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Volume 6, Emitir 1 (2022)

Artigo de Pesquisa

Assessment of Clinical and Radiological Outcome of Type 5 and Type 6 Proximal Tibia Fractures

Vishal Patil*, Chiranjivi Jani, Clevio Desouza

Introduction: Proximal tibia fractures account for around 1% of fractures in adults. Proximal tibial fractures are intricate wounds created by high-or low-velocity injury, the ideal treatment of high energy tibial plateau fracture remains contentious. Open Reduction and Internal Fixation (O.R.I.F.) with a rigid implant achieves the goal of anatomic, articular congruency, and mechanical alignment restoration while allowing early remobilization.

Materials and methods: Ours was a prospective-retrospective study conducted with a sample size of 28 patients who were diagnosed with proximal tibia (Schatzker’s type 5 and 6) fracture between June 2018 and June 2020Clinical outcomes were recorded using The American Knee Society (KS)Score for post- operative knee range of motion, The Knee Society Function (KSF).

Results: The immediate post-operative and the one year follow up outcomes did not show any significant difference in the alignment of the tibia, which indicated that there was no secondary loss of reduction.

We observed no Malunion complications in coronal or sagittal or both planes, in any of the patients. However, post-operative Varus alignment was observed in two patients.

Conclusion: In the Intra articular fractures of proximal tibia, namely Schatzker’s type 5 and 6, treatment outcomes were dependent upon the fracture type, correct and precise reduction along with appropriate fixation techniques.

The outcomes were excellent when the fracture was accurately aligned, the joints were stabilized and the articular surfaces were well reduced.

Relato de caso

A Solitary Enchondroma of Great Toe in an Adolescent Male: A Case Report

Shivam Patel, Shail Shah*, Anurag Anand and Ashwin Deshmukh

Introduction: Solitary enchondromas are benign, usually asymptomatic. Enchondromas are cartilage tumors which are estimated to constitute 3%-17% of all bone tumors and approximately 20% of all cartilage tumors. Enchondroma has higher chances to convert in chondrosarcoma, which varies between 0% and 4.2%. It is difficult to obtain a valid risk estimate, as this requires histopathology MRI reports.

Case study: 17 year old male came to the OPD with swelling in his left great toe since 6 months. Swelling was associated with intermittent pain which was dull aching type, no aggravating or relieving factors. Swelling was insidious in onset and gradual in progression. On physical examination Mild restriction of motion of left great toe and a regular swelling over the dorsal aspect of left great toe, hard in consistency without any neurovascular impairment. No presence of scars, sinuses, pigmentation or any ulceration over the swelling. Palpation of the swelling confirmed the presence of a bony hard swelling, non pedunculated, smooth surface of size 3 × 3 × 2.5 cm with ill-defined margins. Swelling was expansile and fixed to skin. X-ray s/o Lytic lesions, scalloping of the cortex and whorls of calcification.

Discussion: The literature search was primarily performed in the PubMed database: “Chondroma”, “Chondrosarcoma”, “Diagnostic Imaging” and “Magnetic Resonance Imaging.” Dorsal incision was marked along the great toe along the tendon of extensor halluces longus, extending 2 cm proximal to MTP joint and distally to base of nail bed. Complete exposure of the tumour was done and along with excision of proximal phalanx after incising the dorsal aspect of the joint capsule. Swelling was expansile and multiloculated involving whole of the proximal phalanx and inseparable from the skin at some areas .Hence the decision was taken to remove whole of proximal phalanx along with tumour. Gap was filled up with fibular strut graft.

Conclusion: Solitary enchondromas aggressively increasing in size should be treated surgically bane gap caused after removing the tumor can be filled with bone graft or cement depending on the condition of cortex.

Relato de caso

Prosthetic Rehabilitation of Mucormycosis Patients in the COVID 19 Pandemic

Pratiksha Sahare, Shreeya Kulkarni, Kshitij Karmkar and Mokshada Badadare

The COVID 19 pandemic has affected people worldwide, leading to psychological, financial, educational and economic distress. The world has been experiencing numerous post COVID complications. In India the emergence of mucormycosis is being reported with an alarming rise in the number of cases. Often, mucormycosis requires surgical debridement of the infected tissues. Prosthetic rehabilitation is not only involved in pretreatment planning but also in the construction of temporary or permanent post treatment appliances which help the patient to live a normal life. This case report describes the prosthetic rehabilitation of a patient affected by mucormycosis by means of a hollow bulb obturator supported by cast partial denture framework along with an extra coronal attachment..

Mini revisão

Diagnosis and Evaluation of Patent Foramen Ovale in the Era of Device Therapy: A Mini Review

Kaito Abe, Takemi Kusano, Koki Sogame, Hidetoshi Fukui, Moto Shimada, Chika Kawashima, Goro Endo and Jun Okuda

Patent Foramen Ovale (PFO) causes cryptogenic stroke. Recently, device therapy has become widespread to prevent recurrent cerebral infarction caused by PFO. Therefore, it is important to evaluate the diagnosis of PFO and likelihood of cryptogenic stroke being related to PFO. This review summarizes the current diagnosis and evaluation of PFO.

Artigo de Pesquisa

Aerosols Contamination in the Dental Practice Following Everyday Procedures

Magda Mensi*, Silvia Marchetti, Luca Mantelli, Eleonora Scotti, Annamaria Sordillo, Stefano Calza, Niklaus P. Lang

Objectives: The purpose of present observational study was to evaluate the bacterial load in the air following various dental procedures.

Materials and methods: Air contamination following 7 dental procedures resulting in aerosols generation was assessed. The air volume was sampled by means of a wet cyclone collector for 10 minutes during 10 different sessions of each of the following dental procedures: a) air-polishing b) ultrasonic instrumentation c) manual instrumentation d) rubber cup e) cavity preparation with the 1:5 red contra-angle f) cavity preparation with turbine and Low Volume Evacuator (LVE) g) cavity preparation with turbine and High Volume Evacuator (HVE). Baseline air samples were analysed as well. Contamination of the sampled solution was determined using ATP (Adenosine TriPhosphate) quantification of the viable bacterial count.

Results: By far the highest increase in air contamination was observed after the use of turbine with LVE. The use of turbine with HVE and the use of the red hand-piece both resulted in elevated bacterial counts, while the application of air polishing, ultrasonic instrumentation, hand instrumentation and rubber cups did not result in higher bacterial count than baseline.

Conclusion: Routine professional oral hygiene procedures do not increase the air contamination produced by aerosols. However, cavity excavation creates significantly higher bacterial count in the air. The highest contamination was seen after the use of turbine with LVE.

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