Ashwath M. Acharya

Ashwath M. Acharya
Manipal Academy of Higher Education | MAHE · Department of Orthopaedics

MS(Orthopaedics), FNB (Hand and Microsurgery)

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49
Publications
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174
Citations

Publications

Publications (49)
Article
Full-text available
Purpose Ultrasonography is currently used for both diagnostic and therapeutic purposes in de Quervain’s tenosynovitis. There is a dearth of information on how effective an ultrasound-guided (USG) steroid injection is when compared to surgical release of the first extensor compartment. Hence, we performed a non-randomized two-armed comparison study...
Article
Case: A 35-year-old farmer presented with a foot ulcer on his left flail foot because of a sciatic nerve injury of 1-year duration. A gap of 11 cm was observed in the sciatic nerve for which he underwent 2-staged pedicled peroneal nerve grafting and posterior bone block procedure for the ankle. He had S3 grade sensation at 5-year follow-up without...
Book
This handbook brings together the basic elements of hand and upper limb case, from examination to clinical diagnosis of various hand and upper limb related diseases. It improvises the examination skills of the reader with proficiency to arrive for a provisional diagnosis for the given hand surgery and related diseases. The chapters are dealt with s...
Article
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Synovial osteochondromatosis is a disease of the synovium characterized by the formation of multiple cartilaginous bodies. The disease is characteristically monarticular, most commonly involving the knee. Despite frequent mention of elbow involvement in various texts and articles, we wish to review the clinical, radiologic, and histologic features...
Article
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Background Ethnic differences in upper limb anthropometry have significant variations which can influence surgical outcomes and rehabilitation. We hypothesize that there would be a significant difference in the anthropometry based on ethnicity and gender which will reflect on objective measurements. Methods We performed 13 anthropometric measureme...
Article
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Background: Children with congenital differences who require prosthesis, have special needs due to their growth and psychosocial factors. Cosmetic or body-powered prosthesis provides basic functional needs but poses a financial burden on the family. Prostheses with advanced functions need to be deferred until adulthood. 3D printed prosthesis is a n...
Article
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Introduction The surge in the number of trauma cases following relaxation of lockdowns in the backdrop of COVID-19 pandemic, has strained the existing infrastructure to cater to these patients and also prevent the spread of infection. Moreover, with the rise of newer strains, the period ahead has to be tread carefully to prevent resurgence of infec...
Article
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Background Purpose was to correlate flexor pollicis longus tendon (FPL) attrition using Ultrasonography with plate position on radiographs following volar locked compression plate fixation (LCP) in patients who have undergone pronator quadratus (PQ) repair for distal radius fractures. Methods Status of flexor pollicis longus tendon was analyzed by...
Article
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A new nerve transfer option of using viable fascicle of the ipsilateral middle trunk for suprascapular nerve reconstruction is presented. The procedure was used in two patients with upper brachial plexus injury involving loss of shoulder abduction and external rotation. Clinical evaluation and nerve conduction studies in both patients confirmed axo...
Article
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The vanishing bone disease, also known as Gorhams disease usually involves long bones. Isolated carpal bone involvement is uncommon. A 14 year old male presented with pain in the right wrist joint since 4 months. He was a known case of Congenital Adrenal Hyperplasia on oral steroids for 3 years. X-rays showed deformed arthritic scaphoid, lunate and...
Article
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s Background The widely used Hand Injury Severity Score (HISS) has intrinsic drawbacks like inability to score vascular status and questionable correlation with Disability of Arm, shoulder and Hand. We compared it with the Strickland score which is easier to calculate and has provision for evaluation of vascular status. We assessed correlation of...
Article
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s Radial longitudinal deficiency represents a spectrum of musculoskeletal hypoplasia and dysplasia affecting the upper limb involving mainly the radial aspect of the forearm, wrist, and hand and not infrequently the proximal arm. 2/3rd of the patients with this condition suffer from an associated medical or musculoskeletal disorder and 1/3rd of the...
Article
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Digital nerve defects following open injuries in the hand has significant morbidity as it often leads to neuromas and sensory dysesthesias. Reconstruction of such defects with nerve grafts frequently results in donor site complications. A simple solution to bridge such defects is the use of the Tubulisation technique. We present a case report of tw...
Article
