DocumentsDate added
Research article:
Kashyap Shah1,*,Prasanna Ku. Pradhan2,Shreya R Shah2
Affiliation:-
1Department of Quality Assurance, Sigma Institute of Pharmacy, Bakrol, Vadodara, Gujarat, India
2H.O.D, Department of Quality Assurance, Sigma Institute of Pharmacy, Bakrol, Vadodara, Gujarat, India
3Department of Quality Assurance, Sigma Institute of Pharmacy, Bakrol, Vadodara, Gujarat, India
The name of the department(s) and institution(s) to which the work should be attributed:
Department of Quality Assurance, Sigma Institute of Pharmacy, Bakrol, Vadodara, Gujarat, India
Abstract
A simple high-performance liquid chromatography (HPLC) method has been developed and validated for the simultaneous determination of ondansetron (ONDA) and dexamethasone (DEXA) in UV and HPLC. Method was performed using an Enable C18 G column. (150 mm × 4.6 mm, 5 μm: Spinco Biotech Pvt Ltd) and Enable C18 Luna (150 mm × 4.6 mm, 5 μm). The mobile phase consisted of Methanol, acetonitrile and water in ratio 60:10:30 V/V (pH 5.5 with 10% ortho phosphoric acid) at a flow rate of 1.0 ml/min. The method was validated under the range from 50-8000ng/ml for both ONDA and DEXA. The absolute recovery of ONDA ranged from 98.0 to 105.28% while DEXA recoveries ranged from 99.0 to 102.63%.
Keywords: Ondansetron; Dexamethasone; Validation; UV; HPLC
*To whom it corresponds:-
Kashyap Kiritbhai Shah,
Department of Quality Assurance, Sigma Institute of Pharmacy, Bakrol, Vadodara, Gujarat, India
Mo No: 9998978515
9016206961
REFERENCES
1.http://www.clinicaltrial.gov.in/phase-3Trials/Ondansetrone&Dexamethasone,date accessed on 23-06-2013.
2.http://www.clinicalresearch.gov.in/external/socrel/content/hplc.html,date accessed on 05-07-2013.
3.http://www.chemistry.adelaide.edu.au/external/socrel/content/hplc.html,date accessed on 23-06-2013.
4.Drug bank, Drug profile, Ondansetrone ,2013.
5.http://www.drugbank.ca/drugs/DB06203, date accessed on 25-06-2013.
6.Drug bank, Drug profile, Dexamethasone, 2013.
7.http://www.drugbank.ca/drugs/DB06165, 2012.
8.Shethi PD, HPLC-Quantitative analysis of pharmaceutical formulations, 1st edition, CBS publishers & distributors, 2001, 141.
9.ICH, Guidance for Industry, Q1A Stability Testing of New Drug Substances and Products. ICH-Q1A, 2001(August).
10.International Conference on Harmonisation, Guidance for Industry In;
11.Q2B Validation of Analytical Procedures, Methodology, Switzerland, IFPMA, 1996, 1-8.
12.Skoog DA, Holler FJ, Nieman TA, Principles of Instrumental Analysis, Harcourt Asia Pvt Ltd & Harcourt Collage Publishers, 5th edition, 1998, 728-744.
13.Beckett AH, Stenlake JB, UV-visible Spectrophotometry, Practical Pharmaceutical Chemistry, 4th ed, Part-II, C.B.S. Publishers, Delhi, 2001,285-97.
14.Sharma YR, Ultraviolet and visible spectroscopy in Elementary Organic Spectroscopy, 1sted, S. Chand & Company Ltd, New Delhi, 2004, 9-60.
15.Meyer VR, Practical High Performance Liquid Chromatography, 2nded, John wiley and sons, London, 1993, 26 - 258.
16.Kazakevich Y, Lobrutto R, HPLC for Pharmaceutical Scientists, 1sted.John Wiley & Sons Inc, Hoboken New jersey, 2007.
17.Snyder LR., Kirkland JL, Glajch JL, Practical HPLC Method Development, New York, Wiley, 1997
18.The United States Pharmacopoeia 30 NF 25, The US Pharmacopoeial Convention, 2009, 2001.
19.The British Pharmacopoeia, The Stationary office on behalf of the Medicines and Healthcare products Regulatory Agency, 2011, 2, 2146.
