Despite significant advances in cross-sectional imaging, the plain radiograph remains the cornerstone and first-line investigation for evaluation of wrist pathology. Owing to the complex anatomy of the wrist, with eight closely packed carpal bones, interpretation of wrist radiographs can be challenging but is an essential skill for orthopaedic surgeons and trainees. A systematic understanding of wrist anatomy, biomechanics, standardized positioning, and radiological parameters allows accurate diagnosis of a wide spectrum of traumatic and non-traumatic conditions while minimizing the need for expensive advanced imaging. This article provides a practical, step-by-step approach to reading wrist X-rays, emphasizing correct positioning, interpretation of standard posteroanterior and lateral views, and assessment of key parameters such as radial inclination, radial height, ulnar variance, carpal alignment, Gilula’s arcs, and scapholunate relationships. The clinical relevance of lateral view parameters, including volar tilt, teardrop angle, scapholunate angle, and wrist column alignment, is discussed. Common pitfalls, normal variants, and radiographic signs of instability and dislocation are highlighted. In addition, the role and indications of special views for suspected scaphoid fractures and specific carpal bone injuries are reviewed. Mastery of these principles enables clinicians to extract maximum diagnostic information from minimal radiographs, ensuring timely and cost-effective patient care.
Background/Aim: The aim of this study was to study the outcome of antibiotic impregnated cement coated intramedullay nailing in the management of chronic osteomyelitis of shaft of long bones. Materials and Methods: In this prospective study, 17 patients admitted in our hospital who were diagnosed with chronic osteomyelitis of long bones and culture-positive infected fractures of long bones were considered in the study and they were evaluated for a period of 12 months. Results: Bony union was achieved at around 5 months (20 weeks) on average, and duration for control of infection in case of chronic osteomyelitis was around 4 months, complications such as persistent infection and non-union were around 18 % overall. Conclusion: The main advantage of the antibiotic nail is that both the union and the infection can be addressed at the same surgery. Single-staged antibiotic nailing technique provides good results, lessens the duration of hospital stay, and reduces the morbidity in infected nonunion of long bones with <2 cm defect.
Background: Femur fractures are often associated with substantial blood loss, necessitating timely transfusion support. Optimizing the use of whole blood (WB) and packed red blood cells (PRBC) is essential for effective management in tertiary care settings. Materials and Methods: This retrospective observational study was conducted at a tertiary care center and included 45 patients aged ≥18 years with radiologically confirmed femur fractures admitted between July 2022 and June 2023. Data were obtained from hospital records, and the blood bank registers. Data include demographics, blood group, and transfusion details. Results: The study included 27 males (60.0%) and 18 females (40.0%), with a mean age of 46.1 ± 17.9 years. The most common blood groups were B+ (35.6%), O+ (31.1%), and A+ (24.4%). A total of 25 patients (55.6%) received WB and 27 (60.0%) received PRBC; of these, 20 (44.4%) received only PRBC, 18 (40.0%) only WB, and 7 (15.6%) both components. WB transfusions totaled 46 units (mean 1.67 ± 0.95/patient), while PRBC accounted for 50 units (mean 2.05 ± 1.12/patient). The highest WB utilization was in B+ patients (14 units), whereas O+ patients required the most PRBC (18 units). All patients (100%) required transfusion during hospitalization. Conclusion: PRBC was the predominant transfusion modality in femur fracture patients, with higher utilization than WB. The predominance of B+ and O+ groups underscores the need for targeted inventory management. These findings support evidence-based transfusion protocols and optimized resource planning in orthopedic emergencies.
Background: Femoral shaft fractures in limbs affected by post-polio residual paralysis (PPRP) are prone to non-union and implant failure due to altered biomechanics, deformities and compromised bone quality. Case Report: A 36-year-old male with PPRP presented with painful inability to bear weight following implant failure of a previously nailed femoral fracture. Radiographs showed hypertrophic non-union with a bent retrograde nail and screw back-out. Exchange nailing was performed using modified positioning to accommodate severe PPRP-related deformities. Results: The distorted nail was successfully removed, deformity corrected gently, and a larger, longer nail implanted. At 1-year follow-up, radiographs confirmed complete union. The patient achieved pain-free full weight-bearing and functional knee motion with tailored rehabilitation. Conclusion: Exchange nailing is an effective solution for hypertrophic non-union with implant failure, even in complex PPRP-affected limbs, when individualized surgical planning and rehabilitation are employed.
Background: We intend to determine the difference in outcome of core decompression with autologous iliac crest bone graft versus bone marrow infiltration in avascular necrosis (AVN) of femoral head. Materials and Methods: Stage II, III of Ficat and Arlet of AVN of femoral head evaluated clinically and radiologically before getting included into this study. A minimum of 20 cases were studied after clearance from the Ethics committee. Results: In our study, the mean HHS were statistically significant differences between the groups at 3 months and 6 months (P <0.05). At 3 months, the mean Visual Analog Scale (VAS) was 5.7 in Group A and 4.3 in Group B. At the end of the study (6 months), the mean VAS was 4.9 in group A and 2.7 in Group B. However, there were statistically significant differences between the groups at 3 months and 6 months (P < 0.05). Stage III X-ray finding was most common in Group a (63.6%) at pre-operative, and Stage II was most common in Group B (63.6%) at pre-operative. A similar finding was found at 6 months post-operative. Stage III magnetic resonance imaging (MRI) finding was most common in Group a (63.6%) at pre-operative and Stage II was most common in Group B (63.6%) at pre-operative. There was no significant difference (P > 0.05) in MRI and X-ray findings at pre-operative and 6 months between the groups. Conclusion: We conclude that core decompression with bone marrow infiltration is better to iliac crest bone graft because of better HHS and VAS at 6 months in Stage II, III of Ficat and Arlet of AVN of femoral head.
