Surgical Treatment of Retro-calcaneal Bursitis (Haglund’s Disease): Anatomy, Evaluation, Surgical Options, Complications, and Outcome

Vol 32| Issue 2 | July – Dec 2019 | page: 06-13 | Raju Karuppal, Anwar Marthya


Authors: Raju Karuppal [1], Anwar Marthya [2]

[1] Department Of Orthopaedics, Govt. Medical College, Kozhikode, Kerala, India.
[2] Department Of Orthopaedics, IQRAA International Hospital Calicut, Kerala, India.

Address of Correspondence

Dr. Raju Karuppal,
Govt. Medical College, Kozhikode, Kerala, India.
E-mail: drrajuortho@rediffmail.com


Abstract

Retrocalcaneal bursitis (RCB) is one of the common causes of heel pain. Symptoms will often respond well to conventional methods of treatment. Those patients who do not respond to conventional treatment may get benefit from surgical interventions. An awareness of appropriate diagnostic and evaluation techniques are is necessary to diagnose and plan the surgical treatment. Initial treatments of Haglund’s disease include non-steroidal anti-inflammatory drugs, footwear modification, and various physiotherapeutic modalities. Bony hump excision is the main surgical treatment option, which can be performed by various surgical approaches, such as open procedures or by endoscopic techniques. Factors such as local skin condition, and medical co-morbidities which may retard tissue healing, possibilities of Achilles tendon damage, and post-operative pain must be considered while selecting the best surgical option. This article examines patient evaluation, surgical options, complications, and outcome of Haglund’s disease.
Keywords: Retrocalcaneal bursitis, Haglund’s disease, Calcaneal osteotomy, Endoscopic surgery, Complications.


References

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How to Cite this Article: Karuppal R, Marthya | A Surgical Treatment of Retro-calcaneal Bursitis (Haglund’s Disease): Anatomy, Evaluation, Surgical Options, Complications, and Outcome | Kerala Journal of Orthopaedics | July – Dec 2019 ; 32(2): 06-13 .

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Functional outcome of non-resurfacing patelloplasty in primary total knee arthroplasty- A one year follow up study of 62 knee replacements

Vol 32| Issue 2 | July – Dec 2019 | page: 02-05 | Rajanish. R, M. Harisankar, Jim Thomas Malayil, Muhammad P K


Authors: Rajanish. R [1], M. Harisankar [1], Jim Thomas Malayil [1], Muhammad P K [1].

[1] Department of Orthopedics, Baby Memorial Hospital, Calicut, Kerala..

Address of Correspondence

Dr. M. Harisankar,
Department of Orthopedics, Baby Memorial Hospital, Calicut, Kerala
E-mail: drharisankarm@gmail.com


Abstract

The management of the patella during total knee arthroplasty is still controversial. This study aims at assessing the functional outcome of total knee replacements with a non-resurfacing patelloplasty technique. We had a total of 53 patients and 62 total knee replacements. The patients were assessed preoperatively with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and were treated with total knee replacements with a non-resurfacing patelloplasty technique. The patients were followed up for 1 year and WOMAC score was calculated to assess the functional outcome. The results showed a very promising improvement in the functional status of the patient. The authors recommend the use of non-resurfacingpatelloplasty, as the procedure gives comparable results with resurfacing patelloplasty while avoiding its complications.
Keywords: Anterior knee pain, Patelloplasty, Patellar resurfacing, Total knee arthroplasty.


References

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5. ŽupanA, SnojŽ, AntoličV, PompeB. Better results with patelloplasty compared to traditional total knee arthroplasty.Int Orthop2014;38:1621-5.
6. CercielloS, RobinJ, LustigS, MaccauroG, HeyseTJ, NeyretP. The role of patelloplasty in total knee arthroplasty.Arch Orthop Trauma Surg2016;136:1607-13.
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9. ReubenJD, McDonaldCL, WoodardPL, HenningtonLJ. Effect of patella thickness on patella strain following total knee arthroplasty.J Arthroplasty1991;6:251-8.
10. LiuZT, FuPL, WuHS, ZhuY. Patellar reshaping versus resurfacing in total knee arthroplasty results of a randomized prospective trial at a minimum of 7 years’ follow-up.Knee2012;19:198-202.