20.The United States Pharmacopoeia 30 NF 25, The US Pharmacopoeial Convention. 2009,3082.
21.The British Pharmacopoeia, The Stationary office on behalf of the Medicines and Healthcare products Regulatory Agency, 2011,2,5107.
22.Government of India, Ministry of Health and Family Welfare, The Indian pharmacopoeia, The Indian Pharmacopoeia Commission, Ghaziabad,2010:287.
23.Mushabbarbasha MD, and Srinidhi M, Devlopment and Validation Of Ondansetrone In Bulk and Dosage Form. International Journal of Tech Research,2013, 5(1), 86-98.
24.Singh Pradeep Kumar and Dinda S, Devlopment and Validation OfOndansetrone in Films” International Journal Of Pharmaceutical Science, 2013;3(1):57-66.
25.Kalaichelvi R, and MADHAVA RAO M, “Spectrophotometric Method of Ondansetrone Hydrochloride Formulation”, International Journal of Pharmacy and Pharmaceutical Science, 2012;4(1):1491.
26.Dedania Z, Dedania R and Baldania M, Simultaneous Estimation of omeprazole & ondansetrone, Asian Journal of Research Chemistry, 2009;2(2):108-111.
27.Renuka GN and Rahaman H, Sepectrophotometric Method for the Estimation of Dexamethasone Sodium Phosphate. Indo Americal Journal of Pharmaceutical Research, 2013; 3:7103-7113.
28.PravinKumar P and Murlikrisna M, Derivative Spectrometric Estimation of Ondansetrone and Paracetamol.2006;3(3):134-136.
29.Smita M and Priya P, “Simultaneous Estimation of Ondansetrone and Pantoprazole. IOSR Journal of Pharmacy and Biological Science, 2012;4(3):05-08.
30.Raval PB, Puranik M and Wadher SJ, Indian Journal of Pharmaceutical Science. 2013:133-143.
31.Singh Pradeep Kumar, and Dinda S, Development and Validation Of Ondansetrone in Films. International Journal Of Pharmaceutical Science, 2013; 3(1):57-66.
32.Imran A, Jat RK and Varnika S, Development & validation of RP-Hplc Method of ondansetrone hydrochloride & it`s Bulk Drug, IRJP,2012;3(2):111-113.
33.Menyananthan YN, Krisnanveni N, Babu B, and Suresh B, Simultaneous estimation of ondansetrone and ranitidine in pharmaceutical formulation,Indian Journal of Pharmaceutical Science, 2012; 1(2):129-132.
34.ViswewaraRao K, Padmaja Reddy K and Kalyan K, simultaneos trace level quantification of Glyoxol in ondansetrone Hydrochloride, journal of pharmaceutical science, 2012;5(12):5449-5452.
35.Garcia CV, Breier AR, Steppe M and Oppe TP, J. Pharma Biomed Anal, 2013; 31(3):597-600.
36.Prakash K, Katakam S and Kumari R, International Journal of Pharmacy and Pharmaceutical Science, 2012; 4: 505.
37.Gracia CV, Breier AR, Steppe M and Oppe TP, “Determination of dexamethasone acetate in cream by Hplc” journal of Pharma Biomed Anal, 2003; 31(3): 597-600.
38.Katakam P and Sireesha K, Simultaneous Determination of Dexamethasone Sodium Phosphaate and Chloramphenicol In Bulk and Formulation. Int J Pharm Pharm Sci, Vol 4, Suppl 4, 505-510.
39.Chen Q, Zielinski D, Chen J, Koski A and Nowak S, US National Library of Medicine National Institute of Health, 2008;48(3):792.
40.Heda A, Kathiriya M and Puranik P, Simultaneous Determination of Granisetrone and Dexamethasone, Indian Journal of Pharmaceutical Science, 2011: 73(6); 696-699.
41.Melojevic Z, Agbaba D, and Ristic P, High Performance Chromatography of Dexamethasone and Xylometazoline in Nasal Drops, Journal of Pharma Biomed Anal, 2002; 949(1-2):79-82.
42.Dabhi MJ, Patwari AH, Desai AH and Doshi DB, Simultaneous Determination of Moxifloxacin Hydrochloride and Dexamethasone Hydrochloride in Eye Drops, Journal of Chemical and Pharmaceutical Research, 2012;4(10): 4462-4467.
