledge the principle of skin traction using K wires has not been reported for stump closure.
Keywords: Tissue traction, Stump closure, Wound gaping

References

1. Clark N, Birely B, Manson PN, Slezak S, Kolk CV, Robertson B, Crawley W. High-energy ballistic and avulsive facial injuries: Classification, patterns and an algorithm for primary reconstitution. Plast Recons Surg 98 (4): 583-601, 1996
2. Shuker ST. Management of severe facial injuries by local tissue traction. J Oral Maxillofac Surg 52: 817-820, 1994
3. Bashir AH. Wound closure by skin traction: An application of tissue expansion. Br J Plast Surg 40: 582, 1987
4. Shuker ST. Severe lower lip disfigurement resulting from war injuries. J Cranio Max Surg 18: 304-390, 1990
5. Ramazan K.YMEN, Kerim ORTAKOÚLU, Kemal Murat OKCU, Hasan Ayberk ALTUÚ, Yavuz Sinan AYDINTUÚ. Wound Closure By Skin Traction. Turk J Med Sci 32 179-181, 2002
6. Neumann CG. The expansion of an area of skin by progressive distention of a subcutaneous balloon. Plast Reconstr Surg. 1957; 19:124-30
7.Gibson T. (1977). The physical properties of skin. In Converse, J. (Ed). Reconstructive Plastic Surgery. 2nd edition, Philadelphia: W. B. Saunders. pp: 1548, 69-77
8. Mustoe TA, Bartell TH, Garner WL. Physical, biomechanical, histologic and biochemical effects of rapid versus conventional tissue expansion. Plast Recons Surg 83 (4): 683-691, 1989.
9. Carlos Henrique Froner S. Góes, MD, Mateus C. Kawasaki, MD, José Marcos Mélega, MD. Wound Closure by Intraoperative Skin Traction: Analysis of 23 Cases Rev. Soe. Bras. Ciro Plást. São Paulo v.19 n.2 p. 63-74 maijago. 2004

How to Cite this article: Cherian B. S, Georgekutty A. M, Stephen M. Stump Closure using Kirschner Wire – A Novel Technique. J Kar Orth Assoc. Jan – April 2018;6(1):25-29.

                                          (Abstract    Full Text HTML)      (Download PDF)

Late Transverse Patellar fracture following patellar tendon reconstruction using semitendinosus graft via single transverse tunnel

/0 Comments/in /by

Volume 6 | Issue 1 | Jan-April 2018 | Page  | Varshini A, Sandesh Madi, Vivek Pandey, Mohd Suhaib Mudabbir

Authors: Varshini A[1], Sandesh Madi [1], Vivek Pandey[1], Mohd Suhaib Mudabbir [1]

[1]Dept. of Orthopaedics, KMC, Manipal, Manipal Academy of Higher Education.

Address of Correspondence
Dr. Sandesh S Madi
Dept. of Orthopaedics, KMC, Manipal, Manipal
Academy of Higher Education
Email: sandesh.madi@gmail.com

Abstract

Chronic neglected rupture of patellar tendon is a rare but a disabling injury which requires patellar tendon reconstruction to restore the optimal function of the knee. Though many techniques are described in literature to reconstruct the patellar tendon, use of ipsilateral semitendinosus tendon through transverse patellar tunnel is one of the method used to reconstruct the patellar tendon. However, the transverse tunnel acts as a stress riser and could lead to a fracture. We report a rare case of late transverse fracture patella following the patellar tendon reconstruction in a neglected injury using ipsilateral semitendinosus and its management.

References

1. Gilmore JH, Clayton-Smith ZJ, Aguilar M, Pneumaticos SG, Giannoudis PV. Reconstruction techniques and clinical results of patellar tendon ruptures: evidence today. The Knee. 2015 Jun 30;22(3):148-55.
2. Abdou YE. Reconstruction of a chronic patellar tendon rupture with semitendinosus autograft. Arch Orthop Trauma Surg. 2014 Dec 1;134(12):1717-21.
3. Gregory JM, Sherman SL, Mather R, Bach Jr BR. Patellar stress fracture after transosseous extensor mechanism repair: report of 3 cases. Am J Sports Med. 2012 Jul;40(7):1668-72.
4. Singh BI, Sinha S, Singh S, Shrivastava R, Mandalia VI. Stress fracture patella following patella tendon repair. Injury Extra. 2004 Feb 29;35(2):13-6.
5. Schiphouwer L, Rood A, Tigchelaar S, Koeter S Complications of medial patellofemoral ligament reconstruction using two transverse patellar tunnels. Knee Surg Sports Traumatol Arthrosc.2017; 25:245-250.
6. Serino J, Mohamadi A, Orman S, McCormick B, Hanna P, Weaver MJ, et al. Comparison of adverse events and postoperative mobilization following knee extensor mechanism rupture repair: A systematic review and network meta-analysis. Injury. 2017 Dec 1;48(12):2793-9.
7. Pengas IP, Assiotis A, Khan W, Spalding T. Adult native knee extensor mechanism ruptures. Injury. 2016 Oct 1;47(10):2065-70.
8. Takacs IM, Somford MP. Patellar Fracture after MPFL Reconstruction, a Case Report. MOJ Orthop Rheumatol 2016; 6(4): 00228
9. Mohammed R, Hunt N, Gibbon AJ. Patellar complications in single versus double tunnel medial patellofemoral ligament reconstruction. J Orthop Surg (Hong Kong) 2017 Feb 22; 25 (1):2309499017691007.
10. Shah JN, Howard JS, Flanigan DC, Brophy RH, Carey JL, Lattermann C A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med 2012; 40:1916-1923.
11. Nummi J Operative treatment of patellar fractures. Acta Orthop Scand 1971; 42:437-438
12. Ellera Gomes JL Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report. Arthroscopy 1992; 8:335-340
13. Lukosius E, Bonazza N, Lewis G, Roush E, Black KP, Dhawan A. Effect of Patellar Tunnel Placement on Fracture Risk after MPFL Reconstruction-A Cadaveric Study. Orthopaedic journal of sports medicine. 2017 Jul 21;5(7_suppl6):2325967117S00216.
14. Brennan SA, Walls R, Jackson M, Moran R Superior pole sleeve fracture following patellar stabilisation. Knee 2009; 16:235-237.
15. Scuderi G, Scharf SC, Meltzer LP, Scott WN The relationship of lateral releases to patella viability in total knee arthroplasty. J Arthroplasty 1987; 2:209-214
16. Rodeo SA, Arnoczky SP, Torzilli PA, Hidaka C, Warren RF Tendon-healing in a bone tunnel. A biomechanical and histological study in the dog. J Bone Joint Surg Am 1993; 75:1795-1803
17. Zysk SP, Fraunberger P, Veihelmann A, Dorger M, Kalteis T, Maier M, Pellengahr C, Refior HJ Tunnel enlargement and changes in synovial fluid cytokine profile following anterior cruciate ligament reconstruction with patellar tendon and hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc 2004; 12:98-103.