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A cross-sectional study was conducted using a validated and standardized questionnaire answered by willing pediatricians and obstetricians at our university teaching hospitals. Nearly two thirds of the pediatricians (62.8%) and three fourths of the obstetricians (73.6%) continued to accept the terminology of obstetric brachial plexus birth palsy wh...
Article
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We studied the diagnostic accuracy of MRI in 35 adult patients with traumatic brachial plexus injury in comparison with intra operative findings. The overall sensitivity to detect root avulsions was 39% and specificity was 75%. MRI was more useful in the diagnosis of lower root avulsions. At trunk and division level injuries, the sensitivity was 87...
Article
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We evaluated the outcome of new technical refinements in abdominal flap coverage of major defects in upper limb for its reliability and safety. 68 patients were assessed for indications, additional procedures, complications and DASH questionnaire evaluation at the end of a year. The mean size of flap was 56 cm ² (range 6–250 cm ² ). Median DASH sco...
Article
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Carpometacarpal (CMC) joint dislocation other than thumb are rare injuries and can be easily missed. These injuries account for <1% of all hand injuries and are frequently overlooked or missed. CMC dislocations can occur either in dorsal or volar direction and be associated with fractures. However, dorsal dislocation is more commonly encountered th...
Article
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Background: Orthopaedic surgical site infections (SSIs) are among the most common hospital-acquired infections, leading to serious health complications, hospital readmissions, and extended hospitalizations.
Article
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We report functional and cosmetic outcomes in 14 patients (six bilateral and eight unilateral) with type IV radial longitudinal deficiency who underwent radialization. Follow-up ranged from 5 to 19 years. Outcome measures were grip and pinch strengths, Percival and Sykes score, Vilkki score, Cattaneo grading, and a questionnaire to patients. Radiol...
Article
Volar translunate perilunate dislocations are the rarest form of perilunate dislocations with only a handful of cases reported till now. The injury mechanism is not uniform, and the pattern of injury does not follow traditional classifications. We report a case of volar translunate perilunate dislocation with a review of literature of very few prev...
Article
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We report a case of bilateral carpal tunnel syndrome (CTS) with bilateral bifid median nerve (BMN) without a persistent median artery diagnosed by clinical examination, NCV and Ultrasonography. Bilateral BMN to produce bilateral CTS is extremely rare and is contrary to the popular classifications which state that BMN without persistent median arter...
Article
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Radial tunnel syndrome is a compressive neuropathy of Posterior interossei nerve(PIN) in the radial tunnel. Radial tunnel is commonly misdiagnosed and often treated as lateral epicondylitis. The difficulty in diagnoses is due to overlapping features among both the conditions. Understanding the anatomy of radial tunnel and possible sites of compress...
Article
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Various procedures described for deformity correction in radial longitudinal deficiency (RLD) have encountered problems of stiffness, instability, and inadequate correction. Many surgical modifications of these procedures have still resulted in deformity recurrence, shortening, and damage to the epiphysis. To align the hand with the forearm, the de...
Article
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Background: To identify acute un-displaced and minimally displaced scaphoid fractures which are unlikely to unite with non-operative treatment at six weeks with CT scan and stabilize them with percutaneous screw fixation with the aim of preventing non-union. Methods: A scaphoid series radiographs of wrist were obtained for patients with undispla...
Article
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of neighbouring digits caused greater grip and pinch loss, and a higher DASH score. Primary ray resection decreased the total disability and eliminated the costs of a second procedure. Conclusion Following ray amputation, one can predict an approximate 43.3% loss of grip strength and 33.6% loss of pinch strength. The patients can be counselled rega...
Article
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Ancient schwannoma is a rare variant of schwannoma associated with a longstanding course. They differ from classical schwannomas in the long duration for this subtype of schwannoma to develop and also by demonstrating haemorrhagic and degenerative changes with nuclear atypia. It is because of these histologic hallmarks that they are frequently misd...
Article
Full-text available
Ancient schwannoma is a rare variant of schwannoma associated with a longstanding course. They differ from classical schwannomas in the long duration for this subtype of schwannoma to develop and also by demonstrating haemorrhagic and degenerative changes with nuclear atypia. It is because of these histologic hallmarks that they are frequently misd...
Article
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Purpose This study was done to determine the role of endoscopic carpal tunnel release in the treatment of carpal tunnel syndrome and also to note the conversion rates of endoscopic to open release, causes for conversion and to analyse the learning curve of the operating surgeon for endoscopic procedure. Methods A total of 100 consecutive idiopathi...
