Papers by Atin Kumar Kundu
Indian Journal of Orthopaedics Surgery, Sep 15, 2018
Introduction: Intertrochanteric hip fractures are common with advancing age. PFN is now increasin... more Introduction: Intertrochanteric hip fractures are common with advancing age. PFN is now increasingly used to fix unstable intertrochantric fractures however it does not fix greater trochanter. Gluteus medius and gluteus minimus attach to greater trochanter, hence abductor weakness is a likely consequence. In this study we measured the incidence of post operative abductor weakness (trendelenberg gait) and result of targeted physiotherapy on it. Materials and Methods: Between September 2014 and august 2016, 45 patients with unstable intertrochanteric fractures underwent proximal femoral nailing in the Department of Orthopaedics Pt. J. N. M Medical College and Dr. B.R.A.M Hospital, Raipur (C.G.). The patients included in this study were more than 18 years of age with unstable fractures classified according to Modified Evans classification type 3, 4 and 5 with the duration of trauma less than 3 weeks. The functional assessment was made using Mckay criteria through analysis of abductor muscle strength. Result: Immediate Postoperative muscle power was Grade 1 (02 pt.), Grade 2 (27 pt.), and Grade 3 (14 pt.). At 6 months follow up only 02 patients had grade 4 power (due to varus malunion) rest all had muscle power Grade 5. In this study we found that only 2 out of 45 patients (4.4%) had initial abductor power grade 1, grade 2-64.4% and rest had grade 3 muscle power. Only 2 patient (due to varus malunion) had grade 4 power at 6 months follow-up rest all patients regained power grade 5. Conclusion: Abductor weakness and trendelenberg gait are fairly common in patients treated with PFN and this complaint is often overlooked. Abductor muscle power should be properly assessed post-operatively and physiotherapy for abductor weakness is essential for complete rehabilitation of patients.
Indian Journal of Orthopaedics, 2013
Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi. It usually ... more Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi. It usually affects the mucocutaneous tissue of the nose. Bone involvement is rare. We report a case of Rhinosporidiosis of the nasopharynx which later involved the right little finger where ray amputation was performed.
Background: Distal tibial fractures including tibial pilon present a challenge as to their best m... more Background: Distal tibial fractures including tibial pilon present a challenge as to their best method of management due to subcutaneous location of larger portion of tibia, paucity of soft tissue coverage and precarious blood supply of distal leg. MIPO (Minimal invasive plating osteosynthesis) has evolved as a newer concept to treat distal tibial fractures with minimal articular comminution and minimal soft tissue damage. It works on Biological fixation principle which assists physiological process of bone healing wisely with minimal operative intervention.
Method: A prospective study for the management of distal tibial fractures by MIPO technique by using pre-contoured metaphyseal LCP (locking compression plate) was done, in 20 patients, between January 2012 and October 2013. Fractures were classified as per AO system and patients were followed and scored according to TEENY and WISS clinical scoring criteria.
Result: Among 20 patients operated, there were 15 males and 5 females with a mean age of 38.95yrs (range from20-67yrs). 17 patients sustained extra-articular fractures (type A), 02 partial-articular fractures (type-B) and 01 total-articular fracture (type-C). High energy trauma (road traffic accident) predominated causing 13 fractures. Average trauma surgery interval was 12 days (02-22days). Patients were followed minimum for 6 months (range 06-18 months). Superficial wound infections were seen in 02 cases, surgical wound breakdown with implant exposure in 01 case and prominent hardware in 01 case. 17 patients (85%) had excellent/good outcome and 03 cases with complications had fair (02 cases) to poor (01 case) outcome.
Conclusion: MIPO is an effective and safe technique for the management of distal tibial fractures without intra-articular comminution and minimum soft tissue damage. It preserves bone biology by maintaining balance between devascularisation and mechanical perfection. Further studies with longer follow-up and large sample size are warranted.
Key Words: Distal tibia, MIPO technique, Locking Compression Plates (LCP), Tibial pilon
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Papers by Atin Kumar Kundu
Method: A prospective study for the management of distal tibial fractures by MIPO technique by using pre-contoured metaphyseal LCP (locking compression plate) was done, in 20 patients, between January 2012 and October 2013. Fractures were classified as per AO system and patients were followed and scored according to TEENY and WISS clinical scoring criteria.
Result: Among 20 patients operated, there were 15 males and 5 females with a mean age of 38.95yrs (range from20-67yrs). 17 patients sustained extra-articular fractures (type A), 02 partial-articular fractures (type-B) and 01 total-articular fracture (type-C). High energy trauma (road traffic accident) predominated causing 13 fractures. Average trauma surgery interval was 12 days (02-22days). Patients were followed minimum for 6 months (range 06-18 months). Superficial wound infections were seen in 02 cases, surgical wound breakdown with implant exposure in 01 case and prominent hardware in 01 case. 17 patients (85%) had excellent/good outcome and 03 cases with complications had fair (02 cases) to poor (01 case) outcome.
Conclusion: MIPO is an effective and safe technique for the management of distal tibial fractures without intra-articular comminution and minimum soft tissue damage. It preserves bone biology by maintaining balance between devascularisation and mechanical perfection. Further studies with longer follow-up and large sample size are warranted.
Key Words: Distal tibia, MIPO technique, Locking Compression Plates (LCP), Tibial pilon
Method: A prospective study for the management of distal tibial fractures by MIPO technique by using pre-contoured metaphyseal LCP (locking compression plate) was done, in 20 patients, between January 2012 and October 2013. Fractures were classified as per AO system and patients were followed and scored according to TEENY and WISS clinical scoring criteria.
Result: Among 20 patients operated, there were 15 males and 5 females with a mean age of 38.95yrs (range from20-67yrs). 17 patients sustained extra-articular fractures (type A), 02 partial-articular fractures (type-B) and 01 total-articular fracture (type-C). High energy trauma (road traffic accident) predominated causing 13 fractures. Average trauma surgery interval was 12 days (02-22days). Patients were followed minimum for 6 months (range 06-18 months). Superficial wound infections were seen in 02 cases, surgical wound breakdown with implant exposure in 01 case and prominent hardware in 01 case. 17 patients (85%) had excellent/good outcome and 03 cases with complications had fair (02 cases) to poor (01 case) outcome.
Conclusion: MIPO is an effective and safe technique for the management of distal tibial fractures without intra-articular comminution and minimum soft tissue damage. It preserves bone biology by maintaining balance between devascularisation and mechanical perfection. Further studies with longer follow-up and large sample size are warranted.
Key Words: Distal tibia, MIPO technique, Locking Compression Plates (LCP), Tibial pilon