Anterior Cruciate Ligament Reconstruction with Semitendinosus Tendon Autograft among Paramilitary Patients Undergoing Arthroscopic Surgery in a Tertiary Care Centre.

Introduction: In orthopaedic practice, injuries to the anterior cruciate ligaments occur almost on an epidemic scale, yet it continues to be of interest in orthopaedic surgery whether semitendinosus or gracilis hamstring autografts can be used for better anterior cruciate ligament reconstruction. This study aimed to determine the prevalence of anterior cruciate ligament reconstruction using semitendinosus tendon autografts among paramilitary patients undergoing arthroscopic surgery in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among paramilitary individuals who had knee injuries and were admitted between 6 february 2020 and 26 January 2022 for arthroscopic surgery after obtaining ethical approval from the Institutional Review Committee. Demographic details and the mode of injury were obtained from the patients. The treating orthopaedic surgeons evaluated the pre- and post-analysis Lysholm Knee Score and Lysholm Knee Scale based on the patient's response. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 166 patients, anterior cruciate ligament reconstruction using a semitendinosus tendon autograft was done in 58 (34.94%) (27.69-42.19, 95% Confidence Interval). Most of the patients in the pre-analysis had mild/periodic limp issues 52 (89.66%), followed by instability during athletics or other severe exertion 43 (74.14%). Conclusions: The prevalence of anterior cruciate ligament injuries in our study is higher than other studies done in similar settings. Keywords: anterior cruciate ligament; grafts; semitendinosus tendon.

Displaced Midshaft Clavicular Fractures among Patients with Clavicular Fracture Admitted to the Orthopaedic Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Midshaft clavicular fractures are common among young adults. Open reduction and internal fixation of displaced midshaft clavicular fractures with plate and screws have been shown to decrease nonunion, symptomatic malunion, and residual shoulder disability compared with non-operative treatment allowing early pain-free movement and early return to work. The aim of this study was to find out the prevalence of displaced midshaft clavicular fractures among patients with clavicular fractures admitted to the orthopaedics department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Orthopedics of a tertiary care centre from 31 January 2016 to 31 December 2019 after receiving ethical approval from the Institutional Review Committee (Reference number: 659/2021 P). Data were collected using hospital-based records from patients of the age group 18 to 50 years. Convenience sampling method was used. Point estimate and 95% confidence interval were calculated. Results: Among 120 patients, the prevalence of displaced midshaft clavicular fractures was 40 (33.33%) (24.90-41.76, 95% Confidence Interval). Among them 39 (90%) were males and 4 (10%) were females and the mean age of 31.45 years. The average Constant-Murley score were 95.68±5.59. Conclusions: The prevalence of displaced midshaft clavicular fractures among patients with clavicular fractures admitted to the Department of Orthopedics was lower than the other studies done in similar settings. Keywords: clavicle; fracture; open fracture reduction; orthopedics.

Stress Fractures among Paramilitary Trainee Visiting a Paramilitary Hospital of Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Young paramilitary recruits, who undergo strenuous exercise during basic training, are often presented with stress fractures, which could be due to an inadequate vitamin D (25-hydroxyvitamin D) intake. This study aimed to find the prevalence of stress fracture among young paramilitary trainees visiting the orthopedic outpatient department of a paramilitary hospital. METHODS: This was a descriptive cross-sectional study done among paramilitary trainees in a paramilitary Hospital of Nepal between April 2019 to April 2021. The study was approved by the Ethical Review Board (Reference number: 1003) of the Nepal Health Research Council. Convenience sampling was used. Anthropometric variables, serum 25-hydroxyvitamin D level, and bone mineral density of spine and hip were determined. Data analysis was performed using the Statistical Package for the Social Sciences software version 17.0. Point estimate at 95% Confidence Interval was calculated along with frequency, proportion for binary data and mean, standard deviation for continuous data. RESULTS: Among 417 young paramilitary trainees, 24 (5.76%) (3.52-7.99 at 95% Confidence Interval) were found to have a stress fracture. The stress fracture patients had a serum 25-hydroxyvitamin D level of 21.47ng/mL±6.98. Similarly, the bone mineral density value of the spine and hip among the patients was -1.34g/cm2±1.37 and 0.36g/cm2±1.24, respectively. CONCLUSIONS: The prevalence of stress fracture among young paramilitary trainee was high compared to previous studies. Additionally, average Vitamin D and the bone mineral density value of the spine and the total hip among stressed fractured patients were also low.

Radiofrequency Ablation of Osteoid Osteoma of Neck of Femur: A Case Report.

Osteoid osteoma is the most common benign bone forming tumor characterized by a nidus surrounded by reactive sclerotic bone typically associated with nocturnal pain and most common in males less than 30 years. Diagnosis may be difficult in cases of atypical presentation, intraarticular localizations or very small size. Computed tomography guided radiofrequency ablation is one of the promising treatment methods being used with an advantage of minimal invasion, faster recovery and shorter hospitalization. We present a case of an 8-year-old boy with osteoid osteoma of neck of femur managed successfully with radiofrequency ablation. To our knowledge, this is the first case reported on radiofrequency ablation in Nepal.