43.Maria Cristina Urban, Rubjana Mainardes and Maria Gramio, Devlopment and Validation of Dexamethasone Acetate in Microemulsion. Braz. J. Pharm. Sci.2009; 45(1):87-92.
44.Kang Ping Xiao, Yuan Xiao and Rustam Abu M, Trace Betamethasone or Dexamethasone in Betamethasone or Dexamethasone by Reversed Phase Hplc. journal of chromatographic science, 2008, 46.
45.Desai Urvish H, PtwariArpit H, and Bhanubhai N, “Simultaneous Estimation of Ciprofloxacin & Dexamethasone, International Journal of Pharmaceutical Science & Research, 2013;5(2):62-66.
46.Syed Naeem R, Marima I and Ullah Khan I, Determination of Sparfloxacin & Dexamethasone in Formulation, Brazilian Journal of Pharmaceutical Science & Research, 2313;49(2).
47.http//Drugs@FDA, date accessed on 06-07-2013.
48.http//www.drugsupdate.com/generic/view/516, date accessed on 14-07-2013.
49.http//www.medilexicon.com/drugs/xenazine.php, date accessed on 18-07-2013.
50.http//www.virtualmedicalcentre.com/drugs/tetrabenazine/3135, date accessed on 23-07-2013
51.http//www.drugbank.com/DB04844, date accessed on 12-08-2013.
52.http//www.sigma-aldrich.com, date accessed on 12-08-2013.
53.http//www.wikipedia.org, date accessed on 12-08-2013.
54.http//www.standardbase.com,accessed on 15-08-2013.
Abbreviation:- ODA: Ondansetron , DEXA; Dexamethasone, UV:Ultra violet,Abs:Absorption, (HPLC):High-Performance Liquid Chromatography, Conc: Concentration.
Article citation:
SHAH KK, Pradhan PK,Shah SR., Analytical Method Development and validation for simultaneous estimation of ondansetron and dexamethasone in synthetic mixture. J Pharm Biomed Sci 2014;04(05):448-458. Available at www.jpbms.info.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Copyright © 2014 Shah KK., Pradhan PK, Shah SR., This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Research article
Rugmini Kamalammal1,*, P.J.Parameaswari2,Afeed Ibrahim3,Soorya Rao R4.
Affiliation:-
1Associate Professor,Department of pediatrics,Sree Balaji Medical College and Hospital,Bharath University,Chrompet, Chennai,India
2Assistant Professor,Department of Community Medicine, Sree Balaji Medical College and Hospital,Bharath University,Chrompet,Chennai,India
3Fellow in neonatology,Craft Hospital and Research Center, Kodungalur, Kerala, India
4D-97, Sunnyvale Apartments, 351,Konnur High road, Ayanavaram , Chennai,India
The name of the department(s) and institution(s) to which the work should be attributed:
Department of pediatrics, Sree Balaji Medical College and Hospital, Bharath University, Chrompet, Chennai, India
Department of Community Medicine, Sree Balaji Medical College and Hospital, Bharath University, Chrompet, Chennai, India
*To whom it corresponds:-
Dr. Rugmini Kamalammal DNB (Pediatrics)
D-97, Sunnyvale Apartments, 351, Konnur High road, Ayanavaram , Chennai -23,India
Abstract
It is found that various anthropometric surrogates of birth weight in newborn can be used in the community and they correlate each other positively. The aim of this study was to find out the most effective anthropometric parameter in the newborn to assess birth weight. A cross sectional study was conducted in a tertiary care hospital in Chennai. Moderate Positive correlation was observed between birth weight & Mid Arm Circumference(r=+0.56(P=0.000)) & next with Length(r=+0.558(P=0.000)). There was a statistically significant association between chest circumference and Birth weight with an odds ratio of 10.9 (5.29 to 22.7) in identifying the LBW babies. Cut-off values of the aforesaid measurements had good sensitivity and specificity for identifying LBW babies.
Conclusion: Length and Mid Arm Circumference are the best surrogates to predict birth weight.
Keywords: Anthropometric surrogates; birth weight.
REFERENCES
1.Save the children federation. World Health Organization. 2001 estimates saving newborn lives, state of the world children Washington DC 2001:1-49.
