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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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List of All Articles
1.  Review Article
Foot and Ankle Surgery: The Indian Scenario in 2016
Mandeep S Dhillon, John Ebnezar, Rakesh John
[Year:2017] [Month:January-June] [Volume:4 ] [Number:1] [Pages:54] [Pages No:40-44] [No of Hits : 1576]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1068 | FREE

ABSTRACT

In this review, we try to analyze the current scenario of foot and ankle surgery in India, with special emphasis on the problems faced by the indigenous population and also the challenges faced by foot and ankle surgeons of our country. Chronic infections of the foot (like tuberculosis, leprosy), neglected or mismanaged trauma cases (which usually result from a lack of awareness in the people regarding foot and ankle problems), foot and ankle problems faced by sportspersons, geriatric population, etc., form the crux of the discussion in this article.

Keywords: Foot ankle surgery, Geriatrics, Health care, Leprosy, Polio, Sports, Tuberculosis.

How to cite this article: Dhillon MS, Ebnezar J, John R. Foot and Ankle Surgery: The Indian Scenario in 2016. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):40-44.

Source of support: Nil

Conflict of interest: None

 
2.  SYMPOSIUM-Original Article
The Lauge-Hansen Classification for Ankle Fractures: Is it Relevant in 2017?
Mandeep S Dhillon, Lokesh Kumar, Siddhartha Sharma, Nikhil Mehta
[Year:2017] [Month:July-December] [Volume:4 ] [Number:2] [Pages:51] [Pages No:53-56] [No of Hits : 619]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1071 | FREE

ABSTRACT

Despite being one of the commonest fractures, classifications of ankle injuries are still debated, with modern surgeons decrying the use of the so-called antiquated system based on injury mechanisms. Despite glaring lacunae, especially with lack of reproducibility using modern methods, and an understanding that many fractures which we now see routinely may not fit into this classification, the Lauge-Hansen classification is still worth preserving. It clarifies some, if not most deforming forces, allows us to understand the ankle injury in a three-dimensional concept, both on the medial and lateral sides, and allows an understanding of reduction methods. The limitations in its use are the lack of prognostication ability, the fact that most reductions are now done open, and the recognition of some transitional and posterior malleolar injuries unclassifiable by it. Not being alphanumeric is another disadvantage in the computer age. Nevertheless, it is an important landmark in the history of orthopedics, and in the development of our understanding of ankle fractures. Even in 2017, it is too important a piece of work to be discarded, and modern orthopedic students are encouraged to gain an understanding of this classification system, and to combine it with the newer ones to get an overall picture of the ankle injury.

Keywords: Ankle fractures, Danis-Weber classification, Fracture classification, Lauge-Hansen, Malleoli.

How to cite this article: Dhillon MS, Kumar L, Sharma S, Mehta N. The Lauge-Hansen Classification for Ankle Fractures: Is it Relevant in 2017? J Foot Ankle Surg (Asia-Pacific) 2017;4(2):53-56.

Source of support: Nil

Conflict of interest: None

 
3.  Case Report
Rare Lytic Lesions of the Talus: A Diagnostic Challenge
Vishnu Senthil, Vivek Pandey, Kiran Acharya
[Year:2017] [Month:January-June] [Volume:4 ] [Number:1] [Pages:54] [Pages No:49-52] [No of Hits : 522]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1070 | FREE

ABSTRACT

Patients presenting with prolonged ankle pain following trivial trauma should be clinically and radiologically investigated. We present two young adults with incidentally diagnosed lytic lesion of talus. They underwent extended curettage and biopsy. Histopathological examination proved as aneurysmal and simple bone cyst and went for a secondary procedure of bone grafting. We want to emphasize the importance of differential diagnosis in the management of lytic lesions and complete removal of tumor.

Keywords: Aneurysmal bone cyst, Ankle trauma, Curettage, Simple bone cyst, Talus.

How to cite this article: Senthil V, Pandey V, Acharya K. Rare Lytic Lesions of the Talus: A Diagnostic Challenge. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):49-52.

