Outcomes of Exeter cemented total hip arthroplasty in a county hospital: survivorship of eight hundred and ninety four hips with a minimum ten-year follow up.

PURPOSE: A total of 894 hips were evaluated to describe the survivorship of Exeter cemented femoral stems and report the outcomes and complications of our 'Exeter- era', and there is no study from Central or Eastern Europe demonstrating similar results. METHODS: Between January 2000 and December 2009, a total of 894 hips were included who underwent Exeter universal and V40 femoral stems with a mean follow up of 13 years. Cemented Exeter low profile polyethylene cups were used in 889 patients (99.4%) cups. Harris hip score (HHS) was used and statistical outcome measures were calculated with revision as an endpoint for aseptic loosening of the stem, aseptic loosening of any component, all-cause revision of the stem, and all-cause revision of the hip. RESULTS: A total of 103 patients died and 129 (14.4%) operated hips were lost to follow-up before ten years. Out of the 662, ten stems (1.5%) were revised for aseptic loosening. Aseptic loosening of any component was the reason for revision in 43 cases (6.5%), consisting of 40 cup revisions and ten stem exchanges. Periprosthetic fracture occurred in 17 cases (1.9%) Periprosthetic joint infection occurred in 18 cases (2.01%). Three cups were exchanged for recurrent dislocation, and two stems had broken. CONCLUSION: Exeter hip system has provided reproducible results across different centres worldwide, as it did in our series. Thorough surgical and cementing technique is of utmost importance for achieving these results. The cup is the weak point of the system and use of a hybrid system is worth considering.

A new species and new records of Sericini chafers from the Lower Gangetic Plains in India (Coleoptera: Scarabaeidae: Sericinae).

Here, we investigated the diversity of Sericini in the faunistically rather unknown Lower Gangetic plains in North India, based on material from the collection of the Zoological Survey of India. We discovered one new species from West Bengal, Maladerakolkataensis Bhunia, Gupta, Sarkar & Ahrens, and provide further records of an additional 23 species belonging to five genera from the lowlands of the states Bihar and West Bengal. Out of these, 21 species represent new state records: 12 for Bihar and nine for West Bengal. All recorded species are briefly documented by diagnostic illustrations.

Review of Melolontha Fabricius, 1775 (Coleoptera: Scarabaeidae: Melolonthinae) from India with the description of two new species.

The genus Melolontha Fabricius, 1775 (Coleoptera: Scarabaeidae: Melolonthinae) from India is reviewed. Two new species, Melolontha arunachalensis Gupta, Keith, Bhunia, Das, Ghosh & Chandra, new species and Melolontha lachungensis Gupta, Keith, Bhunia, Das, Ghosh & Chandra, new species are described. Melolontha chinensis Guérin-Méneville, 1838 is reported for the first time from India. Taxonomic notes on the identification of previously known species of Melolontha from India are provided, together with a key to the species (males).

Fibular Autograft as Medial Support with Proximal Humerus Locking Plate Construct in Comminuted Proximal Humerus Fractures: A Retrospective Analysis.

Background: Varus collapse is one of the pivotal mechanisms of failure following surgical fixation of proximal humerus fractures. The aim of the present study was to evaluate functional and radiological outcomes of non-vascularized fibular autograft as medial support with locking plate construct for comminuted proximal humerus fractures (PHF's). Materials and methods: We retrospectively evaluated 18 patients with unstable PHF's in the age group 50-70 years with a minimum follow-up of two years. All the fracture patterns were classified according to Resch, Neer's and AO classification and either medial calcar compromise or comminution were present in all. Open reduction internal fixation (ORIF) with a locking plate was performed for all the patients along with intramedullary fibular autograft to support medial calcar. Radiological outcome was assessed by neck-shaft angle (NSA) graded according to the Paavolainen grading method and difference in the humeral head height (HHH). Functional outcome was assessed by shoulder range of motion (ROM), University of California-Los Angeles (UCLA) score and American shoulder and elbow surgeons score (ASES). Results: Radiological union at the fracture site was achieved in all the patients at mean of 8 months (range 6-12 months). Range of movements were mean flexion of 123.89, extension 35.28, internal rotation 66.94, external rotation 57.78 and abduction of 115° at final follow-up. The average NSA was in the range of 120°-130° and none of the patients showed difference in HHH of ≥ 4 mm in the immediate post-operative radiograph and that taken on final follow-up. The functional outcome assessed by ASES score (mean 89.44) and UCLA score (mean 29.61) suggested fair to good results. None of the patients has shown varus collapse and avascular necrosis. Neither there were any complications related to the donor area. Conclusions: In unstable proximal humerus fractures with calcar comminution or void, PHILOS plate fixation augmented with fibular autograft as a medial support reduces varus collapse and promotes early radiological union.

