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Article: A mysterious case of recurrent fracture: Tumour-induced osteomalacia.

Shetty, Sahana / Ravindra, Shruthi / Acharya, Himamshu / Rao, Sharath K

Journal of family medicine and primary care

2022 Volume 11, Issue 3, Page(s) 1204–1207

Abstract: We report a case of tumour-induced osteomalacia in a 59-year-old man who presented with a long-standing history of myalgia, bone pain and pathological fracture of the bilateral femur at different intervals in the past 4 years. A biochemical evaluation ... ...

Abstract	We report a case of tumour-induced osteomalacia in a 59-year-old man who presented with a long-standing history of myalgia, bone pain and pathological fracture of the bilateral femur at different intervals in the past 4 years. A biochemical evaluation revealed hypophosphatemia secondary to phosphaturia. Localization study by Ga-68 DOTANOC PET-CT for adult-onset hypophosphatemic osteomalacia revealed a tumour in the right femoral head. Resection of the tumour resulted in clinical improvement as well as normalization of biochemical parameters.
Language	English
Publishing date	2022-03-10
Publishing country	India
Document type	Case Reports
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_947_21
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Article ; Online: Suprapatellar nailing in proximal third tibial fractures - Clinicoradiological outcome.

Kulkarni, Mahesh Suresh / Tummala, Mohit / Aroor, Monappa Naik / Vijayan, Sandeep / Rao, Sharath K

Injury

2020 Volume 51, Issue 8, Page(s) 1879–1886

Abstract: Aims and objectives: To evaluate the clinical and radiological outcome of proximal third tibia fractures managed by suprapatellar nailing with a minimum follow-up of 12 months.: Methodology: In our retrospective cohort study of 43 consecutive ... ...

Abstract	Aims and objectives: To evaluate the clinical and radiological outcome of proximal third tibia fractures managed by suprapatellar nailing with a minimum follow-up of 12 months. Methodology: In our retrospective cohort study of 43 consecutive proximal third tibia fractures from January 2015 to September 2018 treated with intramedullary nailing through suprapatellar approach in semiextended knee position were included. The patients were followed up regularly at 6 weeks, 3 months, 4.5 months, 6 months, 12 months and every 6 months thereafter. At each visit patients were assessed for union, shortening and rotational alignment. The clinical outcome was analysed using Lower Extremity Functional Scale (LEFS) and anterior knee pain. The radiological outcomes are analysed by evaluating the radiographs for progression of fracture union and tibial alignments. Results: After fulfilling the exclusion and inclusion criteria, 43 out of 60 consecutive proximal third tibia fracture were included in the study with an average age of 38.4 years (20-71 years), follow up of 20.4 months (12-45 months) after the index procedure. The radiological union was achieved in 7.3 months (4-13 months). At the end of 1 year follow up, the average LEFS was 89.4% (60%-95%). 4 patients had Malunion - with 1 valgus and 3 anterior angulations, 8 delayed unions and 1 non-union (with bone loss- which required bone grafting). All the fractures united eventually. No incidence of anterior knee pain. Conclusion: We recommend suprapatellar nailing in proximal third tibial fractures when meticulously performed using the current surgical principles and techniques with proper implant selection. It results in excellent clinical and radiological outcomes with minimal complications when compared to other modalities of management. Suprapatellar nailing is a viable option for proximal third tibia fractures due to its inherent advantages of positioning, perfect nail entry and placement. Additionally, noteworthy absence of anterior knee pain is an additional benefit of this technique.
MeSH term(s)	Adult ; Bone Nails ; Fracture Fixation, Intramedullary ; Humans ; Retrospective Studies ; Tibia ; Tibial Fractures/diagnostic imaging ; Tibial Fractures/surgery ; Treatment Outcome
Language	English
Publishing date	2020-05-18
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2020.05.008
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Zs.A 778: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Thirty-day mortality of patients with hip fracture during COVID-19 pandemic and pre-pandemic periods: A systematic review and meta-analysis.