How to Cite this Article: Rajanish R, Harisankar M, Malayil J T, Muhammad P K | Functional outcome of non-resurfacing patelloplasty in primary total knee arthroplasty- A one year follow up study of 62 knee replacements | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 02-05 .

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Review of the Acquired Adult Flatfoot Deformity

Vol 32| Issue 2 | July – Dec 2019 | page: 62-68| Dennis P Jose, Rajesh Simon, Gautam Kumar


Authors: Dennis P Jose[1], Rajesh Simon[1], Gautam Kumar[1]

[1]Department Of Orthopedics, VPS Lakeshore hospital, Kochi, Kerala, India.

Address of Correspondence
Dr. Rajesh Simon,
VPS Lakeshore hospital, Kochi, Kerala, India.
E-mail: rajeshsimon@gmail.com


Abstract

Acquired adult flatfoot deformity is a common disorder commonly seen in the middle-aged and elderly female that is responsible for foot pain, misalignment, and difficulty to walk. The progressive involvement of dynamic and static stabilizers results in flattening of medial arch, subtalar subluxation, and forefoot abduction. Posterior tibial tendon (PTT) dysfunction is the most common associated pathology though it has been linked to multiple factors including trauma, neuromuscular disorders, and inflammatory pathologies. The PTT is the primary dynamic stabilizer and spring ligament is the primary static stabilizer of the medial arch of the foot. Tendon degeneration involves several stages that include synovitis, peritendinous inflammation to partial, and complete tear with overlapping stages present at the same time. The clinical examination is the cornerstone of diagnosis. Staging is based on clinical examination with objective findings such as the presence or absence of deformity; the deformity is correctable or not, and the presence or absence of osteoarthritis rather than the severity of symptoms. Acquired flat foot deformity (AFFD) is a progressive disorder starting from PTT dysfunction. As the disease progresses the damage to other supporting structure lead to worsening of the disease culminating in misalignment, gait abnormality, and osteoarthritis. The four-tier staging of AFFD by Johnson and Storm weighs the clinical examination findings and level of misalignment. Initial stages can be managed conservatively, but as severity increases, soft tissue and bones get involved warranting surgical procedures directed toward correcting the pathophysiology.
Keywords: Acquired adult flatfeet, Posterior tibial tendon dysfunction, Flattened arch, Too many toes sign.


References

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2. VanBoerum DH, SangeorzanBJ. Biomechanics and pathophysiology of flat foot.Foot Ankle Clin2003;8:419-30.
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8. EllisSJ, DeyerT, WilliamsBR, YuJC, LehtoS, MaderazoA, et al. Assessment of lateral hindfoot pain in acquired flatfoot deformity using weightbearing multiplanar imaging.Foot Ankle Int2010;31:361-71.
9. JohnsonKA, StromDE. Tibialis posterior tendon dysfunction.ClinOrthopRelat Res1989;239:196-206.
10. DiGiovanniCW, LangerP. The role of isolated gastrocnemius and combined Achilles contractures in the flatfoot.Foot Ankle Clin2007;12:363-79, 8.
11. YoungerAS, SawatzkyB, DrydenP. Radiographic assessment of adult flatfoot.Foot Ankle Int2005;26:820-5.
12. ArunakulM, AmendolaA, GaoY, GoetzJE, FeminoJE, PhisitkulP. Tripod Index: Diagnostic accuracy in symptomatic flatfoot and cavovarus foot: Part 2.Iowa Orthop J2013;33:47-53.
13. HastingsMK, SinacoreDR, Mercer-BoltonN, McCormickJJ, HildeboltCF, PriorFW, et al. Precision of foot alignment measures in Charcot arthropathy.Foot Ankle Int2011;32:867-72.
14. FloresDV, MejíaGómez C, FernándezHernando M, DavisMA, PathriaMN. Adult acquired flatfoot deformity: Anatomy, biomechanics, staging, and imaging findings.Radiographics2019;39:1437-60.
15. YangCH, ChouKT, ChungMB, ChuangKS, HuangTC. Automatic detection of calcaneal-fifth metatarsal angle using radiograph: A computer-aided diagnosis of flat foot for military new recruits in Taiwan.PLoS One2015;10:e0131387.
16. SaltzmanCL, el-KhouryGY. The hindfoot alignment view.Foot Ankle Int1995;16:572-6.
17. ArangioG, RogmanA, ReedJF 3rd. Hindfoot alignment valgus moment arm increases in adult flatfoot with Achilles tendon contracture.Foot Ankle Int2009;30:1078-82.
18. TennantJN, CarmontM, PhisitkulP. Calcaneus osteotomy.Curr Rev Musculoskelet Med2014;7:271-6.
19. GuytonGP, JengC, KriegerLE, MannRA. Flexor digitorum longus transfer and medial displacement calcaneal osteotomy for posterior tibial tendon dysfunction: A middle-term clinical follow-up.Foot Ankle Int2001;22:627-32.
20. BarskeHL, DiGiovanniBF, DouglassM, NawoczenskiDA. Current concepts review: Isolated gastrocnemius contracture and gastrocnemius recession.Foot Ankle Int2012;33:915-21.
21. YasuiY, HannonCP, SeowD, KennedyJG. Ankle arthrodesis: A systematic approach and review of the literature.World J Orthop2016;7:700-8.