A Clinical Case of Viral Keratitis.

Keratitis is a pathological condition involving inflammation of the cornea. It can be an infectious or non-infectious disease. The causative organisms of keratitis are categorized as bacteria, viruses, fungi, or parasites. The viruses responsible for causing keratitis are herpes simplex virus (HSV), varicella-zoster virus, and adenoviruses. The clinical features of this infection may range from pain and redness of the eye to scarring of the cornea or blindness. We present the case of a 71-year-old elderly female patient suffering from viral (HSV) keratitis. She was referred to the department of ophthalmology with complaints of diminution of vision and watering in the right eye associated with pain and redness for one month, which was progressive and gradual in onset. On local examination, the surface of the cornea was irregular in the right eye, with the presence of old keratitis precipitates. Viral infection is the second leading cause of keratitis and is very common in the western world. Because the transmission is due to droplets and fomites, strict measures must be taken to prevent transmission. If anyone comes in contact, prophylactic antiviral therapy can be administered. The prognosis is favorable if adequately treated. It can lead to blindness if not treated on time.

Novel Technique for the Management of Fibrous Dysplasia of Radius Shaft with Fibular Strut Autograft without Internal Fixation: A Case Report.

Introduction: Fibrous dysplasia (FD) is a developmental disorder in which the normal bone marrow is distorted and replaced by dense fibrous stroma containing a disorganized matrix. The disorder can be localized to a single bone or affect multiple bones. Although any bone can be affected, the bones of the upper extremity are the rare site of involvement. The disease process results in deformity of the bones and is often complicated by pathological fractures. Case Report: Here, we present a case of a 14-year-old girl, who presented with FD of the radius bone with the progressive deformity with terminal restriction of supination and pronation. Radiographs showed revealed an expansile lytic lesion with ground glass appearance involving the proximal meta-diaphysis of the right radius, with its resultant bowin. Using Henry's approach, we treated with an innovative surgical approach envisioned with the non-vascularized cortical fibular bone graft without an internal fixation. Conclusion: For the management of FD of radius bone, non-vascularized cortical fibular bone grafting provided if tightly fitted gives good radiological and functional outcome without any recurrence with complete osseointegration.

Taxonomic notes on the little-known genus Cyanotiphia Cameron, 1907 (Hymenoptera: Tiphidae: Tiphinae).

Cyanotiphia ruficauda Cameron, 1907 is the genotype of the monotypic genus Cyanotiphia Cameron, 1907. This species was previously known from a single female specimen, the holotype; after an extended period of 114 years, the male of this species is firstly described from North Sumatra, Indonesia. Material information of additional female records is also added.

New species and records of Sericini of India (Coleoptera: Scarabaeidae: Melolonthinae) III.

Here we describe two new species from India: Neoserica panchmariensis Bhunia, Gupta, Chandra & Ahrens, new species and N. debasriae Bhunia, Gupta, Chandra & Ahrens, new species. Moreover, Maladera pseudohongkongica Ahrens & Fabrizi, 2016 is recorded from Jharkhand state of India for the first time. Species morphology is described and illustrated, and their distribution is shown on a map.

A Catalogue of Indian Hydraenidae (Insecta: Coleoptera).

This catalogue lists 46 valid species included in 7 genera and two subfamilies of the family Hydraenidae (Coleoptera), recorded from India. The subfamily Hydraeninae accommodates 24 species (5 genera), and Ochthebiinae 22 species (2 genera). We include synonyms, type localities, type depositories, and distribution of the species. The Himalayan region supports the maximum diversity (31 species), followed by Deccan Peninsula (5 species), Western-Ghats (5 species), Northeast (4 species), Gangetic Plains (4 species), Semi-Arid (2 species), and Islands (one species).

Management of Partial Heel Pad Avulsion using Multiple Kirschner wire Anchorage Technique - Case Report.

Introduction: Isolated Partial Heel pad injuries are very rare and management of heel pad injury is always a challenge to a surgeon because of its complex structure and precious blood supply. The goal of management is to preserve a viable heel pad for weight-bearing during normal gait. Case Report: A 46-year-old male sustained a right heel pad avulsion following motorcycle bike ac-cident. Examination showed contaminated wound, viable heel pad, and no bony injury. Within 6 h of trauma, we reattached partial heel pad avulsion using multiple Kirschner wires without wound closure and daily dressings. Full weight bearing started on 12th post-operative week. Conclusion: A partial heel pad avulsion can be managed using multiple Kirschner wire which is cost-effective and simple method. Partial-thickness avulsion injury has a better prognosis as com-pared to full-thickness heel pad avulsion injury, due to preserved periosteal blood supply.