How to Cite this article: Varshini A, Madi S, Pandey V, Mudabbir MS. Late Transverse Patellar fracture following patellar tendon reconstruction using semitendinosus graft via single transverse tunnel. J Kar Orth Assoc. Jan – April 2018;6(1):25-29.

                                          (Abstract    Full Text HTML)      (Download PDF)

Bone Hydatidosis of Femur: A Case Report

/0 Comments/in /by

Volume 6 | Issue 1 | Jan-April 2018 | Page  | D Varun, Pavan Kumar H Patil, Praneeth Revuri, N Karthik Mittemari, S Hiranya Kumar

Authors: D Varun [1], Pavan Kumar H Patil [1], Praneeth Revuri [1], N Karthik Mittemari [1], S Hiranya Kumar [1].

[1]Department of Orthopaedics, Vydehi Institute of Medical Sciences & Research, Karnataka, Bengaluru

Address of Correspondence
Dr. Pawan Kumar H Patil,
Depatment Of Orthopaedics Vydehi Institute Of Medical Sciences
& Research Centre #82, EPIP Area, Whitefield, Bangalore -560066

Abstract

Background: Hydatidosis is an infection caused by larval form of Echinococcus Species. It primarily involves the liver and lungs. Primary skeletal involvement is rare. The location of hydatid cysts in the femur is seldom described in the medical literature, and its diagnosis is challenging and often presenting with a pathologic fracture simulating benign bone cystic lesion.
Keywords: Anti-helminthics, curettage, hydatid disease, long bones

References

1. Mallik A, Chandra R, Thuklar BB. Imaging appearances of atypical hydatid cysts. Indian Journal of Radiology and Imaging 2016;21:33-9.
2. Song XH, Ding LW, Wen H. Bone hydatid disease. Postgrad Med J 2007;83:536-42.
3. Wuestenberg J, Gruener B, Oeztuerk S, Mason RA, Haenle MM, Graeter T, et al. Diagnostics in cystic echinococcosis: Serology versus ultrasonography. Turk J Gastroenterol 2014;25:398-404.
4. Morris BS, Madiwale CV, Garg A, Chavhan GB. Hydatid disease of bone: A mimic of other skeletal pathologies. AustralasRadiol 2002;46:431-4.
5. Banerjee S, Sabui KK, Mondal J, Nath C, Pal DK. Composite treatment for primary long-bone hydatidosis. Orthopedics 2012;35:e1826-31.
6. Walia JP, Singh B, Singh B, Kalaivanan K, Singh S. Hydatid Disease of femur-a rare case report. J Int Med SciAcad 2011;24:37-8.
7. Emami MJ, Vosoughi AR, Liaghat S. Primary Hydatid Disease of the ilium: A case report. Iran Red Crescent Med J 2010;12:190-4.
8. Nazligul Y, Kucukazman M, Akbulut S. Role of chemotherapeutic agents in the management of cystic echinococcosis. IntSurg 2015;100:112-4.
9. Hemphill A, Stadelmann B, Rufener R, Spiliotis M, Boubaker G, Müller J, et al. Treatment of echinococcosis: Albendazole and mebendazole-What else? Parasite 2014;21:70.
10. Shams-Ul-Bari, Arif SH, Malik AA, Khaja AR, Dass TA, Naikoo ZA. Role of albendazole in the management of hydatid cyst liver. Saudi J Gastroenterol 2011;17:343-7.
11. Besim H, Karayalçin K, Hamamci O, Güngör C, Korkmaz A. Scolicidal agents in hydatid cyst surgery. HPB Surg 1998;10:347-51.
12. Xie Z, Chen L, Wen H. Surgery or radiotherapy for the treatment of bone hydatidosis: A retrospective case report. Int J Infect Dis 2015;33:114-9.

How to Cite this article: Varun D, Patil PK H, Revuri P, Mittemari N K, Hiranya S. Bone Hydatidosis of Femur: A Case Report. J Kar Orth Assoc. Jan – April 2018;6(1):25-29.

                                          (Abstract    Full Text HTML)      (Download PDF)