Cerebral Palsy among Children Visiting the Outpatient Department of Pediatric Orthopaedics in a Tertiary Care Centre

Introduction: Cerebral palsy is a group of neurological disorders that appear in infancy or early childhood and occur as a result of anomalies in the developing brain that impair the brain's capacity to regulate movement, maintain posture, and maintain balance. Healthcare professionals can better predict the need for the medical, rehabilitative, and support services needed by people with cerebral palsy by using accurate prevalence statistics. The aim of the study was to find out the prevalence of cerebral palsy among children visiting the Outpatient Department of Pediatric Orthopaedics in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the Outpatient Department of Pediatric Orthopaedics in a tertiary care centre. Data from 1 January 2018 to 31 December 2019 was collected between 25 April 2023 to 5 May 2023 from medical records after obtaining ethical approval from the Institutional Review Committee. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 6984 children, the prevalence of cerebral palsy was 545 (7.80%) (7.17-8.43, 95% Confidence Interval). The most common type of cerebral palsy was found to be spastic diplegia 219 (40.18%). Conclusions: The prevalence of cerebral palsy among children visiting the Outpatient Department of Pediatric Orthopaedic was found to be higher than in other studies done in similar settings

Extra and Intra-articular Synovial Chondromatosis

Synovial chondromatosis is not so rare intra-articular condition secondary to synovial metaplasia, that affects the knee joint. Extra-articular synovial chondromatosis however is an extremely rare condition that usually involves the synovial sheath or bursa of the foot or hand. We present two cases of synovial chondromatosis, one intra and one extra-articular. The first case was a 25 year old lady who presented with pain, swelling and restricted range of motion of left knee and was found to have an intra-articular synovial chondromatosis which was treated successfully by joint debridement. The second case was that of a 22 year old man who presented with right knee pain and was diagnosed to have an extra-articular synovial chondromatosis of his right medial hamstring tendon sheath, excision of which resulted in complete relief of symptoms. Keywords: extra-articular, intra-articular, metaplasia, rare, synovial chondromatosis

CT Evaluation of Pelvic and Hip Fractures

Introduction: To analyze the spectrum of pelvic and hip joint injuries by computed tomography in patients attending to emergency. Methods: CT evaluation with multiplanar and 3-D reformations of 62 patients done with pelvic and hip fractures during 18 months. The mode of injury and treatment were recorded. Results: Forty four (70.9%) of the injuries were sustained in high speed vehicle accidents (automobile, motorcycle, autopedestrian), 14 patients (22.5%) had sustained fall injury and 4 patients (6.4%) sustained injury following slip on the ground. 31 patients underwent surgery for acetabular fractures. Associated injuries included spinal fractures (5), abdominal visceral injury (3), extremity fractures (13), chest injury (5), head injury (1), urethral injury (4), clavicle fracture (1). Forty patients (64.5%) had acetabular fractures, 25 (40.3%) patients had iliac bone fractures, 47 (75.8%) had pubic bone fracture. Sacral fracture was found in 17 (27.4%) patients. Associated femoral fracture was found in 4, hip joint dislocation was seen in 5 (2- central, 3-posterior). Sacroiliac joint diastasis was found in 13(20.9%) patients, pubic diastasis in 7 (11.2%), fracture ischium in 7(11.%) , protrusio acetabuli in 5 (8%). Conclusions: Spiral CT with multiplanar and 3-D reformations has clinical values for precise diagnosis and treatment plan for the pelvic and hip fractures. Keywords: pelvis; hip fractures; CT scan.  

High Dependency Unit Admissions among Patients with Lower Extremity Long Bone Fracture Visiting the Department of Orthopaedics in a Tertiary Care Centre

Introduction: Lower extremity long bone, femoral and tibial shaft, fractures often have associated injuries. Patients with lower extremity long bone fractures in the Department of Orthopaedics can land up in high dependency unit admissions, mostly due to underlying complications. The study aimed to find out the prevalence of high dependency unit admissions among patients with lower extremity long bone fractures visiting the Department of Orthopaedics in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with lower extremity long bone fractures in a tertiary care centre. The data from 1 March 2017 to 31 January 2020 was collected from the medical records from 1 August 2020 to 30 September 2020. All patients with femoral or tibial shaft fractures in isolation or a part of a multi-system injury were included. Patients with inadequate data were excluded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 507 patients with lower extremity long bone fractures, 137 (27.55%) (23.66-31.44, 95% Confidence Interval) required high dependency unit admission. Among them, 119 (86.86%) were males. A total of 71 (51.82%) cases involved 2-wheelers. Conclusions: The prevalence of high dependency unit admission among patients with lower extremity long bone fractures was high and majority of them required multidisciplinary approach