Atypical Presentation of Gouty Tophus as Posterior Cruciate Ligament Cyst: A Case Report.

Introduction: Gouty tophi generally develop around 10 years after the first attack of gout in untreated patients and are commonly found around feet, hands, and elbows. However, tophi can also occur as first sign of disorder. Tophaceous gout presenting in young at the posterior cruciate ligament (PCL) is extremely rare and difficult to diagnose because of its atypical presentation and no hallmark features in magnetic resonance imaging (MRI).

A Rare Case of Neglected Traumatic Anterior Dislocation of Hip in a Child.

Introduction: Post traumatic hip dislocations are very rare in children. Neglected anterior hip dislocations in children are not described in literature so far. Here, we present a case of 6 weeks old anterior hip dislocation successfully managed by open reduction.

Undiagnosed Hoffa fracture of medial femoral condyle presenting as chronic pain in a post-polio limb.

Isolated coronal fracture of medial femoral condyle with intact lateral femoral condyle is extremely rare. A high index of suspicion is necessary for early diagnosis especially in cases of undisplaced fractures. Here we report a case of medial Hoffa fracture in a post-polio limb presenting as chronic pain.

Primary malignant melanoma of proximal tibia.

Primary malignant melanoma (clear cell sarcoma) of bone is a very rare neoplasm. Although metastatic melanoma to bone is not uncommon, primary malignant melanoma of bone is extremely uncommon. To date, only nine cases have been reported in the English literature.

Isolated Hoffa fracture of the medial femoral condyle in a skeletally immature patient.

Intraarticular coronal fracture of the femoral condyle is rare, and an isolated medial Hoffa fracture in a child is extremely rare. To our knowledge, such a case has not yet been reported in the literature. Early diagnosis and prompt treatment are essential for a good long-term outcome.

Salvage of infected total knee arthroplasty with Ilizarov external fixator.

Background: Knee arthrodesis may be the only option of treatment in cases of chronic infected total knee arthroplasty (TKA) with concomitant irreparable extensor mechanism disruption, extensive bone loss or severe systemic morbidities. Circular external fixation offers possible progressive adjustment to stimulate the bony fusion and to make corrections in alignment. We evaluated the results of knee arthrodesis with one or two stage circular external fixator for infected TKA.

Total Knee Arthroplasty as Salvage for Non Union in Bicondylar Hoffa Fracture: a report of two cases.

Introduction: Bicondylar Hoffa fracture is a rare injury with implant failure and non unions as known complications.

Case Report: Two cases of Bicondylar Hoffa fractures with implant failure and nonunion treated successfully with long stem total knee arthroplasty are reported here. At a minimum follow up of 2 years both the implants were well fixed and the fractures have united.

Coronal fractures of the medial femoral condyle: a series of 6 cases and review of literature.

Isolated coronal fracture of medial femoral condyle with intact lateral femoral condyle is extremely rare. We present our experience with such 6 cases of coronal fractures of medial femoral condyle. We reviewed all case records of cases of coronal fractures of femoral condyle which presented to our centre from Jan 2000 to Jun 2009.

Results of bipolar release in the treatment of congenital muscular torticolis in patients older than 10 years of age.

Purpose: Neglected congenital muscular torticollis (CMT) is a common presentation in developing countries like India, with the primary concern of the patients being cosmesis. Little has been published regarding the management of such patients. The aim of our study was to evaluate the results of bipolar release in this age group.

Are both the knees of the same size? Analysis of component asymmetry in 289 bilateral knee arthroplasties.

Background: Variations in the anatomy of knee are well described, however the true incidence of component asymmetry in bilateral total knee arthroplsties is rarely reported. Incidence of component asymmetry in bilateral total knee arthroplasties (TKA) was retrospectively analysed in 289 cruciate retaining total knee arthroplasties.

Materials And Methods: Medical records of these 289 patients were evaluated for the incidence of asymmetry of either femoral or tibial components.

Management of a neglected femoral neck fracture in a limb affected by poliomyelitis - a case report.

Neglected femoral neck fractures are difficult to treat successfully without resorting to total hip arthroplasty. Baksi described a tensor fascia lata muscle pedicle bone graft procedure for such cases. Management of such fractures following poliomyelitis presents additional challenges.

