Welcome to Journal Of Pakistan Medical Association

 Supplement Vol:64, No:12 December, 2014

Editorial >>

Editorial

Dear colleagues,

Assalam-o-Alaikum

Today we have created history. The scientific committee of Pak Orthocon 2014 is delighted to present this special issue of JPMA. It has published manuscripts of all our accepted papers for O....

Original Article >>

Effect of teriparatide on bone regenerate after distraction osteogenesis

Masood Umer, Tashfeen Ahmad, Sadia Habib, Rasham Rehman, Irfan Qadir, Mahmood Ahmed,

Objective: To determine the effect of teriparatide on new bone formation in a rat model of distraction osteogenesis.
Methods: The experimental study was conducted at the Aga Khan University Hospital, Karachi, in November-December 2010, and comprised male Sprague-Dawley rats w....

Anthropomorphic mismatch between distal femurs and a standard total knee replacement system in Pakistani population

Syed Akmal Sultan, Muhammad Zeeshan Aslam, Syed Ali Anwer Jillani, Muhammad Amin Chinoy, Mansoor Ali Khan, Syed Kamran Ahmed,

Aims: To compare the measurements of distal femurs of a Pakistani population and with the implants used.
Methods: The single-centre prospective cross-sectional study was conducted at the Indus Hospital, Karachi, from 01-06-2011 to 31-10-2011, and comprised total knee replacem....

Decreased bone mineral density and associated risk factors in hospital visiting people of Islamabad

Muhammad Sarfraz Gul, Shahida Tasneem, Shaukat Hayat Khan, Taqdees Iftikhar, Naveed Gul, Jehan Zaib Shah,

Objective: Besides aging there are multiple factors involved in decreasing Bone Mineral Density. Knowing the burden of the diseaseand its related factors in our population can help better treat this. Therefore, our objective was to identify subjects with low Bone Mineral Density (BMD) and ....

Use of distally based random flap in the management of soft tissue defects in upper two thirds of leg

Haroon-ur-Rashid, Kamran Hafeez, Kashif Abbas,

Objective: To assess the results of cases with complex wounds exposing tibia who were managed with distally based random flaps.
Methods: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and Dow University Hospital, Karachi and comprised data bet....

Malrotation after reamed intramedullary nailing with and without a fracture table for closed fractures of the femoral shaft

Rizwan Haroon Rashid, Akbar Jaleel Zubairi, Masood Umer,

Introduction: To observe the effect of the choice of surgical table on the incidence of malrotation.
Methods: The randomised trial was conducted from July 2012 to January 2013 at the Aga Khan University Hospital, Karachi, during which 74 patients were inducted. Randomisation ....

Outcome of single stage vertebral column resection in treatment of kyphotic deformity

Mohammad Arif, Abdul Satar, Muhammad Saeed, Muhammad Saeed, Mohammad Inam,

Objective: To find the frequency of deformity correction, functional outcome and complications of single-stage vertebral column resection in patients with kyphotic deformity.
Methods: The prospective case series was conducted at Hayatabad Medical Complex, Peshawar, and Aman H....

Is smartphone a necessity or luxury among orthopedic specialty?

Kamran Hafeez, Ghulam Mustafa Kaim Khani, Muhammad Bux, Masood Jawaid,

Objective: To assess the utilisation pattern of smart phones by residents and consultants with respect to their clinical work and academics.
Methods: The cross-sectional study was carried out in orthopaedic departments of various hospitals in Karachi in July 2014. Orthopaedic....

Results of injection corticosteroids in treatment of De Quervain's Tenosynovitis

Muhammad Akram, Muhammad Latif Shahzad, Faheem Mubashir Farooqi, Muhammad Irshad, Ranjeet Kumar Sah, Syed Muhammad Awais,

Background: De Quervain's tenosynovitis is defined as stenosing tenosynovitis of the synovial sheath of tendons of abductor polices longus and extensor pollicis brevis in the first compartment of wrist due to repetitive use.
Objective: To assess the results of injecting cor....

Asymptomatic urinary tract infection: Cause of postoperative wound infection

Irfan Ashraf, Masood Umer,

Objective: To determine the rate of urinary tract infection in patients given incomplete treatment before undergoing hip fracture surgery.
Methods: The descriptive case series was conducted at Aga Khan University Hospital, Karachi, From October 25, 2012 to April 24, 2013. 84 ....

Autologous blood injection in the treatment of lateral epicondylitis

Qazi Muhammad Amin, Ijaz Ahmed, Amer Aziz,

Objective: To determine mean decrease in visual analogue pain score after autologous blood injection in patients with lateral epicondylitis.
Methods: The quasi-experimental study was conducted at Ghurki Trust Hospital, Lahore, from December 10, 2012, to June 8, 2013, and comp....