Comparative Analysis of Clavicular Hook Plate Versus Distal Radius Volar Plate With Coracoclavicular Augmentation for Neer's Type 2b Lateral Clavicle Fractures: A Prospective Study.

Background Clavicle fractures are common injuries in the adult population. The commonest site of fracture in the clavicle is the mid-shaft followed by the lateral end fracture. The anatomy and biomechanics of the lateral end clavicle make it prone to be unstable. Conservative management usually fails due to the deforming forces. Aim Our study evaluates pain relief, functional outcome, and the union rate in unstable lateral end clavicle fracture fixed by two different modalities of operative management, namely clavicular hook plate fixation and distal radius volar plate fixation. Materials and method A total of 60 patients with the unstable lateral end of clavicle fracture were evaluated in this study at a single tertiary care center between August 2015 and September 2021. Half of the patients (30 patients) were managed by open reduction and internal fixation with clavicular hook plate. The remaining half (30 patients) underwent open reduction and internal fixation by distal radius volar plate supplemented with coracoclavicular fixation. All patients were followed up for a mean duration of 20 months. The functional outcome was assessed at regular intervals by Constant score and Disability of the Arm, Shoulder and the Hand (DASH) score for a period of one year. Result There was significant pain relief and improvement in the functional status of patients. The pain relief was significant in the group managed by distal radius volar plate. The decrease in DASH score and increase in Constant score suggests better functional outcomes in these patients. Conclusion Our study highlights the fact that the distal radius volar plate is an excellent alternative to the hook plate in the treatment of unstable lateral third clavicle fractures. The decrease in pain and improved functional outcome stresses the fact that the volar locking plate is the recent most advancement in the fracture fixation of Neer's type ll fractures. The distal radius volar plate is the recent internal fixation technique to manage unstable lateral end clavicle fractures.

Chronic Unreduced Anterior Shoulder Dislocation Managed by Latarjet Procedure: A Prospective Study.

The shoulder joint is the most common joint to undergo dislocation, with the anterior subtype being the most common. The most accepted definition of chronic dislocation is a shoulder joint that has remained dislocated for a minimum of three weeks. Due to rare presentation, there is a lack of consensus among surgeons regarding the optimal management option of chronic shoulder dislocation. The goal of this prospective study was to assess the efficacy of open reduction with Latarjet procedure in the management of chronic unreduced shoulder dislocation. A total of seven patients were included in this study. Five patients were males and two were females. The study was conducted in a single tertiary care centre between July 2015 and May 2018. All patients were managed by open reduction with the Latarjet procedure. The capsulolabral structures were repaired in all the cases. The post-operative functional outcome was assessed by shoulder range, Rowe score, and the University of California, Los Angeles (UCLA) score at regular intervals for a period of one year. There was a significant improvement in terms of pain relief and functional status of the patients. The patients were satisfied as they could do their daily routine activities without pain at a one-year follow-up. Early post-operative rehabilitation and physiotherapy are key to improving the functional range.

Catalogue of Indian Alysiinae (Hymenoptera: Braconidae).

This catalogue of the Indian Alysiinae (Hymenoptera: Braconidae) is based primarily on an extensive survey of published data. A total of 67 species of Alysiinae including 13 genera and 60 species in the tribe Alysiini and five genera and seven species in Dacnusini are reported from India. Taxonomic history with details of synonyms, along with type localities, type depositories, and distribution in different states of India and biogeographic zones are provided. Two new combinations are proposed: Dinotrema viructae (Fischer, 1993) comb. nov. and Dinotrema matherana (Fischer, 1993) comb. nov. and one species is considered as an unavailable name. The Himalaya Biogeographic Zone supports the maximum diversity (45 species), followed by the Gangetic Plains (12 species), North-East (4 species), Western Ghats (4 species), Deccan Peninsula (4 species) and Semi-Arid (3 species).

New species and records of Sericini of India (Coleoptera: Scarabaeidae: Melolonthinae) II.

Here we present a new record of Microserica nicobarensis (Redtenbacher, 1868) and describe further two new species from India: Nepaloserica cheemaensis Bhunia, Gupta, Chandra Ahrens new species, and Maladera reyaensis Bhunia, Gupta, Chandra Ahrens, new species. Species morphology is described and illustrated, and their distribution is shown on a map.

Diagnosis and Arthroscopic Treatment of Synovial Chondromatosis of Glenohumeral Joint: A Case Report.