Tripathy, Sujit Kumar / Varghese, Paulson / Panigrahi, Sibasish / Panda, Bijnya Birajita / Velagada, Sandeep / Sahoo, Samrat Smrutiranjan / Naik, Monappa A / Rao, Sharath K

World journal of orthopedics

2021 Volume 12, Issue 1, Page(s) 35–50

Abstract: Background: Timely intervention in hip fracture is essential to decrease the risks of perioperative morbidity and mortality. However, limitations of the resources, risk of disease transmission and redirection of medical attention to a more severe ... ...

Abstract	Background: Timely intervention in hip fracture is essential to decrease the risks of perioperative morbidity and mortality. However, limitations of the resources, risk of disease transmission and redirection of medical attention to a more severe infective health problem during coronavirus disease 2019 (COVID-19) pandemic period have affected the quality of care even in a surgical emergency. Aim: To compare the 30-d mortality rate and complications of hip fracture patients treated during COVID-19 pandemic and pre-pandemic times. Methods: The search of electronic databases on 1 Results: The pooled data of eight studies ( Conclusion: There was no difference in 30-d mortality rate between hip fracture patients treated during the pandemic and pre-pandemic periods. However, the mortality risk was higher in COVID-19 positive patients compared to COVID-19 negative patients. There was no difference in time to surgery, complications and hospitalization time between these two time periods.
Language	English
Publishing date	2021-01-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2649712-8
ISSN	2218-5836
ISSN	2218-5836
DOI	10.5312/wjo.v12.i1.35
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Article: CT based measurement of anatomical dimensions of femur and its relevance in nail designs for proximal femoral fractures.

Kulkarni, Mahesh / Naik A, Monappa / Shetty, Chethan B / Paruthikunnan, Samir M / Rao, Sharath K

Journal of orthopaedics

2019 Volume 20, Page(s) 63–69

Abstract: Introduction: The purpose of this study was to obtain computed tomography (CT) based measurements of femoral dimensions in adults, to identify its relevance with intramedullary nails used in the management of proximal femur fractures and to suggest a ... ...

Abstract	Introduction: The purpose of this study was to obtain computed tomography (CT) based measurements of femoral dimensions in adults, to identify its relevance with intramedullary nails used in the management of proximal femur fractures and to suggest a best fitting implant dimensions to our population. To best of our knowledge our study would be first to compile different CT based dimension in single study. Methods: In our retrospective study of 50 femurs, CT based femoral dimensions measured in standardized cuts and compared with previous studies and commonly available proximal femur intramedullary devices. Results: 68.4 was the mean age in our study, neck shaft angle (NSA) was 127.2±5.2 Conclusion: CT based dimensions in our population is different from other population. Based on this study, a design modification of nails used in present day management of proximal femur fractures has been recommended.
Language	English
Publishing date	2019-12-10
Publishing country	India
Document type	Journal Article
ZDB-ID	2240839-3
ISSN	0972-978X
ISSN	0972-978X
DOI	10.1016/j.jor.2019.12.002
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Article: Functional outcome of tibial fracture with acute compartment syndrome and correlation to deep posterior compartment pressure.

Goyal, Saumitra / Naik, Monappa A / Tripathy, Sujit Kumar / Rao, Sharath K

World journal of orthopedics

2017 Volume 8, Issue 5, Page(s) 385–393

Abstract: Aim: To measure single baseline deep posterior compartment pressure in tibial fracture complicated by acute compartment syndrome (ACS) and to correlate it with functional outcome.: Methods: Thirty-two tibial fractures with ACS were evaluated ... ...