Source of support: Nil

Conflict of interest: None

 
4.  SYMPOSIUM-Invited Article
How We do It. Trimalleolar Fractures: Fixing the Posterior Malleolus by Posterolateral Approach
Mandeep S Dhillon, Kamal Dureja, Sandeep Patel, Tungish Bansal
[Year:2017] [Month:July-December] [Volume:4 ] [Number:2] [Pages:51] [Pages No:63-68] [No of Hits : 508]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1073 | FREE

ABSTRACT

The understanding of trimalleolar fractures and, in particular, the posterior malleolus fragment has drastically evolved over the last decade. There has been a tilt in favor of fixing almost all posterior malleolus fragment in contrast to the old school thought of the 20th century. The concept of stability offered by posterior malleolus fixation to the syndesmotic stability is well understood now. Posterolateral approach has almost evolved as a gold standard approach for posterior malleolus fixation.

Keywords: Ankle fracture, Posterior malleolus, Posterolateral approach ankle.

How to cite this article: Dhillon MS, Dureja K, Patel S, Bansal T. How We do It. Trimalleolar Fractures: Fixing the Posterior Malleolus by Posterolateral Approach. J Foot Ankle Surg (Asia- Pacific) 2017;4(2):63-68.

Source of support: Nil

Conflict of interest: None

 
5.  Original Article
Diabetic Foot Infection: An Indian Scenario
Ashu Rastogi, Anil Bhansali
[Year:2016] [Month:July-December] [Volume:3 ] [Number:2] [Pages:56] [Pages No:71-79] [No of Hits : 1781]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1052 | FREE

ABSTRACT

Introduction: Diabetes mellitus is assuming epidemic proportions and with that an increasing burden of diabetic foot complications. Diabetic foot infections (DFIs) contribute not only to morbidity, amputation, and increased health-care costs but also to mortality.

Aim: To review the literature regarding the epidemiology and management of DFIs in India.

Results: The socioepidemiology of diabetic foot and its complications in India is different from the West. There is a considerable delay in seeking a physician for foot problems, as patients continue invalidated and indigenous methods of treatment. At presentation, most of the foot ulcers are chronic, harbor infection, and neuropathic in origin compared to the West with predominantly neurovascular ulcers. A predominance of Gram-negative bacterial species is reported in DFIs, with Pseudomonas aeruginosa as the most common isolated organism. An initial empirical antibiotic choice covering Gram-negative bacteria is suggested.

Conclusion: There are very few studies on the countrywide prevalence of foot complications from India. In India, DFIs behave differently from the West because of sociocultural and economic differences. We need indigenous ways for prevention and management of DFIs in India.

Keywords: Amputation, Antibiotics, Diabetic foot, Diabetic foot infection, Foot ulcer, IWGDF, Osteomyelitis, Peripheral arterial disease.

How to cite this article: Rastogi A, Bhansali A. Diabetic Foot Infection: An Indian Scenario. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):71-79.

Source of support: Nil

Conflict of interest: None

 
6.  Original Article
Management of Fractures of Distal third Tibia by Interlock Nailing
Satish R Gawali, Shashikant B Kukale, Pramod V Nirvane, Raman O Toshniwal
[Year:2016] [Month:January-June] [Volume:3 ] [Number:1] [Pages:63] [Pages No:15-22] [No of Hits : 1275]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1043 | FREE

ABSTRACT

Introduction: Most of the distal third tibia is subcutaneous and has precarious blood supply. Fractures of the distal third tibia have comminution at the fracture site, as it is metaphyseal cancellous bone with a thin shell of cortex , and have associated significant soft tissue injury. Generally, skin condition is not satisfactory due to ecchymosis, blebs, swellings, wounds, etc. All these factors contribute to delayed union, nonunion, and malunion.

The present study is about the ability to maintain a mechanically stable reduction in the distal third tibia with intramedullary nail, when lower 4 cm of tibia not fractured. If associated with fibula fracture (in lower 10 cm), it is always fixed as a rule to give stability to syndesmosis and stability to same-level tibia fracture.

Materials and methods: From January 2013 to March 2015, 60 patients of distal tibia fracture admitted to Government Medical College and Hospital, Latur, were operated and followed up prospectively.

Results: Mean age of patients was 35 years (25-50). Fracture union was seen radiologically within 3 to 4 months, depending on fracture geometry.