How to Cite this Article: Jose D P, Simon R, Kumar G | Review of the Acquired Adult Flatfoot Deformity | Kerala Journal of Orthopaedics| July – Dec 2019; 32(2): 62-68 .

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Ipsilateral Shoulder and Elbow Dislocation : Case report

Vol 32| Issue 2 | July – Dec 2019 | page: 59-61| Raphael Thomas, M Raffic, Anoop S


Authors: Raphael Thomas[1], M Raffic[1], Anoop S[1]

[1]Department of Orthopaedics, Sree Gokulam Medical College, Venjaramoodu, Trivandrum, Kerala, India.

Address of Correspondence
Dr. Anoop S,
Sree Gokulam Medical College, Venjaramoodu, Trivandrum, Kerala, India.
E-mail: anoopsuresh88@gmail.com


Abstract

Background: The most commonly dislocated joint in the body is the Shoulder, followed by Elbow. A very rare presentation has both these dislocations on the ipsilateral side and only a few cases of these have been reported. In most cases which have been reported, Shoulder dislocation was initially missed and later diagnosed.
This case report is of a 70 year old Female patient who came to our Casulaty following slip and fall at home and sustained injury to the Right Upper Limb. Initially patient was diagnosed to have Right Elbow Fracture Dislocation. Xray was taken and reduction of elbow dislocation was done in the Casualty. After reduction of the elbow dislocation, one joint above and one joint below the injury was done and patient had complaints of pain over the Right Shoulder and Xray of Right Shoulder was taken and it showed Anterior Dislocation of Right Shoulder. This is a rare presentation of Ipsilateral Shoulder and Elbow Dislocation. The Shoulder Dislocation was reduced and an Above Elbow POP Slab was applied on the Right Upper Limb. Patient was reviewed at 2 weeks, 4 weeks, 1.5 months, 3 months and at 6 months. In the initial 4 weeks patient was on Above Elbow POP slab and it was removed at 4 weeks and shoulder and elbow joints were mobilized. Patient came for review again after 1.5 months, 3 months and 6 months and Range of Movement at the Shoulder and Elbow joints were assessed at each visit.
Conclusion: Ipsilateral dislocation of shoulder and elbow are uncommon and can be treated conservatively with good results. The Shoulder and Elbow range of movement was assessed at 4 weeks, 1.5 months, 3 months and 6 months and ROM of Elbow and Shoulder were found to be satisfactory.
Keywords: Shoulder, Elbow, Dislocation, Ipsilateral, Rare Case Report.


References

1. Inan U, Cevik AA and Omeroğlu H. Open humerus shaft fracture with ipsilateral anterior shoulder fracture-dislocation and posterior elbow dislocation: a case report. J Trauma. 2008; 64(5): 18383-6.
2. Suman RK. Simultaneous dislocations of the shoulder and the elbow. Injury. 1981; 12(5): 438.
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5. Ahmet Imerci, Mert Kumbaraci, Mustafa İncesu, Ahmet Savran, Levent Karapinar. Ipsilateral Simultaneous Shoulder and Elbow Dislocation: A Case Report. Tr J Emerg Med. 2011; 11(2):72-5.