Abstract	Aim: To measure single baseline deep posterior compartment pressure in tibial fracture complicated by acute compartment syndrome (ACS) and to correlate it with functional outcome. Methods: Thirty-two tibial fractures with ACS were evaluated clinically and the deep posterior compartment pressure was measured. Urgent fasciotomy was needed in 30 patients. Definite surgical fixation was performed either primarily or once fasciotomy wound was healthy. The patients were followed up at 3 mo, 6 mo and one year. At one year, the functional outcome [lower extremity functional scale (LEFS)] and complications were assessed. Results: Three limbs were amputated. In remaining 29 patients, the average times for clinical and radiological union were 25.2 ± 10.9 wk (10 to 54 wk) and 23.8 ± 9.2 wk (12 to 52 wk) respectively. Nine patients had delayed union and 2 had nonunion who needed bone grafting to augment healing. Most common complaint at follow up was ankle stiffness (76%) that caused difficulty in walking, running and squatting. Of 21 patients who had paralysis at diagnosis, 13 (62%) did not recover and additional five patients developed paralysis at follow-up. On LEFS evaluation, there were 14 patients (48.3%) with severe disability, 10 patients (34.5%) with moderate disability and 5 patients (17.2%) with minimal disability. The mean pressures in patients with minimal disability, moderate disability and severe disability were 37.8, 48.4 and 58.79 mmHg respectively ( Conclusion: ACS in tibial fractures causes severe functional disability in majority of patients. These patients are prone for delayed union and nonunion; however, long term disability is mainly because of severe soft tissue contracture. Intra-compartmental pressure (ICP) correlates with functional disability; patients with relatively high ICP are prone for poor functional outcome.
Language	English
Publishing date	2017-05-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2649712-8
ISSN	2218-5836
ISSN	2218-5836
DOI	10.5312/wjo.v8.i5.385
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Article ; Online: Arthroscopic Suture Pull-Out Fixation of Displaced Tibial Spine Avulsion Fracture.

Pandey, Vivek / Cps, Suman / Acharya, Kiran / Rao, Sharath K

The journal of knee surgery

2017 Volume 30, Issue 1, Page(s) 28–35

Abstract: The aim of this study is to assess the clinical and radiological outcomes of arthroscopic reduction and fixation of tibial spine avulsion in patients with either open physis or closed physis, using high strength nonabsorbable sutures utilizing ... ...

Abstract	The aim of this study is to assess the clinical and radiological outcomes of arthroscopic reduction and fixation of tibial spine avulsion in patients with either open physis or closed physis, using high strength nonabsorbable sutures utilizing intravenous cannula needle as suture passer and retriever. Twenty-six patients of mean age 24.5 years were included in the study with a mean follow-up period of 31 months. Twelve patients had McKeever type III avulsion fracture and 14 had type IV. A follow-up analysis was performed using fracture union time, range of motion assessment, and Lysholm and IKDC (International Knee Documentation Committee) scores with instrumental (KT-1000 arthrometer) laxity assessment. All avulsion fractures showed union at the end of a 3-month follow-up. Mean (± standard deviation [SD]) postoperative Lysholm and IKDC subjective scores were 97.7 (± 3.62, range, 89-100) and 95.55 (± 4.21, 82.8-100), respectively. All patients were graded IKDC grade A except one with grade B. The Lysholm score of open physis group was better than the closed physis group (99.6 vs. 96.5,
MeSH term(s)	Adolescent ; Adult ; Arthroscopy ; Child ; Female ; Follow-Up Studies ; Fractures, Avulsion/diagnostic imaging ; Fractures, Avulsion/surgery ; Growth Plate ; Humans ; Knee Joint/surgery ; Male ; Middle Aged ; Prospective Studies ; Radiography ; Range of Motion, Articular ; Suture Techniques ; Tibial Fractures/diagnostic imaging ; Tibial Fractures/surgery ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2017-01
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2075354-8
ISSN	1938-2480 ; 1538-8506 ; 0899-7403
ISSN (online)	1938-2480
ISSN	1538-8506 ; 0899-7403
DOI	10.1055/s-0036-1579682
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Article ; Online: Variables affecting functional outcome in floating knee injuries.

Kulkarni, Mahesh Suresh / Aroor, Monappa Naik / Vijayan, Sandeep / Shetty, Saurabh / Tripathy, Sujit Kumar / Rao, Sharath K

Injury

2018 Volume 49, Issue 8, Page(s) 1594–1601

Abstract: Background: The surgical outcome of floating knee injuries is difficult to predict. The high-velocity nature of the injury, complex fracture pattern and associated soft tissue/visceral injuries may have some impact on the functional outcome. The present ...