2.International Institute for Population Sciences (IIPS) and Macro International. 2007.National Family Health Survey (NFHS-3), 2005-06,India:Key Findings. Mumbai: IIPS.
3.Blanc AK, Wardlow T, monitoring low birth weight: an evaluation of international estimates and an update estimation procedure – bull world heal organization 2005;83:178-85.
4.Use of a Simple Anthropometric Measurement to Predict Birth Weight. Academic journal article. Bulletin of the World Health Organization. 1993;71 (2):157–163.
5.Kaur H and Bansal R .Anthropometric determinants of low birth weight in newborns of Hoshiarpur district (Punjab) - A hospital based study. Human Biology Review. 2012;1(4):376-386.
6.Kadam Y R, Somaiya P, Kakade S V. A Study of Surrogate Parameters of Birth Weight. Indian J Community Med 2005;30:89-91.
7.Sreeramareddy CT, Chuni N, Patil R, Singh D, Shakya B: . Anthropometric surrogates to identify low birth weight Nepalese newborns: a hospital-based study. BMC Pediatrics. 2008;8(16):1471-2431-8-16.
8.Das JC, Afroze A, Khanam ST, Paul N. Mid-arm circumference: an alternative measure for screening low birth weight babies. Bangladesh Med Res Counc Bull 2005;31:1-6.
9.Nair, R. Bindu, Elizabeth, K. E., Geetha, S., Varghese, Sarath.Mid Arm Circumference (MAC) and Body Mass Index (BMI)–The Two Important Auxologic Parameters in Neonates. Journal of Tropical Pediatrics. 2006; 52(5):341-345.
10.World Health Organization: Multi-centre study on low birth weight and infant mortality in India, Nepal and Sri Lanka. New Delhi: Southeast Asia Regional Office, World Health Organization; 1994:78. (SEARO regional health paper no. 25)
11.Rustagi N, Prasuna JG, Taneja DK. Anthropometric surrogates for screening of low birth weight newborns: a community-based study. Asia Pac J Public Health. 2012 Mar;24(2):343-51.
12.S K Kapoor, G Kumar, and K Anand. Use of mid-arm and chest circumferences to predict birth weight in rural north India. J Epidemiol Community Health. 1996 December; 50(6): 683–686.
13.Zakir Hussain, F Huque. Detection of low birth-weight new born babies by anthropometric measurements in Bangladesh.The Indian Journal of Pediatrics. 1991;58(2):223-231.
14.Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L, Neonatal Survival Steering Team: Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 2005; 365:977-988.
15.Mullany LC, Darmstadt GL, Caffey P, Waley SK, Leclarq SC, Tielsch JM, A Low Cost, Colour Coded, hand held spring scale accurately categorizes Birth Weight in low resource settings, Arch Dis Child 2006; 91:410-13.
Article citation:
Kamalammal R,Parameaswari PJ,Ibrahim A,R Soorya Rao. A Study on anthropometric surrogates to predict low birth weight babies. J Pharm Biomed Sci 2014;04(05):443-447.Available at www.jpbms.info.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Copyright © 2014 Kamalammal R,Parameaswar PJ,Ibrahim A,R Soorya Rao. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case report
Girish Gopal1,*, Gangadhar.B. Belavadi2
Affiliation:-
1Senior Resident, Department of Pediatrics, Mysore Medical College and Research Institute, Mysore -570001, Karnataka, India
2Professor and Head, Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore - 560002, Karnataka.
The name of the department(s) and institution(s) to which the work should be attributed:
Department of Pediatrics, Mysore Medical College and Research Institute, Mysore -570001, Karnataka,India
Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore - 560002, Karnataka,India
Abstract
Ichthyosis constitutes a heterogenous family of skin disorders with Harlequin ichthyosis being the most severe genetic form. It is an autosomal recessive disorder characterized by dry, severely thickened skin with large plaques of hyperkeratotic scales, separated by moist and deep erythematous fissures. Altered development of the skin in utero due to defective lipid metabolism in the lamellar granules of the keratinocytes results in this condition and is usually fatal in the neonatal period. We report a neonate with this rare form of congenital ichthyosis.
Keywords: Autosomal recessive, erythematous fissures, Harlequin ichthyosis, hyperkeratotic scales.
