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Traumatic L5 over S1 spondyloptosis without neurologi- cal involvement managed nonoperatively： a case report

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Chinese Journal of Traumatology 2013年第3期16卷 178-181页

作者： Vijay Goni Nirmal Raj gopinathan Uttam Chand Saini Shashidhar B Kantharajanna Department of Orthopaedics Post Graduate Instituteof Medical Education and Research Chandigarh India

High-grade spondylolisthesis is very rare. We came across a case of high-grade spondylolisthe- sis at the L5-S1 level in a 32-year-old manual labourer who was hit by a heavy object on his flexed back. The patient presented to us with persistent deformity in the back. He complained of back pain on prolonged standing and after moderate work. Because of that he was unable to return to his work. On clinical examination there was a large step in the lower lumbar region. Detailed neurological evaluation of the lower limbs did not reveal any sensory or motor deficit, neither did bowel or bladder involvement. Radiographic examination showed Ls over S1 traumatic spondyloptosis. CT scan revealed that neural canal was in normal width. MRI confirmed spondyloptosis of L5 over S~ without any compromise of the spinal canal and with normal-looking cauda. Concerning the delayed presentation and no neuro- logical deficit, the patient was managed conservatively af- ter thorough counsel. At 6 months, the patient returned to his work and at the latest follow-up （15 months） he was free from back pain. Conservative means of treatment can lead to satisfactory outcome, especially when the patient has delayed presentation.

关键词： Spine Spondylolisthesis Back pain

latrogenic aortic pseudoaneurysm following anterior tho- racic spine surgery masquerading as chronic infection

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Chinese Journal of Traumatology 2013年第6期16卷 368-370页

作者： Vijay Goni A jay Bahl Nirmal Raj gopinathan Vibhu Krishnan Rajesh Kumar Department of Orthopaedics Postgraduate Institute ofMedical Research and Education Chandigarh India

Late vascular complications involving aorta are rare but devastating adversities following anterior thoracic spine operations are *** current article describes our experience with one such patient who had an iatrogenic pseudoaneurysm of the thoracic aorta,mimicking *** patient was treated successfully following concomitant efforts by multidisciplinary experts with *** wish to highlight upon the significance of recognizing the possible sinister consequences of a dangerously prominent spinal implant and the role of a suspicious surgeon in identifying these menacing complications at the right time.

关键词： Fractures, bone Aorta, thoracic Aneurysm, false latrogenic disease

Management of neglected cervical spine dislocation： a study of six cases

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Chinese Journal of Traumatology 2013年第4期16卷 212-215页

作者： Vijay Goni Nirmal Raj gopinathan Vibhu Krishnan Rajesh Kumar Avinash Kumar Department of Orthopaedics Postgraduate Institute ofMedical Education and Research Chandigarh 160012India Department of Orthopedics RML Hospital New DelhiIndia

Objective： To report a case ser/es of six neglected cervical spine dislocations without neurological deficit, which were managed operatively. Methods： The study was conducted fromAugust 2010 to December 2011 and cases were selected from the out- patient department of Postgraduate Institute of Medical Education and Research, India. The patients were in the age group of 30 to 50 years. All patients were operated via both anterior and posterior approaches. Results： During the immediate postoperative period, five （83.33%） patients had normal neurological status. One （16.67%） patient who had C5-C6 subluxation developed neu- rological deficit with sensory loss below C6 level and motor power of 2/5 in the lower limb and 3/5 in the upper limb below C6 level. Conclusion： There is no role of skull traction in ne- glected distractive flexion injuries to cervical spine delayed for more than 3 weeks. Posterior followed by anterior ap- proach saves much time. If both approaches are to be done in the same sitting, there is no need for instrumentation posteriorly. But if staged procedure is planed, posterior sta- bilization is recommended, as there is a risk of deterioration in neurological status.