The Bombay Orthopaedic Society (BOS), founded on Makar Sankranti in 1965, rests on the legacy and ethos laid down by our visionary founding fathers. The values they championed – academic excellence, discipline, camaraderie, and service – have not only endured but have strengthened with each passing decade. Over 60 years, BOS became synonymous with high-quality orthopedic education and set new benchmarks in training surgeons for the service of their patients. This unwavering commitment ensured that our flagship activities continued to evolve while retaining the same intensity and dedication that defined our early years. Today, BOS remains as democratic and inclusive as it was at inception. From a small group of passionate orthopedic surgeons, we have grown into a vibrant community of over 3,000 members across Mumbai, Navi Mumbai, Thane, Kalyan-Dombivli, Palghar, and beyond. Few city-based medical bodies in the country can claim such numbers or this level of sustained participation. Importantly, BOS continues to be professionally run by its own members – a tradition that has preserved our identity and integrity. A Changing Academic Landscape In earlier decades, academic hunger was met through monthly physical meetings and a few flagship courses. Today, however, the learning landscape has transformed. Surgeons consume knowledge through multiple formats; attention spans are shorter; and the need for concise, relevant, clinically applicable content is greater than ever. In this era of information overload, the challenge is no longer access to knowledge – it is filtering what is authentic and useful. This is where BOS stands tall. We have become a *“filter of truth”* for our members – sifting through noise, curating unbiased, peer-reviewed academic content, and presenting it in formats surgeons can directly apply to practice. Our Academic Activities Today Our bimonthly clinical meetings continue to attract both senior surgeons and trainees. The Master Series has matured into a focused, no-holds-barred platform for discussing contentious problems, differing viewpoints, and real-world dilemmas. During the pandemic, our Video Journal Club gained tremendous traction. Today, the BOS YouTube channel hosts a rich repository of surgical techniques, debates, and clinical pearls. With over 3,500 subscribers, it has become a valuable academic resource, especially for younger surgeons. Our Instagram handle is also gaining popularity and helps us reach out to the next generation in a language and format they relate to. Subspecialty affiliate programs in different suburbs of Mumbai, Navi Mumbai, Thane, Mira-Bhayander, Vasai-Virar, and Kalyan-Dombivli have strengthened regional engagement. The BOS Courses have blossomed into comprehensive teaching experiences – with pre-course and post-course material, cadaver dissections, surgical videos, live surgeries, opportunities to scrub in with mentors, and mandatory case discussions. These courses are routinely oversubscribed, reflecting their academic depth and practicality. At the Cusp of Sixty: The Challenge of Relevance As the BOS steps into its 16th year, we stand at an important cusp – where the weight of past glory meets the challenge of future uncertainty. Learning habits have changed, and member expectations have evolved. To stay relevant, we must reimagine how we teach, engage, and support our members. Simon Sinek reminds us that people don’t buy *what* we do; they buy *why* we do it. BOS’s deeper purpose – to serve as a trusted academic home built on mentorship, authentic dialogue, and unbiased knowledge – must remain our guiding force in the years ahead. Meaningful progress, as Morgan Housel writes, is the result of small, consistent actions that compound over time. BOS itself is proof of this: sixty years of disciplined academic activity, generous faculty involvement, and a culture of camaraderie have collectively built an institution of substance and credibility.
Introduction: Segmental tibial fractures, defined by two distinct fracture lines creating an intermediate cortical segment, represent high-energy injuries with significant management challenges. Traditional infrapatellar nailing often falls short due to difficulties in maintaining alignment and a high incidence of anterior knee pain. Technique: This article outlines the suprapatellar approach for intramedullary nailing in segmental tibial fractures, highlighting surgical nuances, anatomical rationale, and advantages in challenging fracture configurations. Conclusion: Suprapatellar nailing offers improved alignment control, reduced anterior knee morbidity, and superior intraoperative ergonomics, making it a preferred technique in segmental tibial injuries. Suprapatellar nailing, High energy trauma, Segmental tibia fracture
Introduction For over 55 years, the Bombay Orthopaedic Society (BOS) has stood as a cornerstone of orthopedic practice, professional growth, and academic excellence in India. Rooted in the rich heritage of Mumbai, BOS has fostered camaraderie among surgeons, promoted innovative learning, and nurtured a spirit of social responsibility. Its journey reflects the evolution of orthopedics in India – from the early days of managing childhood diseases, such as tuberculosis, poliomyelitis, and osteomyelitis, to trauma, joint reconstruction, and cutting-edge surgical interventions today. As medicine evolves rapidly – with emerging technologies, changing patient expectations, and new societal challenges – BOS must envision a future-ready, innovative, inclusive, and socially responsible organization. The Society’s vision goes beyond academic excellence: It encompasses mentoring young surgeons, embracing technology safely, promoting research, delivering premium patient care, fostering happiness among members, and giving back to society. This article outlines BOS’s strategic roadmap for the future, blending its rich history with forward-looking initiatives that will define its journey in the coming decades. A Brief History of BOS: Foundations of Excellence Mumbai, formerly Bombay, was among the first Indian cities to establish an independent orthopedic department within a general hospital. Dr. R.J. Katrak, a pioneering orthopedic surgeon, restricted his practice solely to orthopedics and established the first dedicated department at Bai Jerbai Wadia Hospital for Children, Parel, Mumbai. He later launched another department at King Edward Memorial Hospital, attached to a medical college, marking the beginning of structured orthopedic education and practice in India. During those early years, childhood osteo-articular tuberculosis, poliomyelitis, osteomyelitis, and nutritional deficiency disorders dominated the clinical landscape. Trauma, although significant, remained secondary due to limited management strategies. International influence shaped the evolution of Mumbai orthopedics. In 1953, the World Health Organization sent a medical team to India, including Sir Henry Osmond-Clarke, a distinguished orthopedic surgeon. Later, Sir Harry Platt visited Mumbai in 1958 for the Association of Surgeons of India conference, inspiring local surgeons to elevate their academic pursuits. Mumbai was home to stalwarts, such as Drs. Katrak, MG Kini, AK Talwalkar, KT Dholakia, KS Masalawala, PK Mullaferoze, and MV Sant, who shaped clinical care, rehabilitation, and academic rigor in the city. The 1960s saw younger surgeons, including Drs. Vali, Chawra, Bhansali, Joshipura, Bulchandani, Gaitonde, Chaubal, and others, bring energy, innovation, and academic zeal. Monthly evening meetings began, sparking rich discussions, mentorship, and collaboration. The Johnson and Johnson Traveling Fellowship in 1961 and visits by global experts, such as Sir Herbert J. Seddon in 1962 further fueled academic excellence. By 1965, BOS was formally established, with Dr. Katrak as its first president. Meetings were held every alternate month, combining clinical discussions with camaraderie. Over the years, BOS expanded its activities to include the Western India Regional Orthopedic Conference, Katrak Oration, KT Dholakia Lecture, Young Surgeon’s Forum, quizzes, awards, and advanced courses. Today, BOS is a mature, respected society committed to academic rigor, mentorship, innovation, and social responsibility. The Imperative for a Future-Ready BOS The healthcare ecosystem today is vastly different from when BOS was founded. Surgeons face rapid technological advancements, digital disruption, increasing specialization, global collaborations, and societal inequities. The future of BOS must address these challenges while staying true to its founding principles: Academic excellence, innovation, camaraderie, social responsibility, and ethical practice. The strategic vision of BOS is built around eight pillars, each representing a core area of focus to guide the Society toward being futuristic, inclusive, and socially impactful. Strengthening education and training: A modern, structured pathway Today’s orthopedic landscape demands a balance between generalist knowledge and sub-specialty expertise. BOS can provide structure, guidance, and modern tools to ensure that young surgeons are not overwhelmed by fragmented training pathways. Strategic