Abstract	Background: The surgical outcome of floating knee injuries is difficult to predict. The high-velocity nature of the injury, complex fracture pattern and associated soft tissue/visceral injuries may have some impact on the functional outcome. The present study evaluates the variables affecting the clinical and radiological outcomes of floating knee injuries. Materials and methods: The clinical, radiological and functional outcome (Karlstrom and Olegrud criteria) of 89 patients with 90 floating knee injuries were evaluated at the end of one year who were managed in our level 1 trauma center between January 2013 and December 2016. The details of the injury, fracture pattern, management and complications were collected retrospectively from their records. Results: There were 81 (91.1%) males and 8 (8.9%) females with mean age of 34.34 ± 12.28 years. The mean time for tibia and femur union was 9.52 (±6.6) and 10.5 (±7.37) months. There was significant delay (p < 0.005) in time taken for union in segmental femur fractures (14.3 ± 9.6 months) compared to nonsegmental femur fractures (8.68 ± 5.18 months). Such significant difference in time taken for union was not seen in tibial segmental (10.6 ± 4.62 months) and nonsegmental fractures (9.05 ± 7.27 months). As per the Karlstrom and Olegrud criteria, there were 22 (24.4%) excellent, 26 (28.9%) good, 24 (26.7%) fair and 11 (12.2%) poor outcome. There were 15 patients with malunited tibia, 6 with malunited femur, 10 with limb length discrepancy and 39 with knee stiffness. 28 (33.3%) patients underwent major additional procedures such as bone grafting, re-fixation or bone transport or tendon transfer. It was observed that open tibia fracture, segmental fracture, intra-articular fracture, additional surgical procedures, initial external-fixator (ex-fix) application were significantly associated with development of knee stiffness, limb shortening, malalignment and unsatisfactory (Karlstrom and Olegrud fair to poor) functional outcome. Conclusion: Open tibial fractures, segmental fractures, intraarticular involvement, additional surgical procedures and initial external fixator application are the poor prognostic indicators of floating knee injuries.
MeSH term(s)	Adult ; Female ; Femoral Fractures/complications ; Femoral Fractures/physiopathology ; Femoral Fractures/surgery ; Follow-Up Studies ; Fracture Fixation/methods ; Humans ; Joint Instability/diagnostic imaging ; Joint Instability/physiopathology ; Knee Injuries/physiopathology ; Knee Injuries/surgery ; Knee Joint/diagnostic imaging ; Knee Joint/physiopathology ; Male ; Middle Aged ; Prognosis ; Radiography ; Range of Motion, Articular/physiology ; Retrospective Studies ; Tibial Fractures/complications ; Tibial Fractures/physiopathology ; Tibial Fractures/surgery ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2018-06-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2018.05.019
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Zs.A 778: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Giant cell rich osteosarcoma of the cuneiforms.

Vijayan, Sandeep / Naik, Monappa A / Hameed, Shamsi Abdul / Rao, Sharath K

Journal of cancer research and therapeutics

2015 Volume 11, Issue 4, Page(s) 989–992

Abstract: Osteosarcoma is the commonest primary malignant bone tumor in children and adolescents. Giant cell rich osteosarcoma is a rare subtype of conventional osteosarcoma. Osteosarcomas commonly involve the metaphysis and meta-diaphysis of long bones. We report ...

Abstract	Osteosarcoma is the commonest primary malignant bone tumor in children and adolescents. Giant cell rich osteosarcoma is a rare subtype of conventional osteosarcoma. Osteosarcomas commonly involve the metaphysis and meta-diaphysis of long bones. We report a 19-year-old girl with giant cell rich osteosarcoma of the medial and intermediate cuneiform bones. Even though, giant cell rich osteosarcoma is frequently mistaken for osteoclastoma of the bone; age of onset, location of lesion, radiological features, and histological characteristics on a high power field helps to differentiate the two conditions. Appropriate and early diagnosis of this variant possibly averts severe morbidity and mortality to the patient. Nonmetastatic osteosarcomas in the foot have better prognosis and are amenable to limb salvage surgeries.
MeSH term(s)	Adolescent ; Adult ; Bone Neoplasms/pathology ; Female ; Giant Cell Tumor of Bone/pathology ; Humans ; Osteosarcoma/pathology ; Prognosis ; Young Adult
Language	English
Publishing date	2015-10
Publishing country	India
Document type	Case Reports ; Letter
ZDB-ID	2187633-2
ISSN	1998-4138 ; 0973-1482
ISSN (online)	1998-4138
ISSN	0973-1482
DOI	10.4103/0973-1482.157318
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Article ; Online: Cephalomedullary nails in the management of ipsilateral neck and shaft fractures of the femur--one or two femoral neck screws?

