Third EditionSureshwar Pandey MBBS (Hons) MS (Gen) FICS FIAMS MS (Ortho) FACFAC FACS FNAMS Professor Emeritus, University of Ranchi Founder and Founder Director, GNH Handicapped Children Hospital and RJS Artificial Limb Centre Founder and Consultant, Ram Janam Sulakshana Institute of Orthopaedics and Research Ranchi, Jharkhand, India Founder and Emeritus President and Ex-Secretary General, Indian Foot and Ankle Society [Affiliated to International Federation of Foot and Ankle Societies (IFFAS)] Founder and Emeritus Editor, The Journal of Foot and Ankle Societies Surgery Visiting Professor, Universities of Tokyo, Osaka, Teikyo, Adelaide, Flinders, Ujung Pandang, Singapore Ex-Chairman ASIA-CIP (IFFAS) Founder and Chairman, Ram Janam Sulakshana Pandey Cancer Hospital & Research and Rehabilitation Centre, Ranchi Hon President, Asia-Pacific Society for Foot and Ankle Surgery • Best Book Award of BOS (2000–2001) for his Book Clinical Orthopaedics Diagnosis, 2nd Edition • Best Book Award of BOA 2002 for his Unique Books • Best Book Award (2009–2010) for his book The Clubfoot Revisited Anil Kumar Pandey MBBS CORM PhD (Orth) MAMS Director and Consultant Ram Janam Sulakshana Institute of Orthopaedics and Research (RJSIOR) Associate Director and Consultant GNH Handicapped Children Hospital and RJS Artificial Limb Centre Executive Director and Consultant Ram Janam Sulakshana Pandey Cancer Hospital and Research and Rehabilitation Centre Ranchi, Jharkhand, India Consultant, Kiran Centre for Education and Rehabilitation Varanasi, Uttar Pradesh, India Consultant, RAHA, Chhattisgarh, India Reconstructive Surgeon, Rotary International Project, Government of Nigeria Foreword Padma Bhushan Dr B Mukhopadhaya
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Intra-articular and Allied Injections
First Edition: 1982
First Japanese Edition: 1987
Second Edition: 2005
American Edition: 2007
Third Edition: 2017
The fond memory of my beloved parents
who were, are, and will be
always with me to love, teach and guide
who taught me to persue my“DHANVANTARI”*
The Hindu God of Medicine
Commonly worshipped as the Hindu God of Medicine, Dhanvantari is regarded as the original exponent of Indian medicine. Dhanvantari has many myths and legends woven around him. He emerged with the pot of ambrosia (symbolic of medicine) in his hand from the ocean when it was churned by the contesting gods and demons. He is viewed as the very incarnation of God VISHNU. He is said to have recovered ambrosia which had been lost, and thus obtained a share in sacrifices.
Legends make him reappear as “Divodasa”, the prince of Banaras (Kasiraja), in the family of Ayus. Dhanvantari, Divodasa and Kasiraja are names of the same person who is “the first God and who freed the other Gods from old age, disease and death”, and who in his Himalayan retreat taught surgery to Susruta and other sages. Dhanvantari appeared on earth in Banaras in the princely family of Bahuja and became known as Divodasa; he wandered about as a mendicant even during his early years.
Dhanvantari also appears to have been an actual historical person, although his precise identity is hard to be ascertained. He taught surgery and other divisions of Ayurveda (Indian System of Medicine) at the instance of Susruta, to a group of sages among whom Susruta was the foremost.
Dhanvantari is regarded as the patron-God of all branches of medicine. While Dhanvantari is not credited with any medical treatise of his own, in the early accounts, there is a voluminous glossary and materia medica in the nine sections known as Dhanvantari-Nighantu; it is a compilation which is probably contemporaneous with the famous Amara-Kosha (AD 100). There are a few other works which are also ascribed to Dhanvantari.
There are numerous preparations which are ascribed to him, and many of them are quite ancient.