Conclusion: We conclude that results of fractures of distal third tibia not extending into lower 4 cm of tibia treated with interlock nailing were found satisfactory. Meticulous planning and placement of nail at the center of a wide metaphysis in the anteroposterior and lateral is mandatory to avoid varus, valgus, and posterior tilt. Polar screw or temporary K-wire during surgery is very helpful. Same-level fibula fracture fixation with a plate or square nail is very effective for stability of reduction.

Keywords: Fibula fixation, Fracture distal third tibia, Interlock tibia nailing.

How to cite this article: Gawali SR, Kukale SB, Nirvane PV, Toshniwal RO. Management of Fractures of Distal third Tibia by Interlock Nailing. J Foot Ankle Surg (Asia-Pacific) 2016;3(1):15-22.

Source of support: Nil

Conflict of interest: None

 
7.  Review Article
Midfoot Charcot Arthropathy: Overview and Surgical Management
Sundararajan Silvampatti, HS Nagaraja, S Rajasekaran
[Year:2016] [Month:July-December] [Volume:3 ] [Number:2] [Pages:56] [Pages No:97-106] [No of Hits : 807]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1056 | FREE

ABSTRACT

Midfoot Charcot arthropathy is a progressive deforming condition characterized by recurrent ulceration leading to high morbidity and amputation with lack of timely intervention. Nonoperative treatment is largely reserved for acute phase disease. Recent trend in management is early surgical interventions which could alter deforming forces and prevent deformity progression, as well as surgeries which provide osseously stable plantigrade foot. However, there are no clear-cut evidencebased guidelines regarding timing of interventions and method of techniques in surgical stabilization. This study discusses about surgical technique in the management of midfoot Charcot.

Keywords: Early surgery, External fixation, Fusion bolts, Internal fixation, Midfoot charcot.

How to cite this article: Silvampatti S, Nagaraja HS, Rajasekaran S. Midfoot Charcot Arthropathy: Overview and Surgical Management. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):97-106.

Source of support: Nil

Conflict of interest: None

 
8.  Original Article
Revision Ankle Syndesmosis Fixation: Functional Outcome after TightRope® Fixation
Senthil Rajagopalan, Pradeep Moonot, Anurag Sangar, Heath Taylor
[Year:2016] [Month:January-June] [Volume:3 ] [Number:1] [Pages:63] [Pages No:23-27] [No of Hits : 694]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1044 | FREE

ABSTRACT

Introduction: Syndesmotic injuries present a challenge to orthopedic surgeons. Malreduction of the syndesmosis has been reported to cause instability and secondary osteoarthritis and is correlated with poor subjective and objective outcomes. There are very few studies that report the outcome after revision fixation of these injuries. Previous studies have reported varying techniques for revision syndesmosis reconstruction, including screw fixation and tendon transfers.

We present the results of the use of the TightRope® suture for revision syndesmosis fixation. This implant has the advantage of maintaining physiological motion whilst allowing for healing of syndesmotic ligaments and prevents the need for further surgery to remove screws in already scarred soft tissues.

Materials and methods: We retrospectively analyzed 124 patients who required syndesmotic stabilization from January 2000 until December 2009. Eight of these 124 patients required surgical revision of their failed syndesmosis fixation, each of which was stabilized with the TightRope® Suture. All eight patients were followed up and their outcomes assessed. Seven of the eight patients in our study had technically sound initial fixation of the syndesmosis. Four of the eight patients had syndesmotic separation after screw removal 10 weeks after primary fixation.

Results: In our study, 6 of the 8 patients had good or satisfactory outcomes based on American Orthopedic Foot and Ankle Society (AOFAS) scores. In spite of accurate revision fixation of the syndesmosis, two patients required further surgery. One patient had conversion to an ankle fusion because of persistent syndesmotic widening and ongoing pain after revision surgery. Another patient required syndesmotic arthrodesis as a result of persistent pain.

Conclusion: TightRope® suture fixation is a good method of syndesmosis stabilization in patients requiring revision surgery. Randomized studies would be required to compare the effectiveness of this method of fixation with screw fixation.

Keywords: Ankle, Fracture, Revision, Syndesmosis, Tight rope.

