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Outcome of distal end clavicle fractures treated with locking plates

Chinese Journal of Traumatology 2017年第1期20卷 45-48页

作者： Raju Vaishya vipul Vijay Vikram Khanna Department of Orthopaedics Indraprastha Apollo Hospital New Delhi India

Purpose: Fractures of the lateral end of the clavicle are relatively uncommon. These fractures are unstable due to the various deforming forces which act on the fragments as well as the small distal fracture fragment. At most times the deforming forces are not taken into consideration, and the fracture is not fixed securely. In this study, we assessed a fixation technique using the precontoured locking plates to find out whether it provided a stable fixation with good functional outcome. Methods: Totally, 32 patients with lateral end clavicle fracture (Neer's Type II) were included in the study. After the informed consent and preoperative investigations were obtained, open reduction and internal fixation was done using a 3.5 mm precontoured superior locking plate with lateral extension under general anesthesia. Postoperative X-rays were done on day 1 and every 6 weeks after operation, until radiological union was achieved. The postoperative pain was assessed using Visual Analogue Scale (VAS) on postoperative days 1, 2 and 10. Postoperatively arm pouch sling was given for 2 weeks followed by active mobilization. Patients were asked to do their daily routine work and avoid lifting heavy weights. The functional outcome was assessed at the end of 2nd and 6th months with the help of Disabilities of the Arm, Shoulder and Hand (DASH) scoring. Results: There were no intraoperative complications in the procedure. The mean VAS score on post-operative day 1 was found to be 5 which decreased to 3 on day 2 and 0 on day 10. The mean DASH score was calculated as 11.63 at the end of postoperative month 2 and then 4.6 at the end of month 6. There was one case of malunion in whom the overhead abduction was restricted but was not painful and was managed conservatively. Conclusion: The precontoured locking plates with lateral extension may be a good method to fix the fractures of the lateral end clavicle, which provide a stable fixation with good functional outcome with very few instances of stiffness and decreased range of motion o

关键词： Lateral end clavicle fractures Precontoured locking plates Functional outcome

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Bilateral segmental pelvic and femoral fractures in a young female： A rare case report

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Chinese Journal of Traumatology 2016年第5期19卷 286-289页

作者： Raju Vaishya Amit Kumar Agarwal Nishint Gupta vipul Vijay Department of Orthopaedics and Joint Replacement Surgery lndraprastha Apollo Hospitals New Delhi 110076 India

尽管有前进，多重复杂受伤病人的管理在现代医疗保健仍然是大挑战。我们在场与双边的部分大腿骨的柄联系的双边的不稳定的骨盆的破裂的一个稀罕案例断裂。我们建议了如此的复杂损害模式的机制并且讨论了管理的计划。在稳定病人的医学上... 详细信息

尽管有前进，多重复杂受伤病人的管理在现代医疗保健仍然是大挑战。我们在场与双边的部分大腿骨的柄联系的双边的不稳定的骨盆的破裂的一个稀罕案例断裂。我们建议了如此的复杂损害模式的机制并且讨论了管理的计划。在稳定病人的医学上帮助了我们的病人克服这些严重、致命的损害后不久，我们相信修理所有专业的及时、好攻击的外科的干预断裂。由进行为如此的复杂破裂的管理建立一个最佳的协议是必要的未来并且 multicentric 以后学习。

关键词：骨盆大腿骨的破裂肋骨破裂

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Dislocation of a constrained total knee arthroplasty with patellar tendon rupture after trivial trauma

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Chinese Journal of Traumatology 2015年第4期18卷 241-244页

作者： Raju Vaishya vipul Vijay Abhishek Vaish Orthopedics and Joint Replacement Surgery lndraprastha Apollo Hospitals Sarita Vihar Mathura Road New Delhi 110076 India

Constrained total knee prostheses are used in knees with severe deformities and insufficiency of collaterals to provide stable and mobile knees. Dislocation after constrained knee prosthesis is an extremely rare and dreaded complication. When dislocation is associated with patellar tendon rupture, the management includes restoration of the extensor apparatus along with a stable knee. Repair of the patellar tendon is challenging due to poor soft tissue coverage in the area and a bulky repair can put tension on the wound closure. Ideal method of restoration of the extensor apparatus is a matter of debate. There are various modalities used ranging from primary end-to-end repair, augmentation by medial gastrocnemius flap, semitendinosus and synthetic implants and allograft tendoachilles. We report a rare case of a posterior dislocation of a constrained total knee arthroplasty in association with patellar tendon rupture due to a minor fall after a few weeks of surgery. The first episode was managed by reposition of the dislocation and V-Y plasty of the quadriceps and primary repair. The second episode of dislocation with re-rupture needed augmentation by semitendinosus along with the insertion of the thicker insert. The management of this complex problem along with the review of literature is discussed in this case reoort.

