External fixators allow gradual and precise correction of the deformity. © 2020 Delhi Orthopedic Association. All rights reserved.Background Severe scoliosis can affect respiratory function in growing patients and produce cardiopulmonary complications, leading to significant morbidity. The development of spinal deformity may impact on young patients' level of function and reported quality of life (QOL). The aim of this study was to investigate the relationship between lung function, exercise capacity and quality of life in young patients with spinal deformity. Methods This is a retrospective analysis of 104 patients (31% male, 69% female with mean age 14.9yrs). 77% of patients had an adolescent idiopathic scoliosis, with the remainder having other scoliosis diagnoses or Scheuermann's kyphosis. Principal outcomes included Spirometry [FEV1, FVC], Whole Body Plethysmography, Cardiopulmonary Exercise Testing [CPET] and patient outcome questionnaires (with SRS-22). CPET measures included maximal exercise capacity [VO2peak] as well as VO2 at ventilatory threshold [VT] expressed as %predicted VO2max-a measure of physical conditioning, and minuated with poorer lung function but better exercise capacity, likely related to higher levels of physical conditioning. Higher QOL scores were recorded in patients who had greater VO2peak levels, suggesting that exercise capacity may be a protective factor for emotional well-being in patients with spinal deformity. © 2020 Delhi Orthopedic Association. All rights reserved.Objective Provide an update of the management options for early onset scoliosis patients, including general assessment, conservative and surgical options. Methods We included the updated information about the assessment and management options of Early Onset Scoliosis, taking into consideration the non-fusion methods, including the burden on the patient and their family. Results With the heterogeneity of this population, it is difficult to get a consensus about a unified protocol for management. Accordingly, the surgeon dealing with these cases needs to be aware of the broad range of surgical and non-surgical methods when treating these patients. Conclusion The main aim of early onset scoliosis treatment is to gain a flexible spine associated with normal lung development and thoracic growth. Management needs to be individualized between the surgeon and patient in relation to the etiology and patient conditions. © 2019 Delhi Orthopedic Association. All rights reserved.Background We have studied the growth of Journal of Clinical Orthopaedics and Trauma (JCOT), the official journal of the Delhi Orthopaedic Association indexed in PubMed, Scopus and Embase, along with an analysis of citation trends and levels of evidence of published articles in the last five years. Methods SCOPUS and PubMed databases (2015-19) were used to extract publication-related data for the last five years. The official website of the journal was also used to retrieve issue-specific data. An audit of recent publications in the JCOT was conducted focusing on number of issues and publications(year wise), types of articles published, review speed, level of evidence of publications, types of publication(speciality wise), number of publications in PubMed and SCOPUS, number of citations(year wise), national and international authorship and the Cite Scores. Results The submissions were increased by 2.8 times and the citations rocketed to 16.6 times in 2019, compared to 2015. A total of 890 papers were there and the journal was cited 1702 times in the last five years. More articles with higher levels of evidence papers are now being published. Conclusion There has been a significant increase in the numbers of submissions, publications, citations, Cite Score, h-index and contribution by the International authors. Its Editorial efficiency has also been outstanding with timely reviews and editorial decisions. STA-4783 purchase The JCOT has become increasingly internationally relevant in the last five years, in the orthopaedic community. However, JCOT needs to publish more papers with a higher level of evidence like Systematic reviews, Meta-analyses, Randomized Controlled Trials and should only publish top-class lower hierarchy papers (like Case reports, Case-controlled and Retrospective studies). © 2020 Delhi Orthopedic Association. All rights reserved.Purpose Previous studies have shown that thumb interphalangeal (IP) joint arthrodesis is typically performed between 0 and 30° of flexion, with a recent study in healthy subjects having recommended a range of 15-30° to be an ideal functional IP joint fusion angle for various activities of daily living. The current study aimed to evaluate the ideal thumb IP fusion angle in patients with thumb carpometacarpal (CMC) osteoarthritis (OA). Methods Twenty-seven patients with thumb CMC OA were evaluated; five patients had bilateral pathology, for a total of thirty-two thumbs included. Hand dominance was noted and baseline unsplinted measurements were obtained for power tasks, precision tasks, pinch, and grip strength testing. Patients' thumbs were then splinted at 0, 15, 30, and 45° with repeat measurements taken and compared to baseline. Outcomes were measured by use of a 10-point Visual Analogue Scale, timing of tasks, and a dynamometer. Outcomes were analyzed by Wilcoxon sign ranked tests for each category of trials. Results For significant outcomes, the most favorable simulated thumb fusion angles were 15° in the dominant hand and 0°, 15° in the nondominant hand (precision tasks); the least favorable position was found to be 45° in the dominant hand (precision tasks, pinch strength). When combining all outcomes that both reached and approached significance, the most favorable position was found to be 15° and least favorable position, 45°. Conclusions In patients with thumb CMC OA, an IP fusion angle of 15° is preferable, while a fusion angle of 45° is to be avoided. Type of study/level of evidence Therapeutic Study, Level III. © 2020 Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation.Purpose Fracture healing often requires extended convalescence as the bony fragments consolidate into restored viable tissue for load-bearing. Development of interventions to improve healing remains a priority for orthopaedic research. The goal of this study was to evaluate the ability of a naturally occurring matrix of amorphous calcium carbonate to affect fracture healing in an uninstrumented long bone model. Methods Complete transverse fracture was induced in the fibula of mature mice, followed by daily gavage of crushed gastrolith from crayfish at doses of 0 (control), 1 (1 MG), and 5 (5 MG) mg/kg. At Day 17, bones and sera were harvested. Results Morphologically, the 1 MG treated group had greater bone volume (BV), and both 1 MG and 5 MG had greater tissue volume (TV) than control (p  less then  0.05), as determined by μCT; BV/TV and mineral density did not yield a statistical difference. Histologically, regional variations in mineralized matrix were evident in all specimens, indicating a broad continuum of healing within the callus.