Mohr Borg (securepuffin8)
Early detection of disease and with conservative treatment resulted in complete remission and minimal long term disability. Diagnosing sternoclavicular tuberculosis requires multimodal approach. A strong clinical suspicion is required as the presentation is often atypical. Early detection of disease and with conservative treatment resulted in complete remission and minimal long term disability. To determine the preferred practices in the treatment of slipped capital femoral epiphysis (SCFE) among members of the Paediatric Orthopaedic Society of India (POSI). A questionnaire with 16 vignettes was made about SCFE and sent to all members of the Paediatric Orthopaedic Society of India (POSI) to study the similarity and variation in the management of SCFE. Specifically, respondents were asked about the role of reduction, methods of fixation, prophylactic fixation of the non-affected hip, postoperative management and their view on the prevalence of Femoro Acetabular Impingement (FAI) and anticipated need for secondary surgery. The response rate was 94 out of 203 members of Paediatric Orthopaedic Surgeons of India (51.9%). 62 out of 94 (66%) participating surgeons had an exclusive paediatric orthopaedics workload, with 61 surgeons (65%) having more than ten years of experience. Seventy-eight surgeons (83%) were most consistent in their advice for the management of stable slips based on severity. For enerate high-quality evidence based on meagre numbers. This clearly shows that there is a need for developing a national SCFE registry to pool in all data which would help us to arrive at meaningful conclusions to arrive at the ideal management guidelines for SCFE. Our study documents that about 70% of the practising paediatric orthopaedic surgeons prefer to do capital realignment procedure for severe stable slips. The treatment of unstable slips remains controversial without any consensus though about 70% believe that there is a role of gentle reduction or positional reduction or skeletal traction. About 50% of the respondents treat less than five slips a year and thus would not possible to generate high-quality evidence based on meagre numbers. This clearly shows that there is a need for developing a national SCFE registry to pool in all data which would help us to arrive at meaningful conclusions to arrive at the ideal management guidelines for SCFE. The reduction and fixation of femoral neck fractures is mainly an indirect one with intraoperative fluoroscopy being trusted for the safe containment of screws within the bony limits of the femoral neck. Radiologically undetected bony perforations may have an impact on the fracture stability and radiological outcomes that have not been studied previously. The purpose of this computed tomography (CT) based study is to analyze the safety of containment of triple screw configurations using standard 6.5mm diameter screws for fixation of femoral neck fractures in the Indian population using a software-based analysis. Data from consecutive CT scans with intact proximal femur performed over a six month period were retrospectively analyzed using iPlan® BrainLab AG, Feldkirchen, Germany. The safe containment of virtual screw trajectories placed in inverted triangular and non-inverted triangular configurations for a 6.5mm diameter screw was analyzed in intact femoral necks. A total of 72 cases were considered forof fluoroscopically undetected violation of the bony margins. Replacement of one of the two superior screws with a 4.5mm diameter screw can be helpful in such cases. Inverted triangular configuration is a relatively safer configuration compared to the non-inverted triangular configuration. Standard triple 6.5 mm screws for fixation of femoral neck fractures carry a risk of bony violation, especially in females. A preoperative radiographic assessment to screen the cases with narrow vertical and anteroposterior extent