goals: • Develop standardized fellowship pathways, ensuring exposure to trauma, general orthopedics, and super-specialties • Launch a centralized BOS-accredited fellowship match program for transparency, accountability, and quality control • Introduce self-paced digital learning archives, including recorded lectures, surgical videos, case discussions, and CME modules, accessible to all members • Incorporate modern teaching tools, such as simulation labs, virtual reality, AI-assisted tutorials, and interactive digital modules • Foster mentorship, pairing experienced surgeons with trainees for guidance in both clinical and research domains • Collaborate with government teaching hospitals and institutes to harmonize curricula, standardize training, and ensure uniform quality of teaching across regions. By creating a flexible, modern, and structured learning ecosystem, BOS ensures that its members are well-equipped to meet both today’s challenges and tomorrow’s innovations. Bridging access gaps: Social responsibility and equitable care Healthcare inequity remains a pressing concern. BOS has the opportunity to lead by example; ensuring advanced orthopedic care reaches underserved populations while strengthening social accountability. Strategic goals: • Organize rotational free surgical camps across underserved districts in Maharashtra, Gujarat, Karnataka, and Madhya Pradesh • Partner with NGOs, government hospitals, insurance companies, and local health missions to provide implants, logistics, follow-up care, and subsidized treatment • Launch the BOS Social Responsibility Pledge, encouraging members to dedicate time annually to community service • Collaborate with CAR and other charitable organizations to enhance social outreach and community health initiatives • Promote public awareness campaigns on orthopedic health, injury prevention, and rehabilitation through both traditional and digital channels. Across structured outreach and collaborations, BOS not only reduces disparities but also reinforces the ethical and societal role of orthopedic surgeons. Embracing technology and innovation safely Technology – from robotics and navigation to AI-assisted decision-making – offers transformative opportunities. Yet, adoption can be hindered by cost, lack of training, and medicolegal concerns. BOS can guide its members in embracing these innovations safely, effectively, and responsibly. Strategic Goals: • Develop BOS Technology Adoption Guidelines for safe, ethical, and standardized use of robotics, navigation, artificial intelligence, and tele-orthopedics • Offer medico-legal advisory panels to support members adopting new technologies • Conduct hands-on workshops, simulation labs, and digital tutorials for advanced techniques • Facilitate digital collaboration platforms connecting surgeons, mentors, and researchers nationwide • Partner with government and insurance bodies to streamline adoption of telemedicine, digital health records, and equitable access to care. Across a balanced approach to technology, BOS can ensure its members are well-prepared to integrate innovations into practice safely and effectively. Supporting young surgeons: From training to independent practice Transitioning from fellowship to independent practice can be daunting. BOS seeks to act as a mentor, guide, and support system for young surgeons. Strategic goals: • Launch Mentorship-on-Demand, enabling real-time guidance from senior members • Establish a Job Board and Placement Cell, connecting trained surgeons with hospitals nationwide • Conduct workshops on financial literacy, medicolegal awareness, and entrepreneurial skills, equipping young professionals for ethical and sustainable careers • Facilitate networking, leadership development, and collaborative research opportunities. By providing mentorship, career support, and professional development, BOS ensures that young surgeons thrive in both clinical and personal spheres. Fostering well-being of members and preventing burnout The demands of orthopedic surgery – long training, high patient expectations, and financial pressures – can lead to burnout. BOS prioritizes holistic well-being for its members. Strategic goals: • Introduce BOS Wellness Programs, focusing on mental health, resilience, and work-life balance • Organize “Beyond the Scalpel” retreats, emphasizing family, fitness, hobbies, and personal growth • Establish peer-support groups for confidential sharing of challenges and solutions • Promote mindfulness, stress management, and wellness education across all BOS programs. A focus on well-being ensures surgeons remain passionate, productive, and fulfilled throughout their careers. Driving innovation and research leadership BOS aims to be a hub of innovation, research, and knowledge creation. Encouraging members to explore new ideas, publish findings, and collaborate globally will shape the future of orthopedics. Strategic goals: • Establish a BOS Innovation Lab to incubate ideas in surgical techniques, implants, digital solutions, and patient care • Provide research funding and grant opportunities for multicentre trials and collaborative studies • Maintain an online repository of BOS-generated clinical guidelines, protocols, and best practices • Encourage members to publish, present at conferences, and participate in international forums • Recognize innovation through awards, scholarships, and orations • By fostering a research-driven culture, BOS will maintain global relevance and influence. Expanding global collaboration and digital reach Digital tools enable BOS to transcend geographic boundaries, bringing knowledge and mentorship to all corners of India and the world. Strategic goals: • Launch the BOS Global Virtual University, offering structured online diplomas, masterclasses, CME programs, and digital archives • Collaborate with government teaching hospitals and institutes to standardize curricula and reduce regional disparities • Partner with international and national societies for joint research, webinars, and collaborative programs • Leverage digital archives and self-paced learning modules to democratize education and ensure equitable access to training. Across digital expansion and global collaboration, BOS can strengthen its reach, impact, and influence. Promoting camaraderie, happiness, and social inclusiveness BOS thrives on relationships, mentorship, and shared purpose. Beyond academics, fostering personal satisfaction and social engagement is central to its vision. Strategic goals: • Organize social and cultural events, retreats, and family-inclusive programs to strengthen bonds among members • Promote inclusivity across gender, geography, and sub-specialties, creating a supportive and collaborative environment • Encourage members to join hands with CAR and other charitable organizations, integrating “give back to society” initiatives into BOS activities • Recognize contributions in clinical excellence, research, social responsibility, and innovation, fostering pride and fulfillment. By cultivating community, happiness, and purpose, BOS ensures its members thrive personally as well as professionally. Conclusion: A Future-Ready BOS The BOS has a legacy of academic excellence, mentorship, camaraderie, and social responsibility. Its future vision is bold yet grounded: • Futuristic: Embracing technology, digital learning, and innovation • Inclusive: Providing opportunities for surgeons at all stages, locations, and sub-specialties • Research-driven: Cultivating inquiry, collaboration, and publication • Socially responsible: Bridging healthcare inequities and giving back to society • Human-centered: Prioritizing well-being, happiness, and camaraderie. Across strategic planning, actionable initiatives, and unwavering dedication, BOS is poised to remain a beacon of orthopedic excellence, mentorship, innovation, and societal contribution. It will continue to inspire surgeons, enrich patient care, and cultivate a thriving community – ensuring that the next generation of orthopedic surgeons thrives in a world that is ever-evolving yet grounded in tradition and values.
Background: Wrist swellings are most often benign cystic lesions such as ganglion cysts; however, vascular anomalies such as venous malformations (Vms), though rare, can closely mimic these entities and pose diagnostic challenges. Case Report: A 24-year-old male presented with a painful volar wrist swelling following trauma, radiologically suggestive of a multiloculated ganglion cyst. Conservative management failed, and surgical excision through a modified Henry approach was undertaken. Intraoperatively, an ill-defined, violaceous, non-pulsatile vascular mass was identified and completely excised with assistance from a vascular surgery team. Histopathological examination confirmed a VM. Results: Post-operative rehabilitation led to significant improvement in pain and wrist function, with no recurrence noted at short-term follow-up. Conclusion: VMs, though rare, should be considered in persistent wrist swellings unresponsive to conservative treatment. Complete surgical excision with multidisciplinary support and structured rehabilitation can achieve excellent functional recovery and prevent recurrence.