INTRODUCTION: Synovial chondromatosis is a rare benign entity with the presence of cartilaginous or osseous loose bodies in the synovium. It commonly involves the larger joints such as the knee, hip, ankle and rarely the shoulder joint manifesting with pain, swelling, and restriction of movements. The treatment of choice is surgical intervention in symptomatic patients using either the open or the arthroscopic approach. CASE REPORT: Here, we report a rare case of synovial chondromatosis affecting the right shoulder joint in a 23-year-old male with a 5-year disease duration who presented with progressive pain and restriction in movements which were impacting his routine activities. The loose bodies were removed using the arthroscopic approach combined with a partial synovectomy, and intra-articular methylprednisolone post procedure. The patient showed an excellent recovery in joint mobility within 4 weeks post-operatively, and there were no clinical signs of recurrence during a 6-month follow-up period. CONCLUSION: We believe that arthroscopic surgery is effective in the treatment of patients with synovial chondromatosis with advantages such as good visualization, lesser morbidity, and early return of functional activities.

New species and records of Sericini from India (Coleoptera: Scarabaeidae: Melolonthinae).

Five new sericine species (Coleoptera, Scarabaeidae: Melolonthinae) are described, diagnosed and illustrated from India: Lepidoserica barapaniensis Chandra, Ahrens, Bhunia, Sreedevi Gupta, new species, Maladera kaimurensis Chandra, Ahrens, Bhunia, Sreedevi Gupta, new species, M. silviafabriziae Chandra, Ahrens, Bhunia, Sreedevi Gupta, new species, M. kottagudiensis Chandra, Ahrens, Bhunia, Sreedevi Gupta, new species, and M. tripuraensis Chandra, Ahrens, Bhunia, Sreedevi Gupta, new species. This paper also presents new locality records, including first state records for 74 species (including two subspecies) of Sericini from the Indian subcontinent.

Hibernoma Around Shoulder Joint: Diagnosis and Surgical Treatment of a Rare Presentation.

Introduction: Hibernomas are uncommon benign proliferations arising from the adipocytes of brown fat usually occurring over back, neck, shoulder, and thighs. It is an underreported entity often misdiagnosed as a lipoma. Case Report: We report a case of an otherwise healthy thirty-four-year-old male who presented with a painless swelling, with no preceding trauma, involving the right shoulder joint of three months duration. MRI revealed it to be a fatty intense lesion arising within the anterior fibers of the right deltoid. The tumor was removed en-masse with wide local excision through the deltopectoral route. The histopathology of the resected tumor was consistent with the diagnosis of hibernoma. The patient recovered the previously hindered movements at the shoulder joint 2 weeks post-operatively. Conclusion: Hibernoma should be considered as a differential diagnosis for soft tissue tumors occurring in the above-mentioned sites. It can be completely resected surgically and no recurrences post-excision have been reported till date.

Long-standing case of osteochondromatosis of the hip treated with uncemented modular bipolar hemiarthroplasty: A case report.

INTRODUCTION: Synovial chondromatosis is a rare synovial disorder characterized by the presence of benign loose bodies in the joint space. The affliction of the hip joint is rare. This entity usually goes undiagnosed as it is largely asymptomatic till complications such as secondary osteoarthritis secondary to degenerative changes, subluxation of hip, and fracture neck of femur ensue. CASE REPORT: A 46-year-old farmer presented with a 9-year long history of the left hip pain with restriction in flexion, extension, and internal rotation. He was diagnosed with synovial chondromatosis and had a history of undergoing arthroscopic debridement following which he was asymptomatic but relapsed after 6 months. We performed excision with uncemented modular bipolar hemiarthroplasty after confirming the diagnosis on plain radiographs and computed tomography. Significant recovery in the range of motion was noted postoperatively and the patient showed no signs of relapse in the follow-up period of 18 months. CONCLUSION: Treatment of synovial chondromatosis of the hip joint poses a challenge due to its complex anatomy.

Redescription of Afissa gibbera (Crotch, 1874) and Uniparodentata circummaculata (Pang amp; Mao, 1977) (Coccinellidae: Epilachnini) from India.

Two poorly known species of the tribe Epilachnini (Coleoptera: Coccinellidae) are redescribed and diagnosed from India: Afissa gibbera (Crotch) and Uniparodentata circummaculata (Pang Mao), supported with photographs of the male genitalia. Also, U. circummaculata is a new record to India.

A new species and new records of the genus Bolboceras Kirby, 1819 (Coleoptera: Scarabaeoidea: Geotrupidae: Bolboceratinae) from India.

A new species of the genus Bolboceras Kirby, 1819; Bolboceras arunachalensis Chandra, Gupta Ghosh, new species (Coleoptera: Geotrupidae: Bolboceratinae) from Arunachal Pradesh, India is described, diagnosed, and illustrated. Bolboceras perpunctatum Krikken, 2013 is recorded for the first time from Central India.