Browsing by Author "Surana, Rishabh"

Now showing 1 - 4 of 4
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    Biological Stabilisation vs Mechanical Fixation: Do We Always Require Instrumentation in Anterior Decompression Surgeries for Thoracolumbar Spinal Tuberculosis?
    (Springer, 2023) Singh, Saurabh; Iyer, R Dinesh; Rai, Alok; Gi, Siddalingeshwara; Sharma, Divyansh; Surana, Rishabh
    Study Design: A retrospective cohort study. Purpose: To compare the outcomes of anterior decompression with bone grafting alone and anterior decompression with bone grafting and fixation. Methods: 93 patients with minimum 2�year follow-up were included in the study. 50 patients had undergone anterior decompression with bone grafting without instrumentation (group 1) and 43 patients with instrumentation (group 2). Both groups were compared using their demographic data, vertebral level of involvement, neurological recovery and progression of kyphotic deformity. Results: Demographic data and pre-operative parameters were comparable in both groups. The mean (SD) of pre-operative kyphotic angle (in degrees) in group 1 was 29� (8.47�) and in group 2 was 29.81� (9.51�). The mean loss of correction at follow-up was 9.6� for group 1 compared to 3.4� for group 2. The mean loss of correction in patients of group 1 involving upper thoracic spine was 5.6�. There was no significant difference between the two groups across different age groups. Conclusion: Use of anterior instrumentation for decompression surgeries in cases of tubercular spine have shown significantly better results compared to strut grafting alone with respect to restricting the progression of kyphotic deformity at follow-up. Instrumentation may be avoided in patients older than 60�years of age and those involving the upper thoracic spine, more so if both of these co-exist. However, further studies are needed to make our patient selection more rational, so as to avoid the failures and complications of this morbid procedure. � 2023, Indian Orthopaedics Association.
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    Joint preservation surgery in grade 2 and 3 giant cell tumors of bone around the knee
    (EDP Sciences, 2021) Singh, Saurabh; Rai, Alok; DInesh Iyer, R; Surana, Rishabh; Sharma, DIvyansh
    Objective: To evaluate the clinical and functional outcomes of joint preservation surgery in high-grade giant cell tumors (GCT) around the knee joint. Methods: A retrospective review of 25 patients of high-grade GCT (Campanacci grade 2 and 3) involving proximal tibia or distal femur managed by extended curettage, bone grafting, and stabilization with knee spanning external fixator between 2016 and 2018 was done. The radiographic outcomes, functional outcomes (Musculoskeletal Tumor Society [MSTS] score for lower limb), and complications including donor site morbidity were evaluated. Results: The mean age of the patient population was 24.04 years with an average follow-up period of 30.24 months. Fourteen patients had involvement of distal femur, and 11 involved proximal tibia. There were 16 cases of grade 2 lesions and 9 cases of grade 3 lesions. Twenty-four out of the 25 patients had radiological consolidation of graft, while one patient had graft subsidence. Twenty-two out of 25 patients had full extension and knee flexion more than 100 degrees. The mean MSTS score was 25.2. Three patients had an MSTS score under 20. All three patients had an extension lag with a restricted range of motion. Conclusion: Joint preservation surgery, when done in line with the basic principles of tumor surgery, gives good radiographic and functional outcomes even in grade 2 and 3 giant cell tumors of bone around the knee and should be attempted before replacement surgeries. � The Authors, published by EDP Sciences, 2021.
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    Letter to the editor on the study �Dynamic hip screw fixation of subtrochanteric femoral fractures�
    (Springer-Verlag Italia s.r.l., 2022) Iyer, R. Dinesh; Rai, Alok; Sharma, Divyansh; Surana, Rishabh
    [No abstract available]
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    Outcome Analysis of Fixed Angle Locking Plate in Patella Fractures: A Single Centre Experience from North India
    (Springer, 2021) Singh, Saurabh; Surana, Rishabh; Rai, Alok; Sharma, Divyansh
    Background: Tension band wiring supposedly is the most commonly used technique for displaced patella fractures, but is not effective in comminuted fractures and osteoporotic bones. It often leads to loosening of wires, dislocation of fracture, hardware problem and failure of osteosynthesis, resulting in knee stiffness and post-traumatic osteoarthritis. The aim of the study is to evaluate clinical outcome in patients with acute patella fractures (< 3�week) treated with unidirectional angle fixed low-profile titanium patella locking plate. Materials and methods: Twenty patients who presented with displaced patella fractures, aged between 18�70�years were included in the study. All fractures were reduced and fixed with unidirectional angle fixed stable low-profile titanium patella locking plate. Knee Range of motion and Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL) was used to evaluate the outcome. Results: We were able to achieve union in 19 out of 20 patients. One patient with comminuted patella fracture had failure of fixation, which was revised. Mean flexion at final follow-up was 124� (110��130�) and none of the patients had extensor lag. The final radiograph revealed complete union in all patients. Conclusion: This technique offers an option of fixation in comminuted patella fracture and in osteoporotic individuals. It provides mechanical stability for fracture fixation resulting in anatomical reduction, good functional outcome, lower incidence of symptomatic implant or failure of osteosynthesis. � 2020, Indian Orthopaedics Association.