Rajeev Raj Manandhar

Kathmandu Medical College | KMC · Department of Orthopaedics

Background: Distal radius fractures are among the most common fractures and there is considerable disparity among surgeons regarding the best way to treat these patients. Intraarticular fractures are treated with open reduction and internal fixation with either dorsal or volar plates. Dorsal plating is not much popular due to its reported complicat...

Background: Anterior cruciate ligament injury (ACL) is a common injury in both sporting and non-sporting population. All patients with an ACL injury may not require surgery. The criteria for deciding whether a reconstruction should be performed are not absolute and the trend is to offer reconstruction to the sporting population as they require a st...

Introduction: Acromioclavicular joint dislocations account for approximately 12% of injuries to the shoulder girdle. Reconstruction of these dislocations is advised and various authors have described different techniques. The modern approach has emphasized anatomic reconstruction using semitendinosus autograft. Methods: Adults with chronic acromioc...

Background: The pain and limitation of shoulder function can disrupt daily activities of patients for months to years. Adhesive capsulitis is considered a self-limiting disease but the duration remains uncertain. The brunt of the disease is focussed on the inflamed joint capsule. On this basis, use of corticosteroid injection is justified. However,...

BACKGROUND: Subacromial impingement syndrome is a common cause of pain in the shoulder region. When analgesics and physiotherapy are not helpful in relieving the patient's shoulder pain, subacromial methylprednisolone injection is given. The aim of this prospective study was to determine the one year clinical outcome of subacromial injections of me...

Open reduction and internal fi xation of distal fractures of radius using a dorsal plate is an accepted technique. Extensor tenosynovitis and rupture of the extensor pollicis longus tendon have been reported as complications after dorsal plating. The purpose of this study was to assess the extensor pollicis longus and the functional outcome of dors...

p> Background: Avulsion fractures of the base of proximal phalanx associated with ulnar or radial collateral ligament instability are relatively rare. The small size of the fragment and strong deforming pull of the attached soft tissues make the process of reduction and maintenance difficult. Objective: The purpose of this study was to assess the...

Background Distal one-third tibial fractures with or without articular involvement can be difficult to manage. Variety of treatment methods have been suggested for these injuries, including conservative treatment, external fixation with or without limited internal fixation, intramedullary nailing, plate fixation (medial or anterolateral) and more r...

Background Surgical techniques of ACL reconstruction (ACLR) have evolved over the past three decades along with debate regarding timing of reconstruction. It was a widespread belief that the timing of surgery was an important factor in determining the resulting stiffness after ACLR. Delayed rather than early reconstruction of the ACL is the current...

Brodie’s abscess is a type of subacute osteomyelitis. Opinions differ as to whether treatment should be surgical or medical for these classic lesions. Failure of symptoms to resolve after six weeks of antibiotics or worsening of the condition during treatment should be followed by surgical treatment. Clinical signs of subperiosteal pus or synovitis...

Background: Trochanteric fracture is the commonest fracture in elderly people. These fractures carry risks associated with prolonged immobility. Early fracture fixation allowing early mobilization of the patients is the aim of the treatment. Dynamic hip screw and plate remains the most common method for treating stable intertrochanteric fractures....

Introduction: Tuberculosis (TB) is endemic in South Asia including Nepal. TB spine is the most common musculoskeletal manifestations and can have devastating complications. Early diagnosis by proper history, physical and radiological examination is mandatory. Chemotherapy is effective in most cases while some require surgical treatment. Methods: Fo...

Background: Various surgical treatment methods are available for unstable distal radius fractures. Clinical and radiological outcome with volar locking plate has been very satisfactory. The purpose of this prospective study is to evaluate the results of the treatment of unstable fractures with the volar locking plate with regard to loss of reductio...

Background: Displaced Colles fractures are generally treated by manipulation and below elbow cast application. Malunion is a common complication resulting in pain, mid carpal instability and post-traumatic arthritis. Fracture stabilization by percutaneous pinning is a simple, minimally invasive technique which helps prevent dislodgment of the fract...

BACKGROUND: Subacromial impingement syndrome is a common cause of pain in the shoulder region. When analgesics and physiotherapy are not helpful in relieving the patient’s shoulder pain, subacromial methylprednisolone injection is given. The aim of this prospective study was to determine the one year clinical outcome of subacromial injections of me...

BACKGROUND: Trigger finger is caused by formation of nodule or thickening of A1 pulley by its fibrocartilage metaplasia resulting in entrapment of the flexor tendon. Conservative treatment of this condition consists of NSAIDs, splint immobilization and steroid injection into the tendon sheath. Failure of the conservative treatment is the indication...

Supracondylar fractures of the humerus occur commonly in the paediatric age group. Gartland type III fractures are treated by closed manipulation and percutaneous pinning with K-wires. Open reduction is indicated in open fractures, failed closed reductions and in a dysvascular limb. There are various approaches that can be utilized to perform an op...

Clinical Examination Methods in Orthopedics 2nd Edition, 2010 Author: John Ebnezar Published by Jaypee Brothers Medical Publishers DOI: 10.3126/kumj.v8i2.3578 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 286

The olecranon approach has been the gold standard for surgical approaches to fracture fixation of distal articular surface of humerus. Although it provides a good exposure, it also has disadvantages of delayed union, nonunion and implant related complications at the osteotomy site. The aim of this study was to determine the functional outcome of di...

INTRODUCTION: The olecranon approach has been the gold standard for surgical approaches to fracture fixation of distal articular surface of humerus. Although it provides a good exposure, it also has disadvantages of delayed union, nonunion and implant related complications at the osteotomy site. OBJECTIVE: The aim of this study was to determine the...

The treatment of displaced intra-articular calcaneal fracture is controversial. Conventionally, they were treated non-operatively. However, some surgeons are now operatively treating these fractures because of continuing dissatisfaction with the outcome of conservative treatment of these fractures and improvements that have occurred in surgical tec...

Distal radius fractures are a common injury and without proper treatment leads to high functional impairment and frequent complications. The aim of this study was to see the functional outcome in patients with comminuted distal radius fractures treated with combined external fixation and open reduction and volar plating. All comminuted distal radiu...

Distal one third tibial fractures can be difficult to manage. Variety of treatment methods have been suggested for these injuries, including conservative treatment, external fixation, intramedullary nailing, and plate fixation. None of these techniques can be considered the "gold standard" for these injuries. The purpose of this prospective study i...

Tennis elbow is a common orthopaedic problem presenting in office orthopaedics, but its exact patho-aetiology has not been identified to date. It is treated operatively when conservative measures including multiple local steroid injections are not helpful to the patients. This was a retrospective study to assess the outcome of tennis elbow patients...

Sub-trochanteric fractures of the femur are not commonly encountered as compared to trochanteric or neck of femur fractures. Relatively younger persons are injured more and a considerable violence is required for this fracture to occur. These fractures, treated conservatively by methods like traction, splints or casts, are often associated with com...