How to Cite this Article: Thomas R, Raffic M, Anoop S | Ipsilateral Shoulder and Elbow Dislocation : Case report| Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 59-61 .

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Osteopetrosis– An Experience of Open Reduction and Internal Fixation: A Case Report

Vol 32| Issue 2 | July – Dec 2019 | page: 56-58| Noufal S, VinodKumar B.P, Vikraman C.S.


Authors: Noufal S[1], VinodKumar B.P[1], Vikraman C.S. [1]

[1]Department Of Orthopaedics, Govt. Medical College, Kollam, Kerala, India.

Address of Correspondence
Dr. Noufal S,
Orthopaedics, Govt. Medical College, Kollam, Kerala, India.
E-mail: noufals244@gmail.com


Abstract

We describe a patient with osteopetrosis who sustained multiple fractures including, right neck of femur fracture left subtrochanteric fracture and left forearm both bone fracture. All fractures were internally fixed. Our patient showed fracture union and successful return to normal activities of daily living. Operative treatment in osteopetrosis fractures are extremely difficult along with associated complications including infection and non union. Our experience shows internal fixation of peritrochanteric fracture with good outcome.
Keywords: Osteopetrosis, Internal fixation, Neck of femur fracture, Subtrochanteric fracture, Both bone fracture forearm.


References

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2. SobacchiC, FrattiniA, OrchardP, PorrasO, TezcanI, AndolinaM, et al. The mutational spectrum of human malignant autosomal recessive osteopetrosis.Hum Mol Genet2001;10:1767-73.
3. FrattiniA, OrchardPJ, SobacchiC, GilianiS, AbinunM, MattssonJP, et al. Defects in TCIRG1 subunit of the vacuolar proton pump are responsible for a subset of human autosomal recessive osteopetrosis.Nat Genet2000;25:343-6.
4. KornakU, KasperD, BöslMR, KaiserE, SchweizerM, SchulzA, et al. Loss of the ClC-7 chloride channel leads to osteopetrosis in mice and man.Cell2001;104:205-15.
5. YamamotoN, NaraparajuVR, OrchardPJ. Defective lymphocyte glycosidases in the macrophage activation cascade of juvenile osteopetrosis.Blood1996;88:1473-8.
6. AlexanderW. Report of a case of so-called ‘‘marble bones’’ with a review of the literature and translation of an article.AM J Roentgenol1923;10:280-301.
7. dePalma L, TulliA, MaccauroG, SabettaSP, delTorto M. Fracture callus in osteopetrosis.ClinOrthopRelat Res1994;308:85-9.
8. HasenhuttlK. Osteopetrosis. Review of the literature and comparative studies on a case with a twenty-four-year follow-up.J Bone Joint Surg Am1962;44-A:359-70.
9. KumbaraciM, KarapinarL, IncesuM, KayaA. Treatment of bilateral simultaneous subtrochanteric femur fractures with proximal femoral nail antirotation (PFNA) in a patient with osteopetrosis: Case report and review of the literature.J OrthopSci2013;18:486-9.
10. AslanA, BaykalYB, UysalE, AtayT, KirdemirV, BaydarML, et al. Surgical treatment of osteopetrosis-related femoral fractures: Two case reports and literature review.Case Rep Orthop2014;2014:891963.
11. ShapiroF. Osteopetrosis. Current clinical considerations.ClinOrthopRelat Res1993;294:34-44.


How to Cite this Article: Noufal S, VinodKumar B.P, Vikraman C.S. | Osteopetrosis– An Experience of Open Reduction and Internal Fixation: A Case Report | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 56-58 .

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Giant Cell Tumor of Calcaneum– A Case Report

Vol 32| Issue 2 | July – Dec 2019 | page: 53-55| Abdul Rahman, VinodKumar B.P, C.S.Vikraman


Authors: Abdul Rahman [1], VinodKumar B.P [1], C.S.Vikraman [1]

[1] Department Of Orthopedics, Govt. Medical College, Kollam, Kerala, India.