Sometimes you will never know the value of a moment until it becomes a memory.” — Dr. Seuss Nostalgia is a powerful emotion, it brings back the people, places, and moments that shaped us. It brings into perspective significant events that leave deep imprints in the mind. Memories which are etched forever as a time stamp. They remind you of who you were, how far you’ve come, and what you still hold dear. I am both elated and humbled by this responsibility, especially since I have to trace back countless memories about WIROC and what it means to the entire Bombay Orthopaedic society. Western India Regional Orthopaedic Conference actually embodies the ethos of the culture of BOS. It is reminiscent of the original name of the region that it grew out of. Established in 1965 Bombay Orthopaedic Society was a collective of founder members from Mumbai and the surrounding region within Mumbai province. Bombay Province comprised of Mumbai – rest of Maharashtra, Gujrat and Goa. Since BOS was geographically situated in Western India, it was apt to name the conference Western India Regional Orthopaedic Conference W.I.R.O.C. The inaugural WIROC was held in Mumbai in November 1966. The meeting was spread over two days. In order to get more surgeons interested in the specialty, it was planned to hold such a conference annually and generally out of Mumbai. Orthopaedic surgeons from various parts of Maharashtra, Gujarat, Karnatak and Madhya Pradesh became members. Delegates travelled to Pune, Nashik, Sholapur, Ahmedabad, Vadodara, Mahabaleshwar and Mount Abu for annual conference till almost 1986. Following this it was passed in the AGM that WIROC be permanently stationed in Mumbai and be organised by Mumbai members. Over the last 60 years WIROC has become an event of the magnitude of a mini “Kumbh”. It is a confluence of doyens and the dawning surgeons, young and old, brilliant achievers and novices, path breaking research and innovations and the ultimate litmus test of peer review of your scientific work. It has been the leader of orthopaedic conferences in the country which set the tone and standard for showcasing talent, amalgamating industry and doctors on a common platform for fruitful interaction. WIROC has always been renowned for its crisp conduct, top notch academics, state of the art updates, practice changing ideas, and the pinnacle of excellence. The event is a reflection of the legacy created by our pioneering stalwarts and seniors who were trailblazers in the field of orthopaedics. But did it become a sensation and brand Icon overnight? Let’s take a look at its evolution and noteworthy milestones over 6 decades. Flagship plenary sessions Orations Late R J Katrak Oration: This is the highest honour conferred upon an orthopaedic surgeon and a speaker of great repute by the Bombay orthopaedic society. It is fortitude that the founder of the society himself was there in person as the chair of the oration. It is a statute now that this oration is to be presided by the President of that year. Dr. B. Mukhopadhyay of Patna was the first Katrak Orator. For few initial years only outsiders of repute were invited as Katrak Orators. In course of time, as the body of work in each branch of orthopaedics grew substantially – Katrak Orators are now drawn from members of BOS, both from and outside Mumbai but preferably form within the Bombay Orthopaedic Society and its own members. Late K T Dholakia Eponymous lecture: In 1978. Dr K T Dholakia, the first ever Indian to receive summit this pinnacle of achievement in the world: was elected to the high office of the President of Societe lnternationale De Chirurgie Orthopedique Et De Traumatologie (SICOT). At the felicitation function it was proposed to institute KT Dholakia Lecture, to be delivered every other year on a subject of Basic Science as related to Orthopaedics. WIROC thus had an oration and an eponymous lecture and a variety of other programmes. Dholakia Lecturer speakers need not be restricted to form within the BOS and may also be from within allied specialities. The Dholakia lecture is always presided by the Vice President. Late A K Talwalkar Symposium A flagship best paper prize was commenced at WIROC in legendry Dr Arvind Keshav Talwalkar’s honour in 1974, as he was an outstanding and enterprising surgeon of immense fame and glory to the BOS. In 1996 it was passed in the AGM to commence a symposium dedicated to trauma in his memory, due to his dedication to trauma and innovation. The BOS general body had unanimously passed that this symposium will be beyond the purview of a sponsor and the society itself would year after year hold the symposium as a legacy of Dr Talwalkar. Late K S Masalawala best paper award. – In 1995, senior members of B.O.S. suggested that Best Paper Award be named after Dr Keiki S Masalawala posthumously, to perpetuate his memory and recognise his contribution both in Nair and JJ hospitals. From WIROC 1996 Best Paper Award was rechristened the Dr. Keki Sorabji Masalawala Best paper award, from amongst the top-ranking papers in each of the various orthopaedics specialities, i.e. Trauma, spine, paediatric ortho, onco ortho, arthroplasty, arthroscopy and general ortho. Young Surgeons Forum: Bombay Orthopaedic Society started Y.S.F. to encourage young orthopaedic surgeons who had promise : to bring to centre stage orthopaedic work of either an unusual/original/authentic theme, constitute a nature of serious clinical research deemed to be of valuable contribution. This was usually awarded to one or two Orthopaedic Surgeon under 40 Years age- now rectified to 45 years. Veteran Surgeons Forum In 2003, the AGM decided that instead of granting two young surgeons forum awards, one 20-minute slot was then chosen to be VSF or Veteran Surgeons Forum, as several of the veterans were actually doing a lot of spectacular work and that needed to be showcased. The criteria were same as YSF, and age limit now is above 45 years. Other features that make WIROC Vibrant With each passing year new sessions were added which contributed richly to enhancing the flavor of varied knowledge portals. Focused Symposia, Round table conferences, Free papers, Presidential Guest lectures, Debates, PG activities, Posters, , cradle to grave conclaves ,Master talks -Guru Gyan, What an Idea sirji , Book launch – award, Publications ,Live workshops, Video techniques , technology and social media sessions , practice changing ideas and tips and tricks, Complications, P G sessions, debates, quizzes ,Medico legal sessions , non-academic talks , Trade sessions, Alumni meets , Virtual reality studios, selfie points , camaraderie, banquet and fellowships , F and B , sports , entertainment, events for spouses and accompanying persons- above all team work and social interaction. It is the vibrance of Wiroc and this constant reinventing that keeps the interest of the delegates and faculty alive and ticking. Establishing Brand Value: Financial importance of WIROC have been steadily progressive. The purpose of Wiroc once upon a time was to run the basic expenditure of the Bombay orthopaedic society. It then grew into a small profit-making annual event multiplying steadily each year in an exponential fashion. The handsome profit scaled up by a phenomenal leap in 2009. Over the years it has been multiplying and growing in scale and potential from a few thousands in the 60’s to crores from 2018 onwards and in the future the sky is the limit. Thus, BOS gained substantial financial security which enables various other activities around the year. This financial security is now the heart and pulse of sustenance of the BOS. WIROC became a registered trademark in 2017, a feat not very many conferences or societies can boast of. WIROC Trade mark Registration But brand value is not just about fiduciary stability. Associations around the country emulate and incorporate several sessions based on WIROC success into their own satellite conferences and invite the talent pool