关键词： Cervical vertebrae Neck Postoperative complications

Distal femoral physeal crush injury with metaphyseal comminution - A report of two cases and a new perspective to physeal injury

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Chinese Journal of Traumatology 2017年第6期20卷 366-369页

作者： Prateek Behera Nirmal Raj gopinathan Avinash Kumar Balaji Saibaba Pebam Sudesh Rakesh John Department of Orthopaedics PGIMER Chandigarh 160012 India Central Institute of Orthopaedics VMMC and Safdarjung Hospital New Delhi 110029 India

The physis of a long bone may get ＇sandwiched＇ and crushed between the metaphysis and the epiphysis if it is traumatically loaded along its long axis. Such a physeal injury may lead to complications like angular deformities and growth restrictions and hence, management of such injuries requires adequate planning and attentive execution. Two patients with distal femoral physeal crush injury were treated using a ring fixator such that one ring had the wires passing through the epiphysis and the other through the femoral shaft. On table image intensifier controlled distraction of the crushed physis was done to bring the height of the physis similar to that of the opposite limb. Patients were followed up for more than two years clinically and radio- logically. There was no clinical or radiological angular deformity of the operated limbs. MRI scans showed intact physes with no physeal bar formation in either of the two patients. The distraction obtained by the ring fixator appears to have provided ample ＇breathing space＇ to the compressed physis and that the growth potential may have been re-gained by the procedure. However, two years is a relatively short duration of follow-up and further follow-up of longer duration and in greater number of patients is needed to gauge the actual effectiveness of the technque used bv us.

关键词： Salter Harris classification Physeal injuries Distal femoral physis Distraction Ring fixator

Elucidation of thermally induced internal porosity in zinc oxide nanorods

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Nano Research 2018年第5期11卷 2412-2423页

作者： Albertus D. Handoko Laura-Lynn Liew Ming Lin gopinathan Sankar Yonghua Du Haibin Su Zhili Dong Gregory K. L. Goh Institute of Materials Research and Engineering Agency for Science Technology and Research (A＊STAR) Singapore 138634 Singapore School of Materials Science and Engineering Nanyang Technological University Singapore 639798 Singapore Department of Chemistry University College London London WC1H0AJ UK Institute of Chemical and Engineering Sciences Agency for Science Technology and Research (A＊STAR) Singapore 627833 Singapore

In situ electron microscopy, tomography, photoluminescence, and X-ray absorption spectroscopy were utilized to monitor and explain the formation and growth of internal pores within ZnO nanorods. Careful examination using electron microscopy and tomography indicate that nanosized intemal pores start appearing within the individual solution-grown ZnO nanorods upon exposure to 200 ℃. The pore volume growth rate is proportional to the heat treatment time, indicating that the process is diffusion controlled, akin to a reverse Ostwald ripening-like process. A manageable pore growth rate of 1.4-4.4 nm^3·min^-1 was observed at 540 ℃, suggesting that the effective control over internal porosity can be achieved by carefully controlling the heat-treatment profile. Mechanistic studies using X-ray absorption spectroscopy indicated that the pore formation is linked to the significant reduction of the number of zinc vacancies after heat treatment. An optimum condition exists where most of the native surface defects are removed, while the bulk defects are contained within the internal pores. It is also demonstrated that the internal porosity can be exploited to improve the visible light absorption of ZnO. A combination of the lower defect density and improved light absorption of the heat-treated ZnO films thus lead to an increase in the photo- electrochemical response of more than 20× compared to that of the as-grown ZnO.

关键词： zinc oxide solution growth hydrothermal porosity photocatalysis photocurrent

Predictors of early outcome in unstable pelvic fractures

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Chinese Journal of Traumatology 2013年第2期16卷 94-98页

作者： Ramesh K. Sen Nirmal Raj gopinathan Tajir Tamuk Rajesh Kumar Vibhu Krishnan Radheshyam Sament Department of Orthopaedics and Traumatology Postgraduate Institute of Medical Education and Research Chandigarh India

Objective： To define the preoperative and intraoperative variables which may affect the immediate postoperative outcome in surgically managed patients with unstable pelvic fractures. Methods： This study was performed prospectively from January 2009 to June 2011 on 36 consecutive patients admitted to the trauma ward of Postgraduate Institute of Medical Education and Research, Chandigarh, with unstable pelvic injuries. Results： In the present study of 36 patients, 29 were managed surgically. Surgical duration was 2 hours in pa- tients operated on within 1 week and 3.4 hours in those operated on after 1 week. The blood loss was 550 ml when surgery was done after a week, but when done within a week it was 350 ml. The average blood loss through Pfanenstial approach was 360 ml, through posterior approach was 408 ml and through combined approach was 660 ml which was significantly high. Conclusion： Anterior approach to the pelvis would cause significantly more amount of blood loss than poste- rior approach and extemal fixation. Surgical approaches do not have any influence on the surgical duration or the infec- tion rate. The blood loss significantly increases when the surgical time is more than 1 h. The infection rate is not influ- enced by the duration of surgery. Presence or absence of associated injuries to the head, chest or abdomen is the main determinants of patient＇s survival and it greatly influ- ences the duration of hospital stay.