Address of Correspondence
Dr. VinodKumar B.P,
Govt. Medical College, Kollam, Kerala, India.
E-mail: bpvinodkumar@gmail.com


Abstract

Introduction: The Prevalence of Giant Cell Tumour (GCT) at a typical locations, like such as bones of the feet are rare, seen in <1% of cases. GCT may have aggressive features, including cortical expansion or destruction with a soft-tissue component. Difficult diagnosis most often followed with complicated management and high recurrence rate remains a challenge that is rarely reported.
Presentation of case: We presented a case of a 35-year-old female lady with giant cell tumour of the left calcaneus. Discussion: Curettage with augmentation procedures like such as electric cautery and hydrogen peroxide washing and bone cement application was done. However, aggressive GCTs may require wide excision and reconstruction or may be amputation.
Keywords: GCT, Excision & Curettage, Densumab


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7. O’ConnorPJ, GibbonWW, StoneM, ManghamDC, FreemanSJ. Sonographic demonstration of fluid-fluid levels in an aneurysmal bone cyst secondary to a giant cell tumor of the calcaneus.ClinRadiol Extra2004;59:43.
8. CampanacciM, BaldiniN, BorianiS, SudaneseA. Giant-cell tumor of bone.J Bone Joint Surg Am1987;69:106-14.
9. KumarR, MatasarK, StansberryS, ShirkhodaA, DavidR, MadewellJE, et al. The calcaneus: Normal and abnormal.Radiographics1991;11:415-40.
10. RevengaMartínez M, BachillerCorral FJ, RubioGarcía J, MuñozBeltrán M, ZeaMendoza AC. Cystic lesion of the calcaneus. Intraosseouslipoma.ReumatolClin2007;3:139-42.


How to Cite this Article: Rahman A, VinodKumar B.P, Vikraman C. S | Giant Cell Tumor of Calcaneum–A Case Report | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 53-55.

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Acute Calcific Tendinitis of Flexor Tendon Sheath of Index Finger- A Case Report

Vol 32| Issue 2 | July – Dec 2019 | page: 50-52| Nikhil C S, Harisankar M, N J Mani, K Muraleedharan, Arunlal K P


Authors: Nikhil C S[1], Harisankar M[1], N J Mani[1], K Muraleedharan[1], Arunlal K P[1]

[1]Department Of Orthopedics, Baby Memorial Hospital, Calicut, Kerala, India.

Address of Correspondence
Dr. Nikhil CS,
Baby Memorial Hospital, Calicut, Kerala, India.
E-mail: csnikhil45@gmail.com


Abstract

Acute calcific tendinitis is a common orthopedic problem around the shoulder and hip. It is commonly seen near the insertion of supraspinatus tendon in shoulder. It is rare in the hand and often overlooked and underdiagnosed. Clinically, it is a mimicker of other acute inflammatory conditions such as infection, acute gout, foreign bodies, and even fracture. The most common site in hand is near the insertion of flexor carpi ulnaris (FCU) tendon in women. We describe an unusual case of calcific tendinitis involving flexor tendon sheath of index finger.
Keywords: Acute calcific tendintis, Index Finger, Flexor tendon.


References

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7. LeeKB, SongKJ, KwakHS, LeeSY. Acute calcific periarthritis of proximal interphalangeal joint in a professional Golfer‘s hand.J Korean Med Sci2004;19:904-6.


How to Cite this Article: Nikhil C S, Harisankar M, N J Mani, K Muraleedharan, Arunlal K P | Acute Calcific Tendinitis of Flexor Tendon Sheath of Index Finger- A Case Report | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 50-52 .

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Assessing the effectiveness of PRP infiltration Vs Triamcinolone injection for management of lateral epicondylitis

Vol 32| Issue 2 | July – Dec 2019 | page: 26-30 | Raphael Thomas, M Raffic, Anoop S


Authors: Raphael Thomas [1], M Raffic [1], Anoop S [1]

[1] Department of Orthopaedics, Sree Gokulam Medical College, Venjaramoodu, Trivandrum, Kerala, India.