Article
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Isolated tear of collateral ligaments of thumb are common but combined injuries of both radial and ulnar collateral ligaments are rare. These cases are reported in athletes involved in high-impact sports. Here, we report a case of a 15-year-old boy with pain at base of the thumb and instability following low-impact sporting activity. On subsequent...
Article
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Tarsal tunnel syndrome (TTS) is one of the frequently encountered entrapment neuropathies of the lower limb. Most often the aetiology is considered to be idiopathic. However, it has to be thoroughly investigated to rule out diverse extrinsic and intrinsic causes. The sustentaculum tali (ST) forms the superior part of the distal tarsal tunnel, and a...
Article
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Article
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Background: Rhabdomyosarcomas are malignant tumors arising from striated muscle but can be often confused with primitive neuroectodermal tumors and Ewing sarcoma. They are often classified based on age of presentation and histological features. Three major types of rhabdomyosarcomas are embryonal, alveolar, and pleomorphic with characteristic pres...
Article
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Glomus tumor constitutes 1 to 5% of all hand tumors. They present with the classical triad of severe pain, point tenderness, and cold sensitivity. The diagnosis is mainly clinical, but very often it is missed because of lack of knowledge or inadequate clinical examination. We present the case of a 43-year-old woman with glomus tumor of the middle f...
Article
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Incidence of multiple flexor tendon rupture following distal radius fractures is rare with very few cases being reported in literature. We present an unusual case of a patient who had come to us with complaints of weakness and paresthesia of the right hand of one month prior and with a past history of dorsal plating for distal radius fracture nine...
Article
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We report a case of intraneural synovial sarcoma of the median nerve in a 39 year old lady with multiple local recurrences over thirteen years with no distant metastasis. The diagnosis of biphasic type of synovial sarcoma was confirmed by histopathology and immunohistochemistry. At the time of the fourth recurrence below elbow amputation was perfor...
Article
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A 5-year-old child presented to us with weakness of the left upper limb since birth. With the given history of obstetric trauma and limb examination, a diagnosis of birth brachial plexus palsy was made. Brachial plexus exploration along with microsurgery was performed at the same time which included extrinsic neurolysis of the roots and trunks and...
Article
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Introduction: Perilunate and lunate dislocations are uncommon high energy injuries and have extensive soft tissue, cartilaginous and bony damage. The most common pattern is trans-scaphoid perilunate fracture dislocation which constitutes approximately 50% of these injuries. Unusual injury pattern like Scaphocapitate syndrome can occur with fracture...
Article
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The principle aim in complex defects in hand is to restore a functioning tripod pinch. Among the various options, the use of locally available spare parts offers to improve both functions and cosmetics. 10 patients underwent surgeries to restore tripod pinch using this concept of spare parts. Four of them were children with congenital differences a...
Article
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Superficial angiomyxoma is a distinctive cutaneous soft tissue neoplasm commonly involving dermal and subcutaneous tissues and showing a prominent angiomyxoid matrix interspersed with numerous blood vessels. We report a case of superficial angiomyxoma in a 70-year-old man who presented with a fungating swelling on the distal phalanx of the thumb mi...
Article
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Major injuries of the hand with skin loss often require early flap cover, which should be versatile, simple in technique, and safe. The reverse posterior interosseus flap satisfies all of these requirements. Over the years, refinements in the technique of harvesting this flap have evolved to prevent venous congestion and flap necrosis. This study p...
Article
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Imaging techniques play an important role in evaluating the complex anatomy of bone and soft tissues of the wrist. The standard wrist radiographs and specialized views still form a very important imaging modality to unravel the wrist pathology in their simplest forms. This article discusses the routine radiography of the wrist followed by ancillary...
Article
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One of the most difficult and intricate surgeries in the field of hand surgery is that of Pollicization. It involves transfer of one of the fingers to create a new functioning thumb when it is absent. This elegant surgical technique has evolved over the 100 years from a simple, though unaesthetic transposition of digits to a complex procedure which...

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