of WIROC speakers nationally and internationally. It’s an icon of crisp academics, on time sessions, superlative knowledge exchange and great social bonding. It truly has a brand value beyond measure. It’s a conference that evolves and invariably runs to packed halls where everyone listens with rapt attention. Frank and fair questions with threadbare discussion, great interaction and networking, rigorous time keeping, less fanfare and more science and litmus test of peer acceptance are the hall marks of WIROc. Glimpses of WIROC 2009 Personally, WIROC for me has been a beacon of a true legacy handed over year after year, a heirloom or a symbol of trust, excellence and tradition. I have been fortunate to organize it in 2009, a journey of courage, responsibility, growth and a celebration of life itself. It trained me for higher responsibilities, taught me the importance of group dynamics and how to balance them and consolidate the purpose of the meeting, and how to set and achieve a goal without deviating no matter what.! We published the blue book for conducting WIROC the first time after 2009 which was then amalgamated in the Best Practices book for the society by Dr Anand Thakur and Dr Rajesh Gandhi subsequently. It moulded me into the framework of the Bombay orthopaedic society completely – and the event truly lived up to its tag line “Redefining conventions in pursuit of excellence “. EC of .2009 at Wiroc 2009 inguration WIROC 2009 Entertainment First woman organizing Secretary WIROC 2009. Packed halls. Wiroc 2009 Other memorable WIROC’s For me over the years Winning my first K S Masalawala best paper in 2001 Young surgeons Forum 2010 Winning the Prestigious K S Masalawala best paper at the Golden Jubilee Wiroc 2015 Presidential Theme Symposium as first woman secretary of BOS Wiroc 2021 – as first lady vice president. Late AKT symposium convener Wiroc Max 2022 From the nay sayers to the purists from the guru’s to the disciples , Wiroc is the ultimate Litmus test which grew from strength to strength from 1 hall to 5 halls at times and became a force to reckon with over the last 60 years and may its tribe only increase with greater “ubuntu” meaning I am because we are ! WIROC is traditionally the President ‘s prerogative which is entrusted to the senior EC members to organize. It moulds them truly into leadership roles surrogately under his (as we are yet to have the first woman president yet) watchfully eye. As the flame passes on this year to the next generation of young bright and promising and responsible orthopaedic surgeons – I pray for the flame to glow brighter and brighter and illuminate the orthopaedic world always. Penned by Dr. Rujuta Mehta
The year 2025 marks a Significant meaningful milestone—not only for the Bombay Orthopaedic Society (BOS), which celebrates the 60th WIROC, but also for the Journal of Clinical Orthopaedics (JCORTH). This year, the journal has been officially accepted into the Directory of Open Access Journals (DOAJ), a recognition that affirms its adherence to global publishing standards and makes it eligible for MCI/NMC promotion criteria. That this achievement coincides with the diamond jubilee WIROC makes it all the more significant: it symbolizes both continuity and renewal, tradition and progress, roots and aspirations. The Beginning: A Vision Supported by BOS Leadership When JCORTH was conceived in 2016, it began as a shared belief that BOS needed a dedicated platform for clinically relevant, open-access, ethically robust orthopaedic scholarship—a journal that represented the intellectual voice of one of India’s oldest and most respected orthopaedic societies. This vision could not have materialised without the wholehearted support and encouragement of the BOS leadership of that year. We gratefully acknowledge: • Dr. Sanjay Dhar, then Secretary of BOS, whose clarity, enthusiasm, and administrative insight helped translate the idea into reality. • Dr. Aseem Parikh, then President of BOS, who supported the proposal, provided both strategic guidance and confidence, and ensured that the journal began with a strong institutional foundation. Their trust in the concept of JCORTH laid the cornerstone on which everything else stands today. We also extend our sincere appreciation to the entire BOS Executive Committee (EC) over nearly a decade. Each team—year after year—strengthened the journal through their encouragement, oversight, and belief in its purpose. Every EC has in some way contributed to this milestone, and DOAJ indexing is as much their achievement as it is the journal’s. The Early Years: Building a Clinical, Open and Meaningful Platform From its inception, the journal followed three core principles: 1. Free and Open Access – ensuring that orthopaedic knowledge remained available to every surgeon, irrespective of institutional or financial constraints. 2. Clinical Relevance – welcoming real-world orthopaedic research, experience-based insights, surgical techniques, case series, and practice-oriented papers that address the realities of care in India and similar regions. 3. Quality and Ethics – adopting double-blind peer review, structured editorial processes, and transparent publication guidelines. 4. Innovation – new and inspiring sections like Interviews with BOS Legends, Perspectives and pot pourrie added to the personality of the journal making it more engaging These principles allowed JCORTH to evolve into a journal that truly reflects the breadth and depth of Indian clinical orthopaedics. Over the years, the journal gained steady traction—its submissions grew, its reach expanded, and its readership diversified. Authors, reviewers, and contributors trusted JCORTH even when it was still finding its place among established platforms. We specially thank all the foreign authors for their contributions and now that the journal is indexed we hope they will continue their support by more contributions. A Milestone Moment: DOAJ Indexing The acceptance of JCORTH into DOAJ marks a defining point in its journey. DOAJ recognition validates: • adherence to international standards of open-access publishing, • strong editorial and peer-review processes, • commitment to transparency, quality, and academic ethics. It also means that JCORTH articles become more discoverable, citable, and academically recognised, bringing meaningful credit to authors, institutions, and the BOS community. For young surgeons, residents, and academicians across India, DOAJ indexing ensures that publishing in JCORTH now carries full weight in professional evaluations and promotions. Leadership that Carried the Torch Forward The progress of JCORTH in recent years has been profoundly shaped by the dedication of Dr. Sachin Kale, Dr. Gautam Zaveri, and Dr. Ashish Phadnis—a trio whose combined efforts transformed the journal from a strong foundation into an internationally recognised platform. Under the calm yet resolute stewardship of Dr. Sachin Kale, the journal grew in maturity, academic discipline, and editorial rigour. He strengthened reviewer systems, broadened formats, nurtured inclusivity, and ensured that every issue reflected the BOS philosophy of openness and clinical relevance. Dr. Gautam Zaveri, as the current BOS President, brought vision, academic direction, and strategic encouragement, playing a pivotal role in accelerating the DOAJ indexing process and raising the journal’s visibility across scientific forums. Complementing this, Dr. Ashish Phadnis, as BOS Secretary, provided the administrative clarity, continuity, and relentless follow-through needed to bring the indexing goal to fruition. Their collective leadership along with current EC represents the very best of BOS—collaborative, committed, and forward-looking. The DOAJ recognition is, without doubt, a testament to their shared effort and the collective ownership that defines our society. A Moment of Pride at the 60th WIROC As the print edition of JCORTH is unveiled at the 60th WIROC, it stands not