Address of Correspondence

Dr. Anoop S,
Sree Gokulam Medical College, Venjaramoodu, Trivandrum, Kerala, India.
E-mail: anoopsuresh88@gmail.com


Abstract

Background: A common problem in the population today with a prevalence of 1%–3% is pain over the lateral aspect of elbow. A comparative study was done to assess the effectiveness of single infiltration of platelet-rich plasma (PRP) to a single injection of triamcinolone and a normal saline placebo injection for the management of Lateral Epicondyle pain of Humerus over a 6 month duration.
Materials and Methods: Visual analog scale (VAS) was used to evaluate the effectiveness of the different treatment modalities and a comparative study was done over a period of 6 months with 2nd, 4th month and 6th month followup following treatment. Out of 58 patients in the study, 27 were Females and 31 were Males. Patients included in the survey were between 20 and 40 years and belonged to either sex and had their complaints for over 3-month duration. Patients with elbow pain aetiology due to other problems or those who had previous treatment with any form of injection were excluded from the study. 1ml of 2% Xylocaine was injected before injecting the treatment modality formulation decided under trial. Pain scoring was done using VAS and FPS. Statistical analysis was done using Fisher’s exact test at 12 and 24 weeks.
Results: 29 elbows were included in each group with 27 females and 31 males. At 2nd and 4th months, patients in both the PRP and triamcinolone groups had pain relief (P < 0.05). At the 6th month follow-up, statistically significant results of better pain relief was found with the PRP group when compared to the triamcinolone group. In triamcinolone group 13 patients had injection site hypopigmentation and 3 patients had subdermal atrophy.
Conclusion: After following up the patient it was seen that PRP gives better pain relief when compared to injection of triamcinolone as treatment of tennis elbow and there is also need for long term studies to asses the duration of symptom relief and to confirm the findings from our study.
Keywords: PRP, Platelet Rich Plasma, Infiltration, Triamcinolone, Steroid, Saline, Placebo, Lateral Epicondylitis, Tennis Elbow.


References

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6. Brummel J, Baker CL 3rd, Hopkins R, Baker CL Jr. Epicondylitis: Lateral. Sports Med Arthrosc 2014;22:e1-6.
7. Nirschl RP, Ashman ES. Elbow tendinopathy: Tennis elbow. Clin Sports Med 2003;22:813-36.
8. Walz DM, Newman JS, Konin GP, Ross G. Epicondylitis: Pathogenesis, imaging, and treatment. Radiographics 2010;30:167-84.
9. Saccomanni B. Corticosteroid injection for tennis elbow or lateral epicondylitis: A review of the literature. Curr Rev Musculoskelet Med 2010;3:38-40.
10. Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. J Hand Surg Am 2003;28:272-8.
11. Chung B, Wiley JP. Effectiveness of extracorporeal shock wave therapy in the treatment of previously untreated lateral epicondylitis: A randomized controlled trial. Am J Sports Med 2004;32:1660-7.
12. Galvin R, Callaghan C, Chan WS, Dimitrov BD, Fahey T. Injection of botulinum toxin for treatment of chronic lateral epicondylitis: Systematic review and meta-analysis. Semin Arthritis Rheum 2011;40:585-7.
13. Tosun HB, Gumustas S, Agir I, Uludag A, Serbest S, Pepele D, et al. Comparison of the effects of sodium hyaluronate- chondroitin sulphate and corticosteroid in the treatment of lateral epicondylitis: A prospective randomized trial. J Orthop Sci 2015;20:837-43.
14. Lubkowska A, Dolegowska B, Banfi G. Growth factor content in PRP and their applicability in medicine. J Biol Regul Homeost Agents 2012;26 2 Suppl 1:3S-22S.
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16. Krogh TP, Fredberg U, Stengaard-Pedersen K, Christensen R, Jensen P, Ellingsen T. Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: A randomized, double-blind, placebo-controlled trial. Am J Sports Med 2013;41:625-35.
17. Brkljac M, Kumar S, Kalloo D, Hirehal K. The effect of platelet-rich plasma injection on lateral epicondylitis following failed conservative management. J Orthop 2015;12 Suppl 2:S166-70. 21.
18. Raeissadat SA, Rayegani SM, Hassanabadi H, Rahimi R, Sedighipour L, Rostami K. Is Platelet-rich plasma superior to whole blood in the management of chronic tennis elbow: One year randomized clinical trial. BMC Sports Sci Med Rehabil 2014;6:12.
19. Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: Platelet-rich plasma versus corticosteroid injection with a 1-year followup. Am J Sports Med 2010;38:255-62.
20. Gosens T, Peerbooms JC, van Laar W, den Oudsten BL. Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: A double-blind randomized controlled trial with 2-year followup. Am J Sports Med 2011;39:1200-8.
21. Arirachakaran A, Sukthuayat A, Sisayanarane T, Laoratanavoraphong S, Kanchanatawan W, Kongtharvonskul J. Platelet-rich plasma versus autologous blood versus steroid injection in lateral epicondylitis: Systematic review and network meta-analysis. J Orthop Traumatol 2016;17:101-12.
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23. Gautam VK, Verma S, Batra S, Bhatnagar N, Arora S. Platelet- rich plasma versus corticosteroid injection for recalcitrant lateral epicondylitis: Clinical and ultrasonographic evaluation. J Orthop Surg (Hong Kong) 2015;23:1-5.
24. Park SK, Choi YS, Kim HJ. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. Korean J Anesthesiol 2013;65 6 Suppl: S59-61.


