Open Journal of Orthopedics 

About: Open Journal of Orthopedics is an academic journal published by Scientific Research Publishing. The journal publishes majorly in the area(s): Medicine & Internal medicine. It has an ISSN identifier of 2164-3016. It is also open access. Over the lifetime, 456 publications have been published receiving 871 citations. The journal is also known as: OJO.

Ankle Fractures: A Literature Review of Current Treatment Methods

Abstract: Ankle fracture is one of the most common lower limb fractures for they account for 9% of all fractures representing a significant portion of the trauma workload. Ankle fractures usually affect young men and older women, however, below the age of 50; ankle fractures are the commonest in men. Two commonly used classification systems for ankle fractures include the danis weber AO classification and the Lauge-Hansen classification. There is biomechanical evidence that posterior non-locking plates are superior in stability than laterally placed plates; however there is little clinical evidence. There are several different methods of ankle fracture fixation, however the goal of treatment remains a stable anatomic reduction of talus in the ankle mortise and correction of the fibula length as a 1 mm lateral shift of the talus in the ankle mortise reduces the contact area by 42%, and displacement (or shortening) of the fibula more than 2 mm will lead to significant increases in joint contact pressures. Further research both biomechanically and clinically needs to be undertaken in order to clarify a preferable choice of fixation.

Comparitive Study between Proximal Femoral Nailing and Dynamic Hip Screw in Intertrochanteric Fracture of Femur

Abstract: Background: Internal fixation is appropriate for most intertrochanteric fractures Optimal fixation is based on the stability of fracture The mainstay of treatment of intertrochanteric fracture is fixation with a screw slide plate device or intramedullary device So it is a matter of debate that which one is the best treatment, dynamic hip screw or proximal femoral nailing Method: A prospective randomized and comparative study of 2 years duration was conducted on 60 patients admitted in the Department of Orthopedics in our hospital with intertrochanteric femur fracture They were treated by a dynamic hip screw and proximal femoral nail Patients were operated under image intensifier control The parameters studied were functional outcome of Harris hip score, total duration of operation, rate of union, amount of collapse These values were statistically evaluated and two tailed p-values were calculated and both groups were statistically compared Result: The average age of our patient is 678 years Among the fracture, 31% were stable, 58% were unstable, 11% were reverse oblique fracture The average blood loss was 100 and 250 ml in PFN and DHS group, respectively In PFN there was more no of radiation exposure intraoperatively The average operating time for the patients treated with PFN was 45 min as compared to 70 min in patients treated with DHS The patients treated with PFN started early ambulation as they had better Harris Hip Score in the early period (at 1 and 3 months) In the long term both the implants had almost similar functional outcomes Conclusion: In our study we have found that the unstable pattern was more common in old aged patients with higher grade of osteoporosis and PFN group has a better outcome in this unstable and osteoporotic fracture PFN group has less blood loss and less operating time compared to DHS group In PFN group patients have started early ambulation compared to DHS group

Primary Bipolar Arthroplasty in Unstable Intertrochanteric Fractures in Elderly

Abstract: Unstable intertrochanteric fracture in elderly is a challenging surgical condition with a high risk of morbidity and mortality. The aim of this study is to evaluate the results of bipolar arthroplasty as an alternative to the standard treatment of internal fixation. Materials and methods: 41 patients (22 females and 19 males) who had bipolar arthroplasty for unstable intertrochanteric fractures were prospectively evaluated. Modified lateral approach was used in all patients. Clinical evaluation was done using Harris Hip Score (HHS) and radiological follow up was done using plain X-rays. All the patients were 65 years of age or above. Follow up period ranged from (12 - 24) months. Results: During the last follow up, the Harris Hip Score ranged from 93 to 51 with a mean value 78.19. Four cases (9.76%) were excellent (91 - 100), 16 cases (39.02%) good (81 - 90), 16 cases (39.02%) fair (71 - 80) and 5 cases (12.02%) poor (= or < 70). Six cases had complications; infection (1), dislocation (1), stem loosening and subsidence (2), bleeding peptic ulcer (1) and intra-operative crack of the femur while preparing the femoral canal for implant insertion (1). Five patients died within the first year (12.19%). Four patients had revision surgery. Conclusion: Bipolar hemiarthroplasty for the unstable intertrochanteric fractures of the femur in elderly has a reasonable clinical outcome at 2 years. It is to be considered as one of the treatment options for such injury speciality in case of fragility fractures.

The Impact of Joint Replacement on Driver Function and Safety

Abstract: Background: The timing of return-to-driving following total joint replacement has not been well-defined. The primary aim is to study the impact of joint replacement on driver safety. A secondary aim is to investigate the possible predictors for increased car accidents in patients undergoing total joint replacement surgery. This data will provide the background to support further prospective studies on the relationship of driver safety to joint replacement surgery. Methods: A retrospective analysis of driver safety in the postoperative period was performed by analyzing the self-reporting of 485 patients who had undergone a Total Hip Arthroplasty (n = 196), Total Knee Arthroplasty (n = 258) or Total Shoulder Arthroplasty (n = 31). The mean age was 70 (28 - 88) with 164 male (34%) and 319 female (66%). Patients were mailed a questionnaire and the responses were analyzed to determine what factors affect driving after joint replacement. Results: Overall, increased patient age and gender were associated with increased accidents following surgery. Our subgroup analysis demonstrated that in patients undergoing TSA, increased patient age was associated with increased accidents. TKA patients showed that older patient age predicted increased accidents following surgery. Conclusions: While age and gender are correlated with increased accidents after joint replacement in general, no factors specific to joint replacement surgery are related to increased incidence of accidents.

Endocsopic Decompression of Intermetatarsal Nerve (EDIN) for the Treatment of Morton's Entrapment— Multicenter Retrospective Review *

Abstract: Background: The authors present the results of a four surgeon, multicenter study of endoscopic decompression for the treatment of Civinini-Morton’s entrapment of 193 interspaces. Methods: A retrospective review of 193 interspaces, which were decompressed by four different surgeons. Results: The overall success rate was high, with 92% of patients reporting a good or fair outcome. Higher success rates were reported in the 3rd interspace decompression group (95%) compared to the 2nd interspace decompression group (85%). Complications reported were minimal, with only seven cases requiring a revision with traditional neurectomy. No revisions were required in the 3rd interspace decompression group. Five of the revisions were in the 2nd interspace decompression group, with the remaining two revisions in the combined 2nd/3rd interspace decompression group. Conclusions: Endoscopic decompression for the treatment of Civinnini-Morton’s entrapment is a safe and efficacious method of treatment of this nerve entrapment, with very low complication rates and rapid return to normal activity.