关键词： Pelvis Fractures, bone Treatmentoutcome Pubic symphysis

Proximal tibial and fibular physeal fracture causing popliteal artery injury and peroneal nerve injury： A case report and review of literature

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Chinese Journal of Traumatology 2015年第4期18卷 238-240页

作者： Uday Guled Nirmal Raj gopinathan Vijay G. Goni Arjun Rhh Rakesh John Prateek Behera Department of Orthopaedics Postgraduate Institute of Medical Education & Research Chandigarh 160012 India

Either proximal tibial or tibial physeal injuries are rare. The combination of both is even rarer, let alone causes a vascular injury. Early intervention is the key for management. We hereby present an interesting case of simultaneous proximal tibiofibular physeal injury with popliteal arterial occlusion and common peroneal nerve injury. The present case is important in two aspects： firstly it reports a very rare occurrence of simultaneous proximal tibiofibular physeal injury associated with vascular insult and common peroneal nerve injury; secondly it highlights that with timely intervention excellent results can be achieved in paediatric patients.

关键词： physeal injury Peroneal nerve Popliteal artery Tibia fracture

Expectations from imaging for pre-transplant evaluation of living donor liver transplantation

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World Journal of Radiology 2014年第9期6卷 693-707页

作者： Tiffany Hennedige gopinathan Anil Krishnakumar Madhavan Department of Diagnostic Imaging National University Health and Yong Loo LinSchool of Medicine Department of Department of General Surgery National University Hospital Singapore

Living donor liver transplant(LDLT)is a major surgi-cal *** pre-operative assessment of the vascular and biliary anatomy is crucial for safe and successful harvesting of the graft and *** tomography(CT)and magnetic resonance imaging(MRI)are currently the imaging modalities of choice in pre-operative *** cross-sec-tional imaging techniques can reveal the vascular and biliary anatomy,assess the hepatic parenchyma and perform volumetric *** of the broad indications and contraindications to qualify as a recipi-ent for LDLT is essential for the radiologist reporting scans in a pre-transplant ***,awareness of the various anatomical variations and pathological states in the donor is essential for the radiologist to generate a meaningful report of his/her *** and MRI have largely replaced invasive techniques such as catheter angiography,percutaneous cholan-giography and endoscopic retrograde *** order to generate a meaningful report based on these pre-operative imaging scans,it is also mandatory for the radiologist to be aware of the sur-geon’s *** intend to provide a brief over-view of the common surgical concepts of LDLT and give a detailed description of the minimum that a radiologist is expected to seek and report in CT and MR scans per-formed for LDLT related evaluation.

关键词： Liver transplantation Pre-living donor liver transplant imaging Vascular anatomy and variants Biliary anatomy and variants Computed tomography Magnetic resonance imaging

Elbow dislocation with ipsilateral diaphyseal forearm bone fracture： A rare injury report with literature review

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Chinese Journal of Traumatology 2015年第2期18卷 113-115页

作者： Vijay Goni Prateek Behera Umesh Kumar Meena Nirmal raj gopinathan Narendranadh Akkina R.H.H. Arjun Department of Orthopedics Post Graduate Institute of Medical Education and Research Chandigarh 160012 India

Dislocation of the elbow along with shaft fractures of both bones of the ipsilateral forearm is a rare injury though elbow dislocation or fracture of the forearm bones may occur separately. Such injuries need a concentric reduction of the dislocation and an anatomical fixation of forearm bones for optimal functional outcomes. We report a case of elbow dislocation with fracture of the lateral condyle of the hu- merus along with fractures of shafts of the radius and ulna in a 44-year-old female. Closed reduction of the elbow and operative stabilization of all fractures were done with good clinical, radiological and functional outcomes in 2 years follow-up period. A significant degree of force is needed to produce a combined dislocation of a joint and fracture of bones around that joint and these complex injuries may be missed if the clinician is not aware of the possibility of such injuries. The fact that the previously reported cases had a posterolateral dislocation while our case had a posteromedial dislocation and a fracture of the lateral humeral condyle as well makes it unique in its presentation and worth reporting. We have also included an up to date literature review on this topic.

关键词： Elbow Forearm injuries Fracture fixation Humeral fractures