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  1. Article ; Online: Case of bilateral hip joint Charcot arthropathy in a paediatric patient.

    Hegde, Atmananda / Kamath, Shruthi H / Mane, Prajwal Prabhudev / Shetty, Chethan B

    BMJ case reports

    2023  Volume 16, Issue 1

    Abstract: An adolescent girl came with swelling of both thighs with difficulty in walking for a few months. Based on clinical, and radiological evaluation and nerve conduction studies, she was diagnosed to be having bilateral hips Charcot's arthropathy due to ... ...

    Abstract An adolescent girl came with swelling of both thighs with difficulty in walking for a few months. Based on clinical, and radiological evaluation and nerve conduction studies, she was diagnosed to be having bilateral hips Charcot's arthropathy due to hereditary sensory autonomic neuropathy type 4. Other common causes of Charcot arthropathy were ruled out. The patient was conservatively managed and parents were educated about preventive measures. Through this case report, we want to highlight the myriad number of manifestations and clinical presentations of a child presenting with hereditary sensory autonomic neuropathy type 4.
    MeSH term(s) Female ; Adolescent ; Humans ; Child ; Peripheral Nervous System Diseases/complications ; Hereditary Sensory and Autonomic Neuropathies ; Radiography ; Arthropathy, Neurogenic/diagnostic imaging ; Arthropathy, Neurogenic/etiology ; Hip Joint/diagnostic imaging
    Language English
    Publishing date 2023-01-02
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2022-252420
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Comparison of Posterior and Lateral Surface Plating for Type B Weber Lateral Malleoli Fractures.

    Hegde, Atmananda / Shetty, Chethan / Joseph, Nitin / Mane, Prajwal

    Foot & ankle specialist

    2022  Volume 17, Issue 2, Page(s) 155–161

    Abstract: Purpose: The purpose of this study is to compare the functional outcomes, radiological outcomes, complication rates, and hardware removal between lateral and posterior surface plating in isolated type B Weber lateral malleolus fractures.: Methods: It ...

    Abstract Purpose: The purpose of this study is to compare the functional outcomes, radiological outcomes, complication rates, and hardware removal between lateral and posterior surface plating in isolated type B Weber lateral malleolus fractures.
    Methods: It was a retrospective study that compared the outcomes of type B Weber lateral malleoli fractures treated by either lateral surface or posterior surface plating. Radiological and functional outcomes were assessed at regular intervals. The follow-up details and the complications and need for implant removal were collected from the hospital records.
    Results: Our study included 60 patients (male-35 and female-25). The mean age was 41.7 ± 10.5 years. In all, 28 (46.7%) patients received lateral surface plating and 32 (53.3%) patients received posterior surface plating. The mean time gap between the injury and the surgery was significantly more among patients who underwent lateral plate insertion (
    Conclusion: Posterior surface plating can be considered as the procedure of choice for isolated type B Weber lateral malleolus fractures with respect to better functional outcome, lesser complications rates, and need for implant removal.
    Level of evidence: Level III: Economic/decision.
    MeSH term(s) Humans ; Bone Plates ; Male ; Female ; Retrospective Studies ; Adult ; Fracture Fixation, Internal/methods ; Fracture Fixation, Internal/instrumentation ; Middle Aged ; Ankle Fractures/surgery ; Ankle Fractures/diagnostic imaging ; Treatment Outcome
    Language English
    Publishing date 2022-02-22
    Publishing country United States
    Document type Journal Article ; Comparative Study
    ZDB-ID 2488579-4
    ISSN 1938-7636 ; 1938-6400
    ISSN (online) 1938-7636
    ISSN 1938-6400
    DOI 10.1177/19386400221079197
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 7037: Show issues Location:
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  3. Article ; Online: Neurogenic heterotopic ossificans of hips in a case of expanded dengue syndrome following critical illness polyneuropathy.

    Hegde, Atmananda / Mane, Prajwal Prabhudev / Shetty, Chethan B / Thakkar, Samarth Ajay

    BMJ case reports

    2022  Volume 15, Issue 3

    Abstract: We present a case of 71-year-old man with bilateral hip neurogenic heterotopic ossificans following critical illness polyneuropathy as a complication of expanded dengue syndrome. His left hip was stiff and showed a circumferential ossific mass. After ... ...