*To whom it corresponds:-
Dr. Girish Gopal;
Senior Resident,
Department of Pediatrics, Mysore Medical College & Research Institute, Irwin Road, Mysore – 570001, India
REFERENCES
1.Roya Farhadi, Seyyed Habib Kazemi. Harlequin ichthyosis in a neonate born with assisted reproductive technology: a case report. Medical Journal of the Islamic Republic of Iran 2013; 27(4):229-232.
2.Hueng – Bien Liao, Ruoh – Chiu Hwang, Chie – Yu Liou, Chin – Wang Hwang, Mong – Ling Chu, Jia – Sen Luo. Harlequin fetus – A case report. J Med Sci 1990; 10(6):381-384.
3.Hovnanian A. Harlequin ichthyosis unmasked: a defect of lipid transport. J Clin Invest 2005; 115(7):1708-1710.
4.Michael Mihalko, Karen K. Lindfors, Arthur W. Grix, William E. Brant, John P. McGahan. Prenatal Sonographic diagnosis of Harlequin ichthyosis. AJR 1989; 153:827-828.
5.Kouskoukis C, Minas A, Tousimis. D. Ichthyosis congenital fetalis (harlequin fetus). Int J Dermatol 1982; 21:347-348.
6.Joseph G. Morelli. Disorders of keratinization. Chapter 657 in: Robert M. Kleigman, Richard E. Behrman, Hal B. Jenson, Bonita F. Staton. Kleigman: Nelson Textbook of Pediatrics. 18th Edition. Philadelphia (USA): Elsevier; 2007, pp 2708-2709.
7.Ahmad Hashemzadeh, Farhad Heydarian. Harlequin Ichthyosis. Acta Medica Iranica 2009; 47:81-82.
8.Sriparna Basu, Amrita Ghosh Kar, Arti Mata, S Gupta, Ashok Kumar, BD Bhatia. Harlequin Ichthyosis. Pediatric Oncall Journal 2007; 4(8): Art #32.
9.Belengeanu, Stoicanescu D, Stoian M, Andreescu N, Budisan C. Ichthyosis congenital, harlequin fetus type: a case report. Advances in Medical Sciences 2009;54(1):113-115.
Article citation:
Girish G,Belavadi GB. Harlequin Ichthyosis – A case report. J Pharm Biomed Sci 2014;04(05):439-442. Available at www.jpbms.info.
Copyright © 2014 Gopal Girish,Belavadu GB. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Case report
Girish Gopal1,*, Gangadhar.B. Belavadi2
Affiliation:-
1Senior Resident, Department of Pediatrics, Mysore Medical College and Research Institute, Mysore -570001, Karnataka, India
2Professor and Head, Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore - 560002, Karnataka.
The name of the department(s) and institution(s) to which the work should be attributed:
Department of Pediatrics, Mysore Medical College and Research Institute, Mysore -570001, Karnataka, India
Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore - 560002, Karnataka, India
Abstract
Epidermolysis bullosa (EB) represents a rare, heterogenous group of genetically determined skin disorders manifested by an exceptional tendency of the skin and mucous membranes to form bullae and vesicles either spontaneously or as a result of mechanical trauma/friction. EB has been classified on genetic, clinical, and histological criteria into several distinct categories of which the three major subgroups are Epidermolysis bullosa simplex, junctional epidermolysis bullosa and dystrophic epidermolysis bullosa (DEB). Both autosomal dominant and recessive forms have been described in DEB. Ineffective or absent connective tissue anchoring fibrils, resulting in a loosely bound epithelial/subepithelial connective tissue interface results in this disorder. Autosomal recessive form of DEB is a rare form of EB characterized by a generalized blistering rash involving the entire skin and almost all mucous membranes. It manifests in the early neonatal period and is usually fatal. We report a 13 day old neonate who presented to us with clinical features consistent with recessive form of DEB.
Keywords: Anchoring fibrils; bullae; epidermolysis bullosa; vesicles.
*To whom it corresponds:-
Dr. Girish Gopal;
Senior Resident,
Department of Pediatrics, Mysore Medical College & Research Institute, Irwin Road, Mysore – 570001, India
REFERENCES
1.Gorlin RJ. Epidermolysis bullosa. Oral Surg Oral Med Oral Pathol. 1971; 32:760 - 766.