How to cite this article: Rajagopalan S, Moonot P, Sangar A, Taylor H. Revision Ankle Syndesmosis Fixation: Functional Outcome after TightRope® Fixation. J Foot Ankle Surg (Asia- Pacific) 2016;3(1):23-27.

Source of support: Nil

Conflict of interest: None

 
9.  Review Article
Diabetic Foot Disease—Incidence and Risk Factors: A Clinical Study
Rakesh Sharma, Rajesh Kapila, Ashwani K Sharma, Jagsir Mann
[Year:2016] [Month:January-June] [Volume:3 ] [Number:1] [Pages:63] [Pages No:41-46] [No of Hits : 614]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1046 | FREE

ABSTRACT

Diabetic foot disease is one of the most common, yet dreaded long-term complication of diabetes mellitus, especially in developing countries. It is the single-most common cause of nontraumatic lower limb amputations. Various studies worldwide have shown an incidence of diabetic foot to be 15 to 25%. Elderly males who are smokers and have habit of alcohol intake and have long duration of type 2 diabetes are at major risk for this problem. The other significant risk factors are: Poor glycemic control, neuropathy, angiopathy, nephropathy, and retinopathy. Management of diabetic foot disease involves a multidisciplinary approach. The present study was conducted with the aim to know about the prevalence of the incidence of diabetic foot disease in diabetic patients and to enumerate the different risk factors associated with it for the occurrence of diabetic foot disease in such patients at the time of presentation.

Over a period of 1 year, a prospective study involving 1,016 diabetic patients as per World Health Organization (WHO) criteria were screened for diabetic foot disease. All cases were graded as per University of Texas classification. Incidence of diabetic foot disease was calculated and the risk factors were identified through proper history taking, clinical evaluation, and specialized tests as and when required.

Some of the common risk factors identified in our study were: Elderly males from poor families having long-term type 2 diabetes and who were smokers and alcoholics. Many of these patients had other systemic complications of diabetes in the form of neuropathy, retinopathy, angiopathy, and nephropathy as well. A very important, yet easily modifiable risk factor was poor glycemic control. Our conclusion from the study is being that the diabetic foot disease is much common than anticipated in diabetes mellitus patients; it is on the rise and the resultant morbidity is very crippling to the affected individuals. Therefore it is very important to identify the risk factors and educate patients about them, especially the modifiable risk factors, so that its incidence and the morbidity can be brought down significantly.

Keywords: Angiopathy, Diabetes, Diabetic foot disease, Neuropathy.

How to cite this article: Sharma R, Kapila R, Sharma AK, Mann J. Diabetic Foot Disease―Incidence and Risk Factors: A Clinical Study. J Foot Ankle Surg (Asia-Pacific) 2016;3(1):41-46.

Source of support: Nil

Conflict of interest: None

 
10.  How I Do It
Minimally Invasive Management of Fracture Calcaneum
Mandeep S Dhillon, Sharad Prabhakar, Nitesh Gahlot, Bhava RJ Satish
[Year:2016] [Month:January-June] [Volume:3 ] [Number:1] [Pages:63] [Pages No:47-52] [No of Hits : 588]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10040-1047 | FREE

ABSTRACT

Modern usage of minimally invasive methods has been applied to fractures of the calcaneus with good effect in the 21st century. The Essex-Lopresti maneuver has been modified, distraction devices are being judicially used, and the advent of image intensifiers and small joint arthroscopes have allowed accurate visualization of the reduced fracture as well as joint surfaces. It is important to understand that the three-dimensional (3D) anatomy, Böhler and Gissane angles, and heel height have to be restored. The surgeon should be ready to convert to an open procedure at any time. We describe here the method we use in our institute, and this is one of the many methods of managing this complex injury.

Keywords: Calcaneus fracture, Kirschner wire fixation of calcaneus fractures, Minimally invasive surgery, Percutaneous reduction.

How to cite this article: Dhillon MS, Prabhakar S, Gahlot N, Satish BRJ. Minimally Invasive Management of Fracture Calcaneum. J Foot Ankle Surg (Asia-Pacific) 2016;3(1):47-52.

Source of support: Nil

Conflict of interest: None

 
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