    Abstract We present a case of 71-year-old man with bilateral hip neurogenic heterotopic ossificans following critical illness polyneuropathy as a complication of expanded dengue syndrome. His left hip was stiff and showed a circumferential ossific mass. After initial medical management, the patient underwent excision of ossific mass using posterior approach. For adequate excision, femoral head and neck were resected and a hybrid total hip arthroplasty was performed. The patient was followed up for 2 years and showed good clinical outcome without recurrence of heterotopic ossification. This case highlights the rare aetiology of neurogenic heterotopic ossification which is critical illness polyneuropathy following expanded dengue syndrome. It highlights that adequate resection and a total hip arthroplasty can be a viable option in selected cases of circumferential heterotopic ossification in old individuals.
    MeSH term(s) Aged ; Arthroplasty, Replacement, Hip/adverse effects ; Dengue/complications ; Hip Joint/surgery ; Humans ; Male ; Ossification, Heterotopic/complications ; Ossification, Heterotopic/surgery ; Polyneuropathies/etiology
    Language English
    Publishing date 2022-03-09
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2021-246186
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: A comparative analysis of distal locked and unlocked long proximal femoral nail antirotation (PFNA-II) in the fixation of stable intertrochanteric fractures.

    Hegde, Atmananda / Khanna, Vikrant / Mane, Prajwal / Shetty, Chethan / Joseph, Nitin

    Chinese journal of traumatology = Zhonghua chuang shang za zhi

    2022  Volume 26, Issue 2, Page(s) 111–115

    Abstract: Purpose: Long proximal femoral nail anti-rotation (PFNA-II) is a preferred implant in recent years for fixation of pertrochanteric fractures, especially in osteoporotic patients. The purpose of this study is to prospectively investigate the effect of ... ...

    Abstract Purpose: Long proximal femoral nail anti-rotation (PFNA-II) is a preferred implant in recent years for fixation of pertrochanteric fractures, especially in osteoporotic patients. The purpose of this study is to prospectively investigate the effect of distal locking in long PFNA-II fixation of stable intertrochanteric fractures.
    Methods: A total of 58 patients with isolated stable intertrochanteric fractures and treated in our hospital during the study period of 2017-2019 by distal locked or unlocked long PFNA-II fixation were included in this study. Patients who had multiple injuries or open fractures were excluded. There were 40 female and 18 male patients, with 33 affecting the left side and 25 the right side. Of them, 31 belonged to the distal locked group (group A) and 27 to the unlocked group (group B). Surgical procedures and implants used in both groups were similar except for the distal locking of the nails. General data (age, gender, fracture side, etc.) showed no significant difference between two groups (all p > 0.05). The intraoperative parameters like operative time, radiation exposure and follow-up parameters like functional and radiological outcomes were recorded and compared. Statistical tests like the independent samples t-test Fischer's exact and Chi-square test were used to analyze association.
    Results: The distribution of the fractures according to AO/OTA classification and 31A1.2 type of intertrochanteric fractures were most common in our study. All the included fractures united and the average functional outcome in both groups were good and comparable at the end of one year. The operative time (mL, 107.1 ± 12.6 vs. 77.0 ± 12.0, p < 0.001) and radiation exposure (s, 78.6 ± 11.0 vs. 40.3 ± 9.3, p < 0.001) were significantly less among the patients in group B. Fracture consolidation, three months after the operative procedures, was seen in a significantly greater proportion of patients in group B (92.6% vs. 67.7%, p = 0.025). Hardware irritation because of distal locking bolt was exclusively seen in group A, however this was not statistically significant (p = 0.241).
    Conclusion: We conclude that, in fixation of stable intertrochanteric fractures by long PFNA-II nail, distal locking not only increases the operative time and radiation exposure but also delays the fracture consolidation and increases the chances of hardware irritation, and hence is not required.
    MeSH term(s) Humans ; Male ; Female ; Fracture Fixation, Intramedullary/methods ; Bone Nails ; Treatment Outcome ; Retrospective Studies ; Hip Fractures/surgery ; Hip Fractures/etiology ; Femoral Fractures/etiology
    Language English
    Publishing date 2022-12-14
    Publishing country China
    Document type Journal Article
    ZDB-ID 2276839-7
    ISSN 1008-1275
    ISSN 1008-1275
    DOI 10.1016/j.cjtee.2022.12.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6507: Show issues Location:
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  5. Article: Preoperative estimation of humerus intramedullary nail length using clinical landmarks.

    Hegde, Atmananda S / Shetty, Chethan B / Joseph, Nitin / Mane, Prajwal / Thakkar, Samarth

    Chinese journal of traumatology = Zhonghua chuang shang za zhi

    2023  Volume 26, Issue 5, Page(s) 256–260

    Abstract: Purpose: Intramedullary interlocking nailing is one of the accepted methods of treating humerus diaphyseal fractures. Appropriate nail length and diameter are of paramount importance to achieve a stable fracture fixation. Estimating the nail length can ... ...