merely as a journal but as a symbol of continuity, evolution, and aspiration. It echoes six decades of BOS heritage, and at the same time, announces a new chapter—where our society’s journal steps confidently onto the international stage, indexed, recognised, and ready for broader impact. There is a quiet poetry in this alignment: the society that nurtured generations of orthopaedic surgeons celebrates its diamond jubilee, while its journal, born much later, comes of age in the very same moment. The Road Ahead: Growing With Gratitude and Ambition With indexing secured, JCORTH now carries a renewed responsibility—to rise higher, reach farther, and remain deeply connected to its roots. The future will see the journal: • welcoming robust original research and multicentric collaborations, • engaging with global orthopaedic communities while preserving its Indian soul, • embracing multimedia and digital learning innovations, • continuing to celebrate reflective, narrative, artistic, and humanistic writing that shapes thoughtful surgeons. And through it all, one promise remains unchanged: JCORTH will stay free, open, inclusive, and clinically meaningful—true to the BOS spirit. Conclusion: A Call to the Next Generation The story of JCORTH—from a hopeful idea in 2016 to an indexed journal in 2025—is a story of belief, perseverance, and the power of community. But this milestone is not an endpoint; it is an invitation. To the young surgeons of BOS—the residents, the early-career clinicians, the emerging academics— This journal now belongs to you. Your ideas, your research, your experiences, your reflections will shape its next decade. We encourage you to write boldly, question deeply, document passionately, and contribute generously. Let JCORTH be the platform where your voice finds its place and your work finds its audience. As BOS celebrates 60 glorious years, and JCORTH steps into its new identity, we stand on the threshold of a future filled with possibility. The foundations are strong. The vision is clear. The torch is now yours to carry. Dr. Nicholas Antao & Dr. Ashok Shyam Founding Editors, Journal of Clinical Orthopaedics
WIROC Grande 2015, celebrating the Golden Jubilee of the Bombay Orthopaedic Society, transformed adversity into distinction. With academic excellence as its compass and heritage as its soul, the conference blended tradition with innovation, discipline with imagination, and scholarship with celebration; emerging as a defining moment in Indian orthopaedics and a beacon for future generations.
Background: We intend to determine the utility of the limb reconstruction external fixator as a definitive tool in managing grade II and grade III compound long bone fractures. Materials and Methods: All patients with Grade II and Grade III complex long bone fractures were evaluated clinically and radiologically before inclusion in this prospective observational cohort study. A minimum of 20 cases were studied after clearance from the Ethics Committee. Results: In our study, there is a variable wound healing time, with 20% of patients getting their wound healed within 4 weeks and 80% of patients getting their wound healed within 12 weeks. The mean wound healing time was 9.45 ± 5.78 weeks. 18 patients (90%) in the study showed signs of radiological union with a radiographic union scale in tibial fracture score of 2 or 3. Mean bone union time was 18.11 ± 5.24 weeks after injury. According to the Association for the Study and Application of the Methods of Ilizarov (ASAMI) scoring system, the bone results were excellent in 14 (70%) patients, good in 3 (15%) patients, fair in 1 (5%) patient, and poor in 2 (10%) patients. The functional results as per the ASAMI scoring system were excellent in 13 (65%) patients, good in 6 (30%) patients, and poor in 1 (5%) patient. In our study, 11 patients did not encounter any complications. The common complication was pin tract infections. Limb shortening was observed in 45% of patients. 85% of patients had insignificant limb shortening and did not require a shoe raise. Conclusion: In our study, we achieved excellent to good results in our series by using the limb reconstruction system type of external fixator with fracture union in all the patients in our study. Limb reconstruction external fixators can be used as definitive tools in managing grade II and grade III compound long bone fractures.
Differentiated thyroid carcinoma (DTC) accounts for a small proportion of all malignancies but is among the cancers most frequently associated with bone metastasis, especially in the axial skeleton. Metastatic involvement of the appendicular skeleton is rare, and pathological fractures of the femoral shaft are even more uncommon. Follicular thyroid carcinoma (FTC), due to its angioinvasive nature, shows a markedly higher propensity for hematogenous spread to bone than papillary thyroid carcinoma. These lesions significantly impair mobility and quality of life, often necessitating surgical intervention when life expectancy is reasonable. We describe a rare case of a 45-year-old male with metastatic FTC who presented with a pathological fracture of the femoral shaft. After multidisciplinary evaluation, the patient underwent wide segmental resection of the diseased femur, followed by intramedullary interlocking nailing with polymethylmethacrylate (PMMA) cement augmentation. This strategy provided immediate structural stability, allowed early weight-bearing, and offered potential cytoreductive benefit from PMMA-induced thermal effects. Postoperative recovery was uneventful, with significant pain relief and restoration of full function within 6 weeks. At 2-year follow-up, the patient remained ambulatory without limitations, with stable local control and ongoing oncological management. This case highlights that aggressive surgical management with stable reconstruction can yield excellent functional outcomes in selected patients with metastatic FTC, particularly when presenting with pathological fractures of weight-bearing bones. Durable fixation, early mobilization, and individualized multidisciplinary planning are crucial in optimizing quality of life in advanced thyroid carcinoma with skeletal metastases.
Background: Anterior cruciate ligament (ACL) reconstruction is widely performed to restore knee stability following ligament rupture. The choice of autograft remains pivotal in determining long-term functional outcomes. While hamstring tendon (HT) autografts are commonly used, they are associated with donor site morbidity and variable graft diameter. Fibularis longus tendon (PLT) has emerged as a promising alternative due to its favourable biomechanical properties and potential to preserve hamstring function. Objectives: To assess and compare the functional outcomes, knee stability, and donor site morbidity associated with PLT versus HT autografts in patients undergoing ACL reconstruction. Methods: A prospective comparative clinical study was conducted between August 2023 and March 2025 at a tertiary care institute in Varanasi. Fifty patients with isolated ACL tears were randomly assigned to undergo reconstruction using either HT or PLT autografts (25 per group). All underwent standardized arthroscopic techniques and a uniform rehabilitation protocol. Functional outcomes were assessed using IKDC, Lysholm, and Cincinnati scores; donor site morbidity using AOFAS and FADI scores; and knee stability via Lachman, pivot shift, and anterior drawer tests. Results: Both groups showed significant improvement in IKDC scores postoperatively. The PLT group had a slightly higher mean IKDC at 1 year (90.90 vs 89.52; p=0.068), greater graft diameter, and better preservation of thigh muscle mass. No significant differences in knee stability tests or major complications were observed. Conclusion: PLT is a reliable and effective autograft, showing comparable if not slightly superior functional outcomes to HT in ACL reconstruction, with minimal donor site morbidity.