2.Leverkus M, Ambach A, Hoefeld-Fegeler M. Late-onset inversa recessive dystrophic epidermolysis bul¬losa caused by glycine substitutions in collagen type VII. Br J Dermatol. 2011; 164(5): 1104 - 1106.
3.Van den Akker PC, Mellerio JE, Martinez AE. The inversa type of recessive dystrophic epidermolysis bul¬losa is caused by specific arginine and glycine substitu¬tions in type VII collagen. J Med Genet 2011; 48(3): 160 - 167.
4.Enver Turan, Mehmet Salih Gurel, Aslı Turgut Erdemir, Burcu Isık, Nurdan Yurt. Epidermolysis bullosa dystrophica inversa: A case report. J Clin Exp Invest 2012; 3(3): 412-414.
5.Milne. B, Rosales JK. Anaesthesia for correction of oesophageal stricture in a patient with recessive epidermolysis bullosa dystrophica: case report. Canad. Anaesth. Soc. J 1980; 27(2): 169-171.
6.Hashimoto I, Anton-Lamprecht I, Hofbauer M. Epider¬molysis bullosa dystrophica inversa: report on 2 sis¬ters. Hautarzt. 1976; 27(11): 532-537.
7.Crikelair, George. F, Hoehn, Robert. J, Domonkos, Anthony. N, Binkert, Barbara. BA. Plastic and Reconstructive surgery 1970; 46(1): 89-92.
8.Hashimoto I, Schnyder UW, Anton-Lamprecht I, Gedde- Dahl T, Ward S. Ultrastructural studies in epider¬molysis bullosa hereditaria. III. Recessive dystrophic types with dermolytic blistering (Hallopeau-Siemens types and inverse type). Arch Dermatol Res. 1976; 256(2):137-150.
9.Kahofer P, Bruckner-Tuderman L, Metze D, Lemmink H, Scheffer H, Smolle J. Dystrophic epidermolysis bullosa inversa with COL7A1 mutations and absence of GDA-J/F3 protein. Pediatr Dermatol. 2003;20(3): 243-248.
10.Breit R. Epidermolysis bullosa dystrophica inversa, a review and case report. Hautarzt 1979; 30(9): 471-477.
11.McGrath JA, Schofield OMV, Mayou BJ, McKee PH, Eady RAJ. Epidermolysis bullosa complicated by squamous cell carcinoma: report of 10 cases. Journal of Cutaneous Pathology. 1992;19(2):116-123.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Article citation:
Girish G,Belavadi GB. Dystrophic Epidermolysis Bullosa in the newborn. J Pharm Biomed Sci 2014;04(05):434-438. Available at www.jpbms.info.
Copyright © 2014 Girish G,Belavadi GB. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original Article
P. Jhanwar 1,*, Harish Kumar Jain1, Suresh Dhakar2, Anshul Jhanwar3
Affiliation:-
1Associate Professor, 2Senior Resident, 3Demonstrator, Jhalawar Medical College, Jhalawar (Rajasthan),India
The name of the department(s) and institution(s) to which the work should be attributed:
Department of Orthopaedics, Jhalawar Medical College, Jhalawar (Rajasthan) India
*To whom it corresponds:-
Dr. P. Jhanwar;
Department of Orthopaedics, Jhalawar Medical College, Jhalawar (Rajasthan) India
Abstract
Purpose: To assess the results of minimal internal and hybrid external fixation for the management of a tibial plateau fracture with compromised soft tissue.
Methods: Total 17 cases of tibial plateau fracture with compromised soft tissue underwent minimal internal and hybrid external fixation between June 09 to June 12 in orthopedic department of S.R.G. Hospital & Medical College,Jhalawar (Rajasthan),India after a minimum of 12 months of follow-up (range 12–24 months) each affected knee was evaluated using Rasmussen’s radiological and functional scoring system.