Vidyadhara, S / Rao, Sharath K

Injury

2009 Volume 40, Issue 3, Page(s) 296–303

Abstract: This was a prospective study of 43 consecutive cases of combined ipsilateral femoral neck and shaft fractures treated with cephalomedullary nails. Sequential clinicoradiological evaluation of all high-energy femoral shaft fractures to detect associated ... ...

Abstract	This was a prospective study of 43 consecutive cases of combined ipsilateral femoral neck and shaft fractures treated with cephalomedullary nails. Sequential clinicoradiological evaluation of all high-energy femoral shaft fractures to detect associated ipsilateral neck fracture improved diagnosis. All but 1 of 35 cases included in the study achieved union of both fractures and excellent or good functional outcome. Mean Harris Hip Score at the last follow-up was 92+/-4 in single-neck screw configurations, and 94+/-3 for two-neck screw cephalomedullary nails which had better tip-apex distance. Mean sliding of the neck screw was 5+/-2mm with single-neck and 3+/-2mm with two-neck screw constructs. In six cases shortening was <1cm; 22 had delayed union of the shaft fracture, but only four of these needed additional surgery. Early aggressive fixation of both fractures using a cephalomedullary nail with the least possible surgical trauma is the key to success in these polytrauma cases.
MeSH term(s)	Adult ; Bone Nails ; Female ; Femoral Fractures/diagnostic imaging ; Femoral Fractures/surgery ; Femoral Neck Fractures/diagnostic imaging ; Femoral Neck Fractures/surgery ; Fracture Fixation, Intramedullary/methods ; Humans ; Middle Aged ; Prospective Studies ; Radiography ; Treatment Outcome
Language	English
Publishing date	2009-03
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2008.08.009
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Zs.A 778: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: ACL reconstruction using femoral Rigid-fix and tibial Bio-intrafix devices.

Singh, Rahul / Tripathy, Sujit Kumar / Naik, Monappa A / Sujir, Premjit / Rao, Sharath K

Journal of clinical orthopaedics and trauma

2017 Volume 8, Issue 3, Page(s) 254–258

Abstract: Objectives: The objective of this study is to report the clinical and functional outcomes of Hamstring graft ACL reconstruction fixed with femoral Rigid-fix and tibial Bio-intrafix devices.: Methods: In a prospective study, the clinical (Lysholm ... ...

Abstract	Objectives: The objective of this study is to report the clinical and functional outcomes of Hamstring graft ACL reconstruction fixed with femoral Rigid-fix and tibial Bio-intrafix devices. Methods: In a prospective study, the clinical (Lysholm score) and functional outcomes (International Knee Documentation Committee, IKDC) of 44 patients who underwent autologus hamstring graft ACL reconstruction using femoral Rigid-fix and tibial Bio-intrafix devices, were evaluated at the end of one year. Joint laxity was assessed with KT-1000 arthrometer (MEDmetric, San Diego, CA). Results: None of the patients complained of instability, joint swelling or severe pain in the postoperative period. The IKDC score improved from 66.62 + 5.36 to 92.36 + 5.30 (P < 0.001). Lysholm scores in the preoperative and follow up period were 68.28 + 5.54 and 93.87 + 4.75 respectively; the improvement was statistically significant with P value < 0.001. Similarly, the mean anterior translation of tibia improved from 7.45 mm in the preoperative period to 3.89 mm after one year of ACL reconstruction. Associated meniscus injury didn't have significant impact on the overall outcome. No intraoperative or postoperative complications were documented. Conclusion: Hamstring graft fixation using femoral Rigid-fix and tibial Bio-intrafix devices provide secure graft fixation and allows aggressive rehabilitation. The clinical and functional outcome of this hybrid fixation technique is rewarding.
Language	English
Publishing date	2017-07-08
Publishing country	India
Document type	Journal Article
ZDB-ID	2596956-0
ISSN	2213-3445 ; 0976-5662
ISSN (online)	2213-3445
ISSN	0976-5662
DOI	10.1016/j.jcot.2017.06.021
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