关键词：下线服务迁移

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Computerized tomography based “patient specific blocks” improve postoperative mechanical alignment in primary total knee arthroplasty

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World Journal of Orthopedics 2016年第7期7卷 426-433页

作者： Raju Vaishya vipul Vijay Vikas P Birla Amit K Agarwal Department of Orthopaedics Joint Replacement and ArthroscopyIndraprastha Apollo Hospital

AIM: To compare the postoperative mechanical alignment achieved after total knee arthroplasty(TKA) using computer tomography(CT) based patient specific blocks(PSB) to conventional instruments(CI).METHODS: Total 80 knees were included in the study, with 40 knees in both the groups operated using PSB and CI. All the knees were performed by a single surgeon using the same cruciate sacrificing implants. In our study we used CT based PSB to compare with CI. Postoperative mechanical femoro-tibial angle(MFT angle) was measured on long leg x-rays using picture archiving and communication system(PACS). We compared mechanical alignment achieved using PSB and CI in TKA using statistical analysis.RESULTS: The PSB group(group 1) included 17 females and seven males while in CI group(group 2) there were 15 females and eight males. The mean age of patients in group 1 was 60.5 years and in group 2 it was 60.2 years. The mean postoperative MFT angle measured on long-leg radiographs in group 1 was 178.23°(SD = 2.67°, range: 171.9° to 182.5°) while in group 2, the mean MFT angle was 175.73°(SD = 3.62°, range: 166.0° to 179.8°). There was significant improvement in postoperative mechanical alignment(P value = 0.001), in PSB group compared to CI. Number of outliers were also found to be less in group operated with PSB(7 Knee) compared to those operated with CI(17 Knee).CONCLUSION: PSB improve mechanical alignment after total knee arthroplasty, compared to CI. This may lead to lower rates of revision in the PSB based TKA as compared to the conventional instrumentation.

关键词： Knee Replacement Arthroplasty Patient specific jigs Conventional jigs

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Global Dynamics of a Multi-group SEIR Epidemic Model with Infection Age

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Chinese Annals of Mathematics,Series B 2021年第6期42卷 833-860页

作者： vijay Pal BAJIYA Jai Prakash TRIPATHI vipul KAKKAR Jinshan WANG Guiquan SUN Department of Mathematics Central University of RajasthanBandar Sindri-305817KishangarhAjmerRajasthanIndia Complex Systems Research Center Shanxi UniversityTaiyuan 030006China Department of Mathematics North University of ChinaTaiyuan 030051China Complex Systems Research Center Shanxi UniversityTaiyuan 030006China.

Consider the heterogeneity(e.g.,heterogeneous social behaviour,heterogeneity due to different geography,contrasting contact patterns and different numbers of sexual partners etc.)of host population,in this paper,the authors propose an infection age multigroup SEIR epidemic model.The model system also incorporates the feedback variables,where the infectivity of infected individuals may depend on the infection age.In the direction of mathematical analysis of model,the basic reproduction number R_0 has been computed.The global stability of disease-free equilibrium and endemic equilibrium have been established in the term of R_(0).More precisely,for R_(0)≤1,the disease-free equilibrium is globally asymptotically stable and for R_(0)>1,they establish global stability of endemic equilibrium using some graph theoretic techniques to Lyapunov function method.By considering a numerical example,they investigate the effects of infection age and feedback on the prevalence of the disease.Their result shows that feedback parameters have different and even opposite effects on different groups.However,by choosing an appropriate value of feedback parameters,the disease could be eradicated or maintained at endemic level.Besides,the infection age of infected individuals may also change the behaviour of the disease,global stable to damped oscillations or damped oscillations to global stable.

关键词： Multi-group model Infection age Feedback Graph-theoretic approach Lyapunov function

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