Results: Fourteen procedures involved the right and three procedures involved the left knee. Five procedures were open and twelve were closed injuries with compromised soft tissue and skin blisters. Twelve cases of tibial plateau fractures were Schatzker type I, II & III, 2 were type IV and three type V & VI. Complications consisted of 2 pin site infections and 2 superficial infections. Soft tissue necrosis and proximal tibial bone exposure occurred in one patient, who was managed with split skin grafting. The mean Rasmussen radiological score was 12.62(range, 4–18).This score was excellent in 5 cases, good in 9 cases, fair in 1 and poor in 2 cases. The mean Rasmusssen functional score was 26.22(range, 9–30). This score was excellent in 10 patients, good in 4 patients, fair in 2 patients, and poor in 1 patient. Functional results were not parallel to radiological results. Fourteen patients (82.35%) had acceptable functional results (sum of excellent and good results).
Conclusion: Minimal internal and hybrid external fixation for management of a tibial plateau fracture is more biological, requires less surgical and hospital stay time, can be done in the presence of compromised soft tissue, is cost effective, and has minimal complications and good functional outcomes.
Keywords: External fixator; tibial plateau fractures; hybrid fixator.
REFERENCES
1.Watson JT. High-energy fractures of the tibial plateau. Orthop Clin North Am 1994; 25:723–52.
2.ColePA,ZlowodzkiM,KregorPJ.Treatment of proximal tibia fractures using the less invasive stabilization system:surgical experience and early clinical results in 77 fractures.J orthop Trauma.2004;18:52835.
3.MillsWJ,NorkSE.Open reduction and internal fixation of high-energy tibial plateau fractures. Orthop
Clin North Am 2002; 33:177–98.
4.Sirkin MS,Bono CM,Reilly MC,Behrens FF. Percutaneous methods of tibial plateau fixation. Clin Orthop Relat Res 2000;375:608.
5.Piper KJ, Won HY, Ellis AM. Hybrid external fixation in complex tibial plateau and plafond fractures:an Australian audit of outcomes. Injury 2005;36:178–84.
6.Schatzker J,McBroom R,Bruce D.The tibial plateau fracture.The Toronto experience 1968-1975.Clin Orthop Relat Res 1979;138:94–104.
7.Oestern HJ,Tscherne H. Pathophysiology and classification of soft tissue damage in fractures [in German]. Orthopade 1983;12:28.
8.Rasmussen PS. Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am 1973;55:1331–50.
9.DeCosterTA,NepolaJV,el-KhouryGY.Castbrace treatment of proximal tibia fractures.A ten- year follow-up study.Clin
10.Moore TM, Patzakis MJ, Harvey JP. Tibial plateau fractures: definition, demographics, treatment rationale, and long-term results of closed traction management or operative reduction. J Orthop Trauma 1987;1:97–119.
11.Young MJ, Barrack RL. Complications of internal fixation of tibial plateau fractures. Orthop Rev 1994;23:14954.
12.Christensen K,Powell J,Buchol zR,StillsM.Early results of combined internal-external fixation for treatment of high-grade tibial plateau fractures. J Orthop Trauma 1990;4:226.13.RangitschMR,DuweliusPJ,ColvilleMR.Limited internal fixation of tibial plateau fractures:a prospective protocol. J Orthop Trauma 1993; 7:168–9.
14.Salter RB, Simmonds DF, Malcolm BW, Rumble EJ, MacMichael D, Clements ND. The biological effect of continuous passive motion on the healing of full-thickness defects in articular cartilage.An experimental investigation in the rabbit. J Bone Joint Surg Am 1980;62:1232–51.
15.StannardJP, Wilson TC, VolgasDA, Alonso JE. The less invasive stabilization system in the treatment of complex fractures of the tibial plateau: short-term results. J OrthopTrauma2004;18:552–8.
16.Golyakhovsky V, Ferrara PL. Operative manual of Ilizarov techniques. Mosby; 1993:171–90.
17.WatsonJT,RippleS,HoshawSJ,FhyrieD.Hybrid external fixation for tibial plateau fractures:clinical and biomechanical correlation. Orthop Clin North Am 2002;33:199–209.
18.LachiewiczPF,FuncikT.Factors influencing the results of open reduction and internal fixation of tibial plateau fracture.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Article citation:
Jhanwar P, Jain HK, Dhakar S, Jhanwar A. Management of a tibial plateau fracture with compromised soft tissue using minimal internal and hybrid external fixation. J Pharm Biomed Sci 2014;04(05):427-433.Available at www.jpbms.info.
Copyright © 2014 Jhanwar P, Jain HK, Dhakar S, Jhanwar A. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.