Introduction: Osteonecrosis (ON) of the femoral head is responsible for roughly 2 to 10% of total hip arthroplasty (THA) indications. The purpose of this study is to compare complication rates for patients under 50 years old undergoing THA for ON versus osteoarthritis (OA). Methods: Patients between the ages of 18- and 50-years old undergoing THA for ipsilateral osteonecrosis were identified in the PearlDiver database. A control cohort of patients between the same age thresholds were identified who underwent THA for osteoarthritis. Any patient with a history of proximal femur fracture or prior operative fixation of a proximal femur fracture was excluded. Patients were included if they had a 5-year postoperative database followed up after THA. The 90-day rates of post-operative medical and 5-year surgical complications were recorded. Multivariate analysis was conducted to account for confounding variables and covariates. Subgroup analyses were also performed stratified by age (<30, 30–40, and 40–50 years) to assess revision outcomes. Results: A final cohort of 6,955 patients met inclusion criteria, 1,769 (25.4%) underwent THA for osteonecrosis while 5,186 (74.6%) underwent THA for OA. Patients undergoing THA for ON had a higher incidence of 5-year post-surgical instability (3.1% vs. 2.2%, OR 1.51, P=0.025) when compared to THA for OA. Similarly, those undergoing THA for OA had a higher incidence of 5-year revision (4.4% vs. 3.0%, OR 1.45, P=0.018) and 90-day readmission (8.0% vs. 4.4%, OR 1.41, P=0.006), and emergency department visits (18.4% vs. 11.1%, OR 1.33, P=0.001) when compared to those undergoing THA for OA. Conclusion: Patients younger than 50 years old undergoing THA for ON experience increased post-surgical complications such as revision, dislocation, hospital readmission and emergency department visits compared to patients under 50 years old undergoing THA for OA. These findings provide insight for preoperative considerations for arthroplasty surgeons in this patient population.
In March 2021, amidst an atmosphere of uncertainty and cautious optimism, we undertook the monumental task of organizing Western India Regional Orthopedic Conference (WIROC) 2021 in Mumbai. This was not just another academic gathering – it was a symbol of resilience, scientific progress, and professional solidarity. Occurring in the narrow window between the first and second waves of the COVID-19 pandemic, WIROC 2020 Unlocked (so-named as WIROC 2020 due to it being in financial year 2020-21) emerged as one of the first major medical conferences in India to be held physically after the initial lockdowns and restrictions. As the Organizing Secretaries, led by our extremely supportive and ever-resilient Organizing chairman (and BOS President) Dr. Shubhranshu Mohanty, we were driven not just by duty, but by a deeper conviction: The orthopedic community needed to reconnect – not just virtually, but in person. After a long period of webinars and virtual meets, it was very important to have the personal human touch. The pandemic had isolated us, strained hospital systems, and transformed our professional lives. The time was ripe to reignite collaboration, share experiences, and reinvest in learning and teaching. Conceptualization: More than Just a Conference In September 2020, when Dr. Mohanty first proposed the idea of holding a physical in-person WIROC, we were met with a mix of enthusiasm and apprehension (Figure 1). While the desire to resume academic activities was unanimous, the shadow of the pandemic loomed large. The first COVID-19 wave was just subsiding, and the medical fraternity was exhausted. Planning a physical conference felt ambitious – some even called it reckless. We still remember the calls from very senior orthopedic surgeons who, in their gentle (and some not-so-gentle words), tried to dissuade us from even thinking of such a thing. Figure 1: The first zoom meeting about the concept of Western India Regional Orthopedic Conference (WIROC) unlocked with Dr. SS Mohanty (BOS President), Dr. Swapnil Keny (BOS General secretary), Dr. Mandar Agashe, and Dr. Satish Mutha (WIROC secretaries). Yet, we believed that with the right precautions, strategic planning, and unwavering commitment, we could pull it off – not just as an event, but as a beacon of revival. The decision to proceed was not made lightly. We consulted infectious disease experts, epidemiologists, hospital administrators, government officials, and colleagues. What convinced us to move forward was the shared longing among orthopedic professionals to engage, learn, and connect after a prolonged period of isolation. We named our conference “Unlocked” as we wanted to unlock our lives after the unnerving Lockdowns and bring about a sense of normalcy after this devastating period. Planning in A Pandemic: Navigating Uncharted Territory Unlike traditional conference planning, organizing WIROC 2021 demanded that we rethink everything – from venue logistics to travel arrangements, delegate safety to session formats. Every detail required a COVID-aware approach. Our trusted team at VAMA events – Mr. Vikram Patwardhan, Mr. Vaibhav, and others also were supremely helpful in finding and keeping all rules in abeyance for the event – something which most were not aware of. The second wave of COVID 19 started around February 2021 and almost put a spanner in the works. With the ever-increasing COVID numbers, there was some skepticism in the air, but we had full confidence in our preparations and our ability to pull off this seemingly impossible task. There were some hiccups with the constantly changing governmental and BMC rules just few days before the conference. However, Vikram and team VAMA ensured that everything was sorted and all precautions were taken. We tried to make our conference as “COVID-proof” as possible by the following means: Safety protocols Our first priority was health and safety. We worked closely with local health authorities to design protocols that followed standard government guidelines. This included: • Reverse transcription-polymerase chain reaction testing and temperature screening for all attendees • Mandatory mask-wearing and hand sanitization stations across the venue • Social distancing enforced in lecture halls with reduced seating capacity • Controlled movement flows to avoid crowding in exhibition areas and dining zones • We also provided on-site medical assistance and a dedicated isolation room in case of emergencies. Hybrid format WIROC 2020-Unlocked was probably the first conference which utilized the hybrid model of delivering high-quality education from distant parts of the world and coordinating it with live physical lectures. We coordinated with many premier institutes around the world such as the King’s college, London, Mayo Clinic, Rochester, Rady Children’s hospital, San Diego, and many more. This ensured that international faculty and those unable to attend in person could still participate. While this added a layer of logistical complexity, it was essential for inclusivity and safety. Our AV team led by the maverick Mr. Peter Anand was up to the task and ensured a seamless experience both to the overseas faculty as well as the delegates sitting in the auditorium. Venue and infrastructure We selected a venue that offered spacious halls with excellent ventilation, open-air dining arrangements, and advanced tech infrastructure to support live streaming. The Rennaisance convention center proved to be a perfect place for this conference and the team really bent over backwards to see to it that all rules and protocols were followed and no mishaps occurred. Collaborating with AV teams, we rehearsed extensively to ensure seamless hybrid delivery, pre-recorded presentations, and real-time interactions with virtual faculty. The Day Arrived: The Thrill of Reuniting Despite the countless hours of planning, nothing could prepare us for the energy that filled the halls on the opening day of WIROC 2020. There was a palpable sense of joy and gratitude among delegates. For many, this was their first in-person meeting in over a year. Old friendships were rekindled, new ideas exchanged, and the communal passion for orthopedics