Preventing the preventable: role of transamine in total knee arthroplasty

Obaid-ur-Rahman, Sohail Hafeez, M Sohail Amin, Hassan Mahmud Syed, Waris Ali Shah, Mohammad Talha, Ali Shan,

Objectives: To assess the efficacy and safety of perioperative intravenous Tranexamic Acid in reducing blood loss and transfusion requirements in patients undergoing Total Knee Arthroplasty.
Methods: The prospectivedouble-blind randomised control trial was conducted from Marc....

Improvised explosive device bombing police bus: Pattern of injuries, patho-physiology and early management

Muhammad Saeed Minhas, Kashif Mahmood Khan, Jahanzeb Effendi, Anisuddin Bhatti, Seemi Jamali,

Objective: To understand the different types of blast injuries, their mechanisms, patho-physiology of wounds and clinical consequences caused by improvised explosive device detonation, and their early management.
Methods: The retrospective study related to 70 Special Security....

"The role and ability of orthopaedic postgraduate resident's clubfoot treatment with ponseti's methodology." A comparative study of resident's versus consultant's directed treatment

Anisuddin Bhatti, Pervez Ali, Zeehan Naeem, Javed Ahmed, Iftikhar Memon, Kashif Mahmmod, Muhammad Saeed Minhas,

Objective: To evaluate the outcome of Ponseti treatment carried out by the Postgraduate Orthopaedic Trainees compared with the treatment given by their Mentors.
Methods: The prospective comparative case series study was conducted at Jinnah Postgraduate Medical Centre, Karachi....

Treatment of long-segment fracture at middle-up part of femur with long proximal femoral nail antirotation

Lin Yanbin, Li Renbin, Zhuang Yan, Xiong Guosheng, Xiong Shenren, Huang Xiangui,

Objective: To investigate the results of non-invasive operation method and evaluate clinical and radiological outcome of long proximal femoral nail antirotation in treating long-segment fracture at middle-up part of femur.
Methods: The retrospective study was conducted at the....

Difficulties in maintenance of clubfoot abduction brace and solutions - maintenance of clubfoot abduction brace, locks and keys

Iftikhar Memon, Anisuddin Bhatti, Parvez Ali, Kashif Mahmood, M. Saeed Minhas,

Objective: To determine the frequency of early relapse after achieving good initial correction in children who were on clubfoot abduction brace.
Methods: The cross-sectional study was conducted at the Jinnah Postgraduate Medical Centre, Karachi, and included parents of childr....

Precontoured anatomical plates new era in the complex tibail plateau fractures fixation

Imran Khan Mangi, Intikhab Taufiq, Syed Danish Ali Shah, Syed Aamir Ali Shah, Muhammad Kazim Rahim Najjad,

Objective: Functional outcome of Intraarticular Tibial Plateau Fractures fixed with precontoured anatomical plates using Knee Society Score.
Methods: Observational study with retrospective review of collected data. Patient's demography, mechanism of injury, schatzker'....

Functional outcome of ACL reconstruction using patellar bone tendon bone graft

Syed Danish Ali, Shahid Noor, Imran Khan Mangi, Syed Kamran Ali Shah, Muhammad Sufyan,

Purpose: To evaluate the mid-term functional outcome using Lysholm score of anterior cruciate ligamentreconstruction using bone patella-tendon bone graft.
Methods: The retrospective study of prospectively collected data was conducted at Liaquat National Hospital, Karachi, fro....

Early outcome of surgical intervention in subaxial cervical spine injuries

Abdul Satar, Zahid Wazir, Muhammad Saeed, Mohammad Arif, Mohammad Inam,

Objective: To determine the surgical outcome of patients with axial cervical spine fractures.
Methods: The study was conducted at the Spine Unit of Hayatabad Medical Complex, Peshawar, and Aman Hospital, Peshawar, from January 2012 to March 2013. Patients with sub-axial cervi....

The use of locally harvested bone chips as a graft in spine fusion surgery

Muhammad Saeed, Bahdar Ali Khan, Zahid Wazir, Mohammad Inam, Abdul Satar,

Objective: To evaluate the outcome of local corticocancellous bone chips used for fusion in various kinds of spine surgeries.
Methods: The observational prospective study was conducted at the Hayatabad Medical Complex, Peshawar, and Aman Hospital, Peshawar, from April 2011 to....

Knee dislocations and popliteal artery injury: A single centre experience from Karachi

Mehroze Zamir, Syed Shahid Noor, Muhammad Kazim Rahim Najjad, Akram Muhammad Aliuddin, Asad Khan Ghilzai,

Objective: To determine the association of popliteal artery injury with simple knee dislocations or knee fracture dislocations, and to evaluate the role of clinical assessment and colour Doppler ultrasound examination in diagnosing these injuries.
Methods: The prospective cas....

