Outcome analysis of surgically managed unstable burst fracture

oai:ojs.ijoro.org:article/1Background:Burst fractures are common injuries of dorsolumbar spine. In indicated cases, surgery is the treatment of choice. Significant controversy exists regarding surgical intervention for these fractures. Posterior decompression, anterior decompression and instrumentation, and combined anterior decompression and posterior instrumentation have been recommended in various studies. Here we are going to evaluate unstable burst fractures of thoracic and lumbar spine treated by isolated anterior decompression and instrumented fusion with TSM-Bone graft composite.Methods: Prospective study of thirty-six cases of unstable fracture of thoracic and lumbar spine treated in Sri Ramachandra Medical centre from January 2011 to January 2014. The inclusion criteria were burst fractures of thoracic or lumbar spine complete or incomplete neurological deficit and burst fractures of thoracic or lumbar spine without neurological deficit but with mechanical instability. The exclusion criteria were pathological fractures, chance fracture, stable burst, wedge compression and osteoporotic compression fractures. The results were analyzed during the follow-up using the Pain – Visual analogue scale, Fusion status and radiographic parameter – K-angle .For pain score were given as 3,2,1 for absent, moderate and severe pain respectively. Regarding fusion status score of 3,2,1 were given when fusion was good, fair and no sign of fusion respectively.Results:Mean pre-operative K-angle was 28o. Average loss of correction at final follow up was 3o.Mean correction of K-angle was 140.Moderate to severe loss of correction of K- angle was observed in 4 patients. Mild to moderate pain in 5 patients treated with analgesics. Average TSM subsidence was 3mm.Conclusions:Bone graft composite provides stable biomechanical support to deficient anterior column in burst fractures and allows early rehabilitation and mobilization. Neural recovery may occur after anterior decompression, stabilization and fusion with TSM-Bone graft composite in dorsolumbar burst fractures with incomplete cord injury

Article level metrics: a look beyond the journal impact factor

The journal Impact Factor (IF), developed by Eugene Garfield at the Institute for Scientific Information (ISI), reflects the average number of times articles from the journal published in the past two years have been cited in the Journal Citation Reports (JCR) year. The Impact Factor is calculated by dividing the number of citations in the JCR year by the total number of articles published in the two previous years. For example, if there were 200 papers published in a journal in 2013 and 2014 and there were 400 citations in that time period, then the 2015 IF for the journal would be 2. Impact Factor uses Thomson Reuters (ISI Web of Knowledge) citation data. The Impact factor citation data was first derived from the Science Citation Index, a citation index created by Garfield and produced by the Institute for Scientific Information (ISI). ISI was later acquired by Thomson Reuters along with the Science Citation Index, which Reuters grew into the Science Citation Index Expanded. That index is now housed in the Web of Science, a subscription-based scientific citation indexing service encompassing six other online databases. Today, Thomson Reuters calculates IFs using the data from all of the journals indexed in the Web of Science, and releases an IF listing on an annual basis in its yearly Journal Citation Reports, which is available with paid Web of Science subscriptions

Isolated sacrum tuberculosis with presacral and paraspinal abscess: case report of a common disease at uncommon site

Refractory backache in the elderly calls for further evaluation to rule out any sinister underlying disorder. Radiological features with extensive destruction of bony tissue may raise suspicion of malignant process and a careful assessment with the help of advance imaging modalities along with isolation of an infective agent is necessary to establish a diagnosis of infective pathology as the cause. We, hereby, report a case of recalcitrant low back pain in the elderly that was evaluated and resulted in the final diagnosis of tuberculosis of sacrum and resultant abscess collection in the presacral and paraspinal region. Early identification of infective organism by culture resulted in early and appropriate treatment and subsequent excellent recovery

Outcome of fracture of intra articular distal femur treated with distal femur locking compression plate

Background: Intra articular fracture of the distal femur is a composite and complex injury that poses various challenges for orthopaedic surgeon starting from management of fracture to a protracted recovery of the patient.Methods: We have done retrospective study of 25 patients with intra articular distal femur fracture operated during the period of 2008 to 2014. NEER score is used as criteria for evaluation of patients.Results: With use of DFLCP, anatomical reduction and rigid fixation, early mobilization and aggressive physiotherapy can be started with the use of these plates.Conclusions: Our study shows that distal femur locking compression plate (DFLCP) is the evolving approach to treat distal femur fractures