Dhanvantari-Nighantu is considered the most ancient of the medical glossaries that are available. The original work is said to have been in three recensions; the present version which may have been based on one of them, is in six sections and deals with 373 medicinal substances; their names, synonyms, and brief description of properties being given. The work which claims to be ‘like the third eye’ for the practising physician, is extensively relied upon, despite several more comprehensive glossaries that have been compiled subsquently. Since there is no authentic source of information, this text can be considered more as indicative.
(By courtesy Pfizer Limited)
*This painting has been commissioned by Pfizer Ltd (India) based on an old painting belonging to the Late Maharaja of Mysore, Krishnaraja Wodeyar II (South India).
Oath (for a Medical Practitioner)
“Not for the self,
Not for the fulfillment of any worldly material desire or gain, but solely for the good of suffering humanity, I will treat my patient and excel all”Foreword
Local injection of hydrocortisone, whether intra-articular or extra-articular, is today an accepted method of treatment for a variety of painful conditions, although its exact manner of action is not completely understood, its usefulness is beyond question.
No monograph detailing the proper procedure of these injections is available. The result of treatment depends largely on the exact location of the injection. Dr Pandey's monograph is, therefore, not only timely but is sure to prove valuable for those who use this method of treatment for their patients.
Padma Bhushan Dr B Mukhopadhaya
MBBS (Hons) FRCS (Eng) MCh Orth (L Pool) FAMS
Professor Emeritus, Patna University
Hunterian Professor, Department of Orthopaedics
Royal College of Surgeons, England
Vice-President, Medical Council of India
As our first attempt to write a book, this monograph came out of press as Intra- articular and Allied Injections in 1982. Since then, beyond our expectations this practical handbook became popular in many countries of the world with its English, Japanese and American editions. This proved to be a useful guide for the interns, registrars, practitioners rheumatologist, acupuncture practitioners and orthopaedic surgeons.
In this third edition, besides updating the manuscript, here and there, small sections have been added on acupressure and yoga and the role of platelet-rich plasma (PRP) injections as the introductory knowledge. We humbly solicit the esteemed opinion, advices and guide to improve the monograph further.
It is always difficult to organise and sustain academic activity especially in print format, but for the doggedness and sustained enthusiasm, which only gets augmented by the observations over the subjects—the patients. We are obliged to them for providing experiences to us to the extent which stimulated us to bring out the third edition. To upgrade the Second Edition we have taken help from different sources—we are obliged to them, especially the two books—(1) Campbell's Operative Orthopaedics, 12th Edition by S Terry Canale and James H Beaty (Editors), Mosby: Elsevier, 2013. (2) Orthopaedic Management in Cerebral Palsy, 2nd Edition by Helen M Horstmann and Eugene E Bleet, Mac Keith Press, 2007.
Unless the users, the young orthopaedic and general surgeons, rheumatologists and even general practitioners, would have accepted the first edition willingly, the stimulus to bring out the third edition would not have been sustained. We are indebted to them.
Arranging the manuscript and putting them in proper order and further printing it out are really great annoying jobs. These all have been very gladly and patiently done by my dear granddaughter Dr Pallavi. I (SP) cannot return her debt.
My (SP's) grandchildren—Dr Pallavi, Dr Sangam, Dr Shivam, Dr Vaishnavi, Dr Soumya, Shruti, and Satyam and my great grand child Atharva Pranjal Kanha have been real source of easing tensions of my life with pleasant moments with them—God bless them always.
I bow my head to the feet of my reverend illustrious fatherly teacher Padma Bhushan Emeritus Professor B Mukhopadhaya, who remained the perennial source of inspiration for me.
How can I forget the immense help of Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President) of M/s Jaypee Brothers Medical Publishers (P) Ltd, and all persons involved in producing such a nice monograph. We are really thankful to one and all of Jaypee—The Health Sciences Publisher.