Fixation of Superomedially Displaced Acetabular Fractures Using an Anatomical Suprapectineal Quadrilateral Surface Plate Through Modified Stoppa Approach

Treatment of superomedially displaced acetabular fractures including a quadrilateral surface (QLS) is challenging. We present a surgical technique using an anatomical suprapectineal QLS plate through the modified Stoppa approach and report the availability of this plate to treat this fracture type along with the surgical outcomes. Thirteen consecutive patients (11 men and 2 women) who underwent surgical treatment using an anatomical suprapectineal QLS plate through a modified Stoppa approach for superomedially displaced acetabular fractures between June 2018 and June 2020, were enrolled retrospectively. These fractures included 10 both-column fractures and 3 anterior-column and posterior hemitransverse fractures, which were confirmed on preoperative 3-dimensional computed tomography. Surgical outcomes were clinically assessed using the Postel Merle d’Aubigné (PMA) score and visual analog scale (VAS) score at the final follow-up, and radiological evaluations were performed immediately after the operation and at the final follow-up. The follow-up period was longer than 1 year in all patients with a mean 22.9 months. The mean operation time was 103 min. Anatomical reduction was achieved in 11 (84.6%) patients, while imperfect reduction was achieved in the remaining two (15.3%) patients. At the final follow-up, radiographic grades were excellent, fair, and poor in 11 (84.6%), one (7.6%), and one patient, respectively. The mean PMA score was 16.3 (range, 13-18) and the mean VAS score was 1.0 (range, 0-3). No secondary reduction loss or implant loosening was observed. However, two patients underwent conversion to total hip arthroplasty due to post-traumatic arthritis and subsequent joint pain. No other complications were observed. Simultaneous reduction and fixation using an anatomical suprapectineal QLS plate through the modified Stoppa approach can provide satisfactory outcomes in superomedially displaced acetabular fractures, resulting in shorter operation times and fewer complications.

STUDY OF SYNOVIAL FLUID IN DIAGNOSIS OF JOINT DISEASES IN A TEACHING HOSPITAL

Background: Analysis of synovial uid has been recommended as a routine procedure to assist in the diagnosis of arthritis. Arthritis can be either a monoarticular or polyarticular lesion leading to morbidity, affecting all ages . Aim of the study: To study synovial uid analysis in the diagnosis of joint diseases in a teaching hospital. Materials and methods: Prospective study was done on synovial uid samples over a period of two years at the Department of Pathology. ACS medical college ,Chennai for duration of 6 months ie, from February 2021 to August 2021. Results: Majority of the cases were osteoarthritis constituting 33.3 % .Rheumatoid arthritis constituted 20%..Chronic nonspecic synovitis were noted in 30% cases .01 case of Traumatic arthritis and 02 cases of Tubercular arthritis were noted. Conclusion: Synovial uid analysis will give us an idea about the differential diagnosis of joint diseases. Synovial uid aspiration should be done for the analysis and also used as a treatment procedure of synovial inammation.

Treatment of the Temporomandibular Joint Arthritis

Temporomandibular joint (TMJ) arthritis is an inflammatory process in the TMJ. It`s more common in young and middle-aged people. Among the reasons of the TMJ arthritis development may be the following: local infection (periodontal disease, gingivitis, stomatitis, otitis, tonsillitis, osteomyelitis of the jaw, etc.), general infectious diseases (acute respiratory infections, influenza, pneumonia, dysentery, tuberculosis, syphilis, etc.), allergic diseases, traumatic effects, etc. Para-allergic factors contribute to the onset of TMJ inflammatory processes (hypothermia, overheating, etc.), changes in the endocrine and nervous systems, foci of chronic infection (especially in the oral cavity), etc. The purpose of this pare is to determine the effectiveness of the use of the non-steroidal anti-inflammatory drug “Nimesil” in the complex treatment of acute arthritis of the TMJ. We observed 64 patients in age from 24 to 65 years who were diagnosed with acute post-traumatic arthritis of the TMJ. Patients were divided into 2 observation groups: 1st group (the main one) – 31 patients who were treated with the nonsteroidal anti-inflammatory drug “Nimesil” and 2nd group (the control one) – 33 patients who were prescribed treatment, including the use of a nonsteroidal anti-inflammatory drug “Indomethacin.” The duration of the treatment was 7-8 days. After the relieving of acute inflammation, according to indications, prosthetic treatment was carried out. Treatment was carried out in 64 patients with acute post-traumatic arthritis of the temporomandibular joints by comparative use of various non-steroidal anti-inflammatory drugs in different observation groups. It has been proved that the drug “Nimesil” has a more expressed analgesic, antiinflammatory and antipyretic effect, and also has a significantly smaller number of side effects compared to the drug “Indomethacin.”

1001 Intra-Articular Distal Radius Fracture Surgical Intervention Threshold Origins and Development

Background Treatment of intra-articular distal radius fractures is guided by the displacement of the articular fragments. Symptomatic post-traumatic arthritis is expected to occur if step displacement is > 2mm; this value is often used as an indication for surgery if closed reduction is not possible. Method A systematic review was performed to establish the origin and adaptations of the threshold, with papers screened and relevant citations reviewed. Orthopaedic textbooks were reviewed to ensure no earlier mention of the threshold was present. Results Knirk and Jupiter, 1986, are the first to quantify a threshold, with all their patients developing arthritis with >2mm displacement. Some papers have discussed using 1mm, although 2mm is most widely reported. Current guidance from the British Society for Surgery of the Hand supports 2mm. Although this paper is still widely cited, the authors published a re-examination of the data showing methodological flaws which is not as widely reported. They claim their conclusions are still relevant today; however, the radiological arthritis does not correlate with the clinical presentation. Conclusions Knirk and Jupiter originated the threshold value of 2mm. The lack of correlation between the radiological and clinical presentations warrants further investigation. The principle of treatment remains restoration of normal anatomical position.