reignited. Highlights included Keynote lectures from national and international stalwarts in orthopedics, including live Q&A with overseas speakers joining remotely. Interactive workshops and symposia conducted with stringent hygiene protocols. Inauguration by the legendary Padma-Vibhushan Mr. Ratan Tata (Figure 2 and 3). Figure 2: Inauguration ceremony by Padma Vibhushan Mr. Ratan Tata, IOA President Dr. Shivashankar, BOS President and Western India Regional Orthopedic Conference (WIROC) Organising chairman Dr. SS Mohanty, and WIROC secretaries Dr. Mandar Agashe and Dr. Satish Mutha. Figure 3: Padma Vibhusan Mr. Ratan Tata with Dr. Mandar Agashe and Dr. Satish Mutha. Presidential guest lecture by famous author, thinker, and social commentator, Mr. Chetan Bhagat. Masterful orations by Dr. AR Karkhanis (Dr. RJ Katrak Oration) (Figure 4) and Dr. Daryl D’Lima (Dr. KT Dholakia eponymous lecture). Sessions on telemedicine, mental health, and the future of orthopedic care in a post-COVID world, which resonated deeply with attendees. In many ways, the conference became therapeutic – a safe space for the community to reflect, recharge, and move forward together. Figure 4: Dr. AR Karkhanis delivering the prestigious Dr. RJ Katrak oration. Overcoming Challenges: Grit, Teamwork, and Innovation The road to WIROC 2021 was anything but smooth. Every phase presented unprecedented challenges, demanding flexibility, rapid problem-solving, and emotional strength. Uncertainty and fear With COVID-19 cases fluctuating and the possibility of a second wave looming, every week brought new anxieties. Hotels, sponsors, and even delegates were hesitant. We had to maintain constant communication, update contingency plans, and assure all stakeholders of our preparedness. Sponsorship and funding The economic impact of COVID-19 meant that sponsorship budgets were limited, and convincing partners to invest in an uncertain event was challenging. We adopted a lean financial model, reduced frills, and focused on value-driven content. Sponsors who did come on board appreciated the brand visibility in a high-impact, pioneering event. Delegate and team morale and teamwork Many on our team were frontline workers who had been battling the pandemic first-hand. Balancing conference duties with professional and personal commitments was tough. Yet, the shared purpose gave us strength. The dedication of the team, support staff, and committee members was extraordinary. We were bound by a common belief: this mattered. Legacy and Reflection WIROC 2021 was not just a successful academic event; it was a symbol of what is possible when purpose, planning, and passion align. It reminded us that even in times of crisis, the medical community can rise, adapt, and lead. Our Chairperson, Dr. SS Mohanty’s vision of re-starting and in fact “unlocking” our lives post the pandemic in a safe manner was fulfilled and this served as a template for future conferences to emulate (Figure 5, 6 and 7). Figure 5: Team VAMA led by Mr. Vikram Patwardhan and ably supported by Mr. Vaibhav Pisal, Mr. Pramesh, and others did a stellar job in making it happen. Figure 6: The ever-supportive BOS Executive council- (from L to R)- Dr. Mandar Agashe, Dr. Satish Mutha, Dr. Sangeet Gawhale, Dr. SS Mohanty, Dr. Swapnil Keny, Dr. Harshad Argekar, and Dr. Ashish Phadnis (Missing in picture: Dr. Sunil Shahane, Dr. Gautam Zaveri, Dr. Ashok Shyam, Dr. Abhijit Kale and Dr. Vishal Kundnani) Figure 7: ….. And we did it…. The look of relief on our faces at the end of Western India Regional Orthopedic Conference 2020 Unlocked…….The team signing off…..!!. On a personal note, for both of us, WIROC 2021 was one of the most challenging yet fulfilling projects of our careers. It demanded everything – vision, stamina, negotiation, humility, and leadership. But the smiles, the gratitude, the shared learning – it made it all worth it. Looking back, I see not just a conference, but a moment in history. We helped script a new chapter for academic medicine in India, proving that with courage and collaboration, even the impossible can become a reality.
Background: With pre-operative carbohydrate loading emerging as a possible approach to improve post-operative outcomes, enhanced recovery after surgery protocols have attracted much interest recently. The purpose of this systematic review is to assess, in patients undergoing hip surgery, pre-operative carbohydrate beverages’ impact on post-operative recovery and glucose levels. Methods: For randomized controlled trials (RCTs) published up to April 2023, a thorough literature search was undertaken in PubMed, Cochrane Library, EMBASE, and Web of Science databases. Included studies were those comparing pre-operative carbohydrate loading with fasting or placebo in adult patients having hip fixation or replacement surgery. Indices of surgical healing and glucose levels dominated the results. Secondary results covered surgical complications, insulin resistance, and hospital stay length. Results: Twelve RCTs totalling 1247 participants are included in this investigation. Pre-operative carbohydrate loading is clearly connected to improved post-operative recovery based on reduced post-operative nausea and vomiting, earlier resumption of bowel function, and better patient well-being scores. After surgery, the group on carbohydrates had more controlled glucose levels than the fasting group. Although these findings were not consistent across all studies, secondary findings showed a trend toward reduced length of hospital stay and raised insulin sensitivity. Conclusion: This systematic review suggests that pre-operative carbohydrate drinks may improve post-operative recovery and glucose control in patients undergoing hip surgery. However, the heterogeneity of the included studies and the variability in outcome measures warrant further large-scale, well-designed RCTs to confirm these findings and establish standardized protocols for pre-operative carbohydrate loading in hip surgery patients.
Introduction: Hardware removal after orthopaedic or fracture fixation surgeries, including locking plates and screws removal after fracture union, is a common practice; however, sometimes it is not as straightforward a procedure as it looks. Case Report: We present a case of a male patient, 36 years old, who had a right tibial plateau fracture 2 years back, which was treated by open reduction and internal fixation using a locking 3.5 mm lateral proximal tibial plate. During hardware removal, we encountered an unusual complication: A breakage of the screwdriver tip. Results: The screws were successfully removed after using a new screwdriver with no further complications. Conclusion: Various unexpected circumstances might occur, such as damage or breakage of the screws heads or screwdriver tip, which hinders the complete removal of the hardware. The surgeon should be prepared with the proper tools to handle potential unusual situations.
The objective of this systematic review is to evaluate the effectiveness and impact of artificial intelligence (AI)-based applications in the management of back pain, particularly through mobile health solutions. The review examines current AI interventions for their potential to improve pain outcomes, enhance self-management, and increase patient adherence. We conducted a comprehensive literature search across multiple databases, including PubMed, Scopus, and IEEE Xplore, following a rigorous inclusion and exclusion process. Studies were selected based on their focus on AI-enabled mobile applications specifically designed to aid back pain patients, with data extracted on outcomes such as pain reduction, patient engagement, and quality of life improvements. The findings reveal promising results, with many AI applications achieving notable success in pain management and user satisfaction; however, certain limitations, such as user engagement rates and app accessibility, were identified. This review underscores the potential of AI-driven health interventions in personalizing care and improving back pain outcomes, while also highlighting areas for future research, particularly in advancing AI algorithms and expanding access to digital health tools.