    Abstract Purpose: Intramedullary interlocking nailing is one of the accepted methods of treating humerus diaphyseal fractures. Appropriate nail length and diameter are of paramount importance to achieve a stable fracture fixation. Estimating the nail length can be as challenging in certain cases as it is important. This study aims to provide an easy-to-use formula utilizing clinical measurements from contra lateral arm to accurately estimate humeral nail length.
    Methods: This descriptive cross-sectional study was conducted at 3 tertiary care hospitals in Mangalore, India. Patients above the age of 18 years coming to the outpatient department with elbow, shoulder or arm complaints requiring radiological investigation from July 2021 to July 2022 were included. Patients with fractures or dislocations of upper limbs, malunited or non-united fractures of upper limbs, congenital or developmental deformities and patients with open growth plates were excluded. Patients' variables (like age and gender), radiological humerus length and contralateral arm clinical measurements were recorded. An independent samples t-test was used for univariate analysis, and linear regression analysis was done to estimate the desired nail length using the clinical measurement of the humerus (cm) in both genders separately. The significance level was set at p < 0.05.
    Results: Our study included 204 participants of which 108 were male and 96 were female. The formula for predicting humeral nail length in males is (-2.029) + (0.883 × clinical measurement). The formula for females is 1.862 + (0.741 × clinical measurement). A simplified formula to determine humeral nail length is 0.9 clinical length - 2 cm (in males) and 0.7 × clinical length + 2 cm (in females).
    Conclusion: To improve the stability of fixation with intramedullary nails it is imperative to select the appropriate nail length. There have been studies that devised reliable methods of determining nail lengths in the tibia and femur using preoperative clinical measurements. A similar clinical method of determining humeral nail length is lacking in the literature. Our study was able to correlate radiological lengths of the humerus medullary canal with clinical measurements performed using anatomical landmarks to arrive at a formula. This allows for a reliable and easy nail length determination preoperatively.
    MeSH term(s) Humans ; Male ; Female ; Adolescent ; Cross-Sectional Studies ; Bone Nails ; Humerus/diagnostic imaging ; Humerus/surgery ; Fracture Fixation, Intramedullary/methods ; Humeral Fractures/diagnostic imaging ; Humeral Fractures/surgery ; Treatment Outcome
    Language English
    Publishing date 2023-06-07
    Publishing country China
    Document type Journal Article
    ZDB-ID 2276839-7
    ISSN 1008-1275
    ISSN 1008-1275
    DOI 10.1016/j.cjtee.2023.06.001
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    Zs.A 6507: Show issues Location:
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  6. Article: "Screw First" Technique to Get Past Nail-Jig Mismatch in Proximal Femoral Nailing.

    Hegde, Atmananda S / Mane, Prajwal P / Shetty, Chethan B / Thakkar, Samarth A

    Indian journal of orthopaedics

    2021  Volume 56, Issue 4, Page(s) 699–704

    Abstract: Proximal femoral nailing is the gold standard of surgical treatment for unstable intertrochanteric hip fractures. One of the intraoperative complications encountered in this procedure is the nail-jig mismatch due to causes such as manufacturing errors ... ...

    Abstract Proximal femoral nailing is the gold standard of surgical treatment for unstable intertrochanteric hip fractures. One of the intraoperative complications encountered in this procedure is the nail-jig mismatch due to causes such as manufacturing errors and fatigue deformation of sleeves or jig. Nail-jig mismatch leads to eccentric placement of guidewire within the screw slots of PFN and subsequent difficulty in reaming and screw insertion. The potential complications of this include guide wire deformation, breakage, nail damage and screw malposition. We propose a simple and effective technique to tackle this complication, called as "Screw first" technique. The principle of this technique is to utilize screws as guide wire sleeves to effectively centralize the guidewire position within nail slots. On identifying a mismatch by the eccentric position of guidewire, a long screw is first inserted partially till its shaft engages into the screw slot allowing subsequent insertion of a guidewire which assumes a centralized position, thus bypassing the mismatch of jig. Following this, the usual steps of reaming and final screw insertion are undertaken. This method is effective, simple, quick and requires no special instrumentation.
    Language English
    Publishing date 2021-11-08
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 603194-8
    ISSN 0019-5413
    ISSN 0019-5413
    DOI 10.1007/s43465-021-00552-w
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    Zs.A 1720: Show issues Location:
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  7. 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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