How to Cite this Article: Thomas R, Raffic M, Anoop S | Assessing the effectiveness of PRP infiltration Vs Triamcinolone injection for management of lateral epicondylitis | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 26-30.

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Thoracic dumbbell shaped tumor causing Compressive Myelopathy– A Case Report

Vol 32| Issue 2 | July – Dec 2019 | page: 39-41 | Rahul Srinivasan, KrishnaKumar


Authors: Rahul Srinivasan [1], Krishna Kumar [1]

[1] Department Of Spine surgery, Medical Trust Hospital, Kochi, Kerala, India.

Address of Correspondence

Dr. Krishna kumar,
Medical Trust Hospital, Kochi, Kerala, India.
E-mail: krishnakumar.ram@gmail.com


Abstract

Spinal schwannomas are tumors arising from Schwann cells covering nerves, exiting from spinal cord. They may present as intradural extramedullary mass and occasionally extend extradurally forming dumbbell-shaped tumor. We present a case of a large sporadic spinal schwannoma with predominant extradural component. These types of tumors usually require two-staged procedure, but in our patient, tumor was completely removed in single stage through posterior approach.
Keywords: Dumbbell, Schwannoma, Compressive myelopathy.


References

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5. Bhardwaj S, Saraswat KB, Singh AP. Multiple spinal schwannomas in absence of neurofibromatosis: Review with case report.Indian Spine J2019;2:158-62.
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How to Cite this Article: Srinivasan R, KrishnaKumar | Thoracic Dumbbell-shaped tumor causing compressive Myelopathy– A Case Report | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 39-41.

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Salvage of Femoral Head in Aneurysmal Bone Cyst of the Neck of Femur Presenting with Pathological Fracture in Pregnancy: A Case Report

Vol 32| Issue 2 | July – Dec 2019 | page: 46-49 | George M Srampickal, Mohamad Gouse, Subin Babu, Vinoo Mathew Cherian


Authors: George M Srampickal[1], Mohamad Gouse[1], Subin Babu[1], Vinoo Mathew Cherian[1]

[1]Department Of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India.

Address of Correspondence
Dr. George M Srampickal,
Christian Medical College, Vellore, Tamil Nadu, India.
E-mail: drmsgeorge@gmail.com


Abstract

Salvage of femoral head following aneurysmal bone cysts (ABCs) of the neck of femur in pregnancy, presented with pathological fracture treated with a dual approach to the neck of femur, was not reported in the scientific literature. A 28-year-old lady at her 3rd month of gestation presented with pathological fracture through ABC of the neck of femur. The femoral head was salvaged successfully with single single-stage dual approach (anterior and lateral approach) extended curettage, allografting, and internal fixation. At two-2-year follow-up, her hip and function are preserved. This case highlights the advantages of a dual approach in salvage of femoral head in pathological fracture following destructive lesion of the neck of femur.
Keywords: Aneurysmal bone cysts, Pathological fracture, Femoral neck, Tumor in pregnancy, Femoral head salvage.


References

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How to Cite this Article: Srampickal G M, Gouse M, Babu S, Cherian V M | Salvage of Femoral Head in Aneurysmal Bone Cyst of the Neck of Femur Presenting with Pathological Fracture in Pregnancy:A Case Report | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 46-49.

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