En bloc excision and autogenous fibular reconstruction for aggressive giant cell tumor of distal radius: a report of 12 cases and review of literature.

Introduction: Giant cell tumor (GCT) of distal radius follows a comparatively aggressive behaviour. Wide excision is the management of choice, but this creates a defect at the distal end of radius. The preffered modalities for reconstruction of such a defect include vascularized/non-vascularized bone graft, osteoarticular allografts and custom-made prosthesis.

En bloc resection of osteosarcoma of the proximal fibula. An analysis of 8 cases.

Osteosarcoma of the proximal fibula is a rare entity that poses a surgical challenge. Limb salvage is the goal of treatment, and this entails sacrifice of the common peroneal nerve as well as the anterior tibial artery. Also the loss of the lateral collateral ligament and biceps attachment leads to unavoidable knee instability which requires special reconstructive procedures.

Management of idiopathic clubfoot by the Ponseti technique: our experience at a tertiary referral centre.

Background: Clubfoot or congenital talipes equinovarus is a common congenital abnormality of uncertain etiology. The purpose of this study was to assess the results of the Ponseti method in India and to investigate the demography of relapse and resistant cases.

Methods: A total of 86 children (146 feet) below 1 year of age who had presented to the paediatric orthopedic outpatient department of our institution between June 2003 and January 2007 with unilateral or bilateral idiopathic clubfoot deformity were included in our study and treated conservatively by use of the Ponseti technique.

Neglected irreducible posterolateral knee dislocation.

Knee dislocations are rare injuries. Posterolateral knee dislocations are only a small subset of them. There is a paucity of literature regarding the management of such neglected cases.

Application of the Ponseti principle for deformity correction in neglected and relapsed clubfoot using the Ilizarov fixator.

We treated 15 cases of neglected and relapsed clubfeet by the Ilizarov distraction method using the Ponseti principle in 12 children (mean age 7.3 years). The deformities were corrected around the talar head in the sequence of the cavus, adduction, varus and finally equinus (as per the Ponseti principle).

Tuberculosis of symphysis pubis in a 17 year old male: a rare case presentation and review of literature.

Tuberculosis of symphysis pubis is a rare condition with hardly any report of such cases in the last decade. It is necessary to distinguish the entity from more common ones like Osteitis pubis and Osteomyelitis of pubis symphysis by urgent means in order to start the treatment early and thereby minimize morbidity and prevent complications. A rare case of tuberculosis of symphysis pubis in a 17 year old male is described.

Displaced proximal humeral fractures: an Indian experience with locking plates.

Background: The treatment of displaced proximal humerus fractures, especially in elderly, remains controversial. The objective of this study was to evaluate functional outcome of locking plate used for fixation of these fractures after open reduction. We also attempted to evaluate the complications and predictors of loss of fixation for such an implant.

Arthrodiastasis and surgical containment in severe late-onset Perthes disease: an analysis of 14 patients.

Late-onset Perthes disease usually carries a poor prognosis. In severe cases there may be increasing pain, decreased range of motion and hinge abduction which forms a contraindication for surgical containment. We have managed 14 such patients in a two-stage procedure.

Low-grade fibromyxoid sarcoma of the talus: a case report.

Low-grade fibromyxoid sarcoma is a rare tumor, which most commonly arises from the deep soft tissues of the lower extremities in young men. Diagnosis of this tumor can be difficult because of its deceptively benign histopathologic appearance. Specifically, the lesion is characterized by alternating fibrous and myxoid areas with variable cellularity and a whorled growth pattern.

MRI evaluation of femoral and acetabular anteversion in developmental dysplasia of the hip. A study in an early walking age group.

MRI assessment of acetabular and femoral anteversion was done in 45 children with developmental dysplasia of the hip in an early walking age group of 12 to 48 months. Femoral anteversion, acetabular anteversion, acetabular anteversion of the cartilage anlage and acetabular index were measured by MRI in 45 dislocated hips and in a control group of 37 normal contralateral hips of index cases. We found that there was no statistically significant difference between these two groups for femoral anteversion.