Cemented bipolar hemiarthroplasty for unstable intertrochanteric fracture in elderly patients over 70 years: Boon or bane?

Introduction: The surgical management of intertrochanter femur fracture in elderly patient is still under debate. Various implants can be utilised but prosthetic replacement is gaining popularity. This study was performed to evaluate the functional and clinical outcomes of cemented bipolar arthroplasty as a primary treatment for unstable intertrochanteric fracture in elderly patients (> 70 years).

Acquired Hallux Varus Deformity Correction: Pivotless Distraction Technique.

Acquired hallux varus deformity secondary to postburn contracture is a rare condition. It causes cosmetic disfigurement, pain, and inability to wear a shoe. Soft-tissue procedures and tendon transfers have been described for correction; however, these may require multiple operations and the outcome may be poor.

Proximal Tibiofibular Joint: A Forgotten Entity in Multi-Ligament Injuries of the Knee.

Purpose: The proximal tibiofibular joint (PTJF) can be injured with the structures in the lateral aspect of the knee in a multi-ligament knee injury (MLKI) patient. Such injuries are scarce but require attention in the management of the complex MLKIs. The assessment and management of such injuries are not well described in the English literature.

3D CT evaluation of femoral and tibial tunnels in anatomic double bundle anterior cruciate ligament reconstruction.

Background: An anatomical double bundle ACL reconstruction replicates the anatomy of native ACL as the tunnels are made to simulate the anatomy of ACL with AM and PL bundle foot prints. The goal of anatomic ACL reconstruction is to tailor the procedure to each patient's anatomic, biomechanical and functional demands to provide the best possible outcome. The shift from single bundle to double bundle technique and also from transtibial to transportal method has been to provide near anatomic tunnel positions.

A Percutaneous Technique to Reposition the Cortical Button of Adjustable-Loop Devices in Anterior Cruciate Ligament Reconstruction.

Adjustable-loop devices are relatively new but quite popular and have been routinely used for around a decade in arthroscopic anterior cruciate ligament reconstruction for hamstring graft fixation on the femur. They allow surgeons to adapt to different tunnel lengths, eliminate the need for multiple loop sizes, decrease the "bungee cord effect," maximize