Dynamic hip screw fixation for inter-trochanteric fractures: determinants of outcomes

Adil Aijaz Shah, Santosh Kumar, Abdul Rehman, Rizwan Haroon Rashid, Shahryar Noordin,

Objective: To evaluate factors associated with revision of dynamic hip screw implant in patients undergoing the procedure for the fixation of intertrochanteric fractures.
Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprise....

Vitamin D deficiency and possible link with Bony pain and onset of Osteoporosis

Syed Kamran Ali Shah, Intikhab Taufiq, Muhammad Kazim Rahim Najjad, Syed Danish Ali, Muhammad Ather Siddiqui,

Objective: To explore if vitamin D deficiency had a direct correlation with bone pain or if it contributes in any way to the onset of osteoporosis.
Methods: The cross sectional Study was conducted from February to May 2014, presented at Liaquat National Hospital, Karachi, and....

Functional outcome of complex tibial plateau fractures managed with closed ilizarov

Umer Farooq, Shahzad Javed, Ijaz Ahmad, Amer Aziz,

Objectives: To determine the functional outcome of closed Ilizarov treatment in complex tibial fractures in terms of range of motion and stability of collateral ligaments of knee.
Methods: The descriptive case series was conducted at Ghurki Trust Teaching Hospital/Lahore Medi....

Pseudomonas as trespassers in diabetic foot infections: More questions and fewer answers

Muhammad Kazim Rahim Najjad, Zaki Idrees, Mehroze Zamir, Sana Zeeshan, Syed Amir Ali Shah,

Objective: To assess microbiological isolates from diabetic foot ulcers presented at a tertiary care teaching hospital.
Methods: The prospective observational study was conducted at department of Orthopaedics, Liaquat National Hospital Karachi, from January 2009 to October 20....

Operative management of patients with non-spinal metastatic bone disease. Does it actually improve quality of life?

Masood Umer, Yasir Mohib, Hafiz Umer,

Objective: To determine the survival rate and functional outcome of skeletal stabilisation in patients with metastatic bone disease.
Methods: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients with non-spinal metasta....

Bone mineral density in patients with chronic backache

Asadullah Makhdoom, Manzoor Ahmed Memon, Syed Muhammad Tahir, Shazia Awan, Zameer Hussain Tunio, Ghulam Mustafa Qaim Khani, Pervaiz Anjum,

Objective: To evaluate the association of bone mass density with chronic backache.
Methods: The case-control observational study was conducted at Bone Mass Density Assessment Unit, Liaquat University of Medical & Health Sciences Jamshoro from January 2011 to December 2013....

Significance of strontium ranelate in healing of surgically fixed tibial diapyseal fractures treated with strontium ranelate vs placebo; a randomised double blind controlled trial

Muhammad Zeeshan Aslam, Mansoor Ali Khan, Syed Akmal Sultan, Muhammad Amin Chinoy, Syed Kamran Ahmed, Syed Ali Anwer Jillani,

Abstract: To assess the effect of strontium ranelate, an approved drug for treating osteoporosis, on the healing process of tibial fractures.
Methods: The randomised double-blinded placebo-controlled clinical study was conducted at the Indus Hospital, Karachi, from August 201....

A comparison between orthopedic surgeon and allied health worker in pirani score

Syed Ali Anwer Jillani, Muhammad Zeeshan Aslam, Anum Saleem, Muhammad Amin Chinoy, Mansoor Ali Khan, Syed Kamran Ahmed,

Objectives: To assess the strength of agreement for each of the Pirani assessment categories between an orthopaedic surgeon and allied health worker on scoring clubfeet.
Methods: The descriptive cross-sectional study was conducted at the Indus Hospital, Karachi, from November....

Perception about braces in parents of children with clubfoot

Syed Kamran Ahmed, Syed Ali Anwer Jillani, Muhammad Zeeshan Aslam, Sundus Iftikhar, Muhammad Amin Chinoy, Mansoor Ali Khan, Jose Morcuende, Pehla Qadam Working Group,

Objectives: To access the acceptability of Steenbeek brace by children undergoing clubfoot correction and their parents to ensure long-term compliance.
Methods: The cross-sectional study was conducted at the Indus Hospital, Karachi from October 2013 to March 2014. A trained r....

Functional and radiological outcome of Intramedullary nailing vs. plate fixation for humeral shaft fractures. Does treatment method bring any difference?

Pervaiz Mehmood Hashmi, Yasir Mohib, Kashif Abbas,

Background: Operative Management of Humeral shaft fractures may be accomplished with the help of Plate fixation or IM Nails. Controversy exists as to which modality is superior to the other in terms of fewer complications and better functional and radiological outcome.
Objective:....

Our experience with Van Nes Rotationplasty for locally advanced lower extremity tumours

Raza Askari, Masood Umer, Mohsin-e-Azam, Haroon-ur-Rashid,

Objective: To present an early experience with the time-tested technique of Van Ness Rotationplasty to save distal lmbs.
Methods: Van Nes Rotationplasty for locally advanced lower extremity tumours. A reterorespective audit was conducted at Aga Khan University Hospital, Karac....

Transfusion practice in orthopedic patients: do we really need it?

Kashif Abbas, Raza Askari, Masood Umer, Kamran Hafeez,

Objectives: To determine the proportion of inappropriate transfusions in patients undergoing orthopaedic surgery at a tertiary care university hospital, and factors associated with inappropriate transfusions.
Methods: The prospective study was conducted at Aga Khan University....

Use of fresh parental fibular allograft for reconstruction of skeletal defects after limb salvage surgery

Masood Umer, Raza Askari, Sher Baz,

Objective: To share early experience with paediatric patients having undergone skeletal reconstruction after limb salvage surgery.
Methods: A reterorespective audit study was conducted at Aga Khan University Hospital, Karachi, from 1994 to 2011 An audit of the institutional t....

Role of injecting bone marrow aspiration injection in treating delayed union and non-union

Muhammad Akram, Muhammad Irshad, FaheemMubashir Farooqi, Ranjeet Kumar Sah, Muhammad Latif Shahzad, Ahmad Humayun Sarfraz, Syed Muhammad Awais,

Objective: To access the role of bone marrow injection in the management of delayed union and non-union.
Methods: The prospective study was conducted at the Department of Orthopaedic Surgery and Traumatology, Mayo Hospital, Lahore, from January 2012 to December 2013, and comp....

Variability of magnification on digital pelvic radiographs from patients with fractures of the femoral neck - a retrospective audit

Akbar Zubairi, Tashfeen Ahmad,

Objective: To determine the variability in magnification of radiographs in an emergency setting.
Methods: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of patients who underwent Austin Moore hemiarthroplasty over a two-y....

Operative treatment of displaced intra-articular fractures of Calcaneum: Is it worthwhile?

Syed Furqan Gilani, Muhammad Suhail Amin,

Objective: To compare the results of operative treatment for displaced intra-articular fractures of calcaneum with conservative treatment.
Methods: The retrospective non-randomised comparative study using. purposive non-probability convenient sampling was conducted at the Com....

Outcome of neurolysis combined with anterior submuscular transfer of ulnar nerve in McGowan Grade II and III tardy ulnar nerve palsy

Ayesha Saeed, Usman Zafardar, Muhammad Awais, Muhammad Akram,

Objective: To see the impact of combined neurolysis and submuscular transposition approach in patients with tardy ulnar nerve palsy of Mc Gowan grades II and III.
Methods: The descriptive case series was conducted at King Edward Medical University, Mayo Hospital, Lahore, betw....

Burkhalter opponensplasty; role in isolated median nerve injury

Muhammad Akram, Faheem Mubashir Farooqi, Muhammad Latif Shahzad, Muhammad Irshad, Ranjeet Kumar Sah, Syed Muhammad Awais,

Objective: To report the outcome of Burkhalter opponensplasty using Extensor Indicis Proprius with isolated traumatic low median nerve palsy.
Methods: The prospective study was conducted at the Mayo Hospital, Lahore, from June 2010 to June 2013, and comprised cases of Burkhal....

Chondromyxoid fibroma; experience of 36 cases of an intriguing entity

Saroona Haroon, Nasir Uddin, Shahid Pervez, Naila Kayani, Rashida Ahmed, Kamran Hafeez, Masood Umer,

Objectives: To evaluate the clinico-pathological features and treatment options of chondromyxoid fibroma patients.
Methods: The retrospective study was conducted at the Aga Khan University Hospital (AKUH), Karachi, and comprised data of all cases of chondromyxoid fibroma of b....

Case Report >>

Metallosis, complete osteolysis of ilium, acetabulum and proximal femur. Disastrous complication of total hip arthoplasty: A case report

Badaruddin Sahito, Dileep Kumar, S. M. Tariq, Hassan Dost Afridi, Farooq Mamji,

Metallosis is serious condition that comes about when metallic debris builds up in the soft tissues of the body. This condition is seen in individuals undergoing joint replacement surgery, like those of the hip, knee and elbow. Incidence of metallosis is not common. Here we present a case of 61 y....

Review Article >>

Competing interests of undergraduate medical education and industry: integration into longitudinal curricular themes

Shahryar Noordin, Sheilla Pinjani,

Recent changes in curricula around the globe with emphasis on teaching/learning and assessing professionalism in medical schools has been the priority. With the changing public expectations and professional demands, it has become imperative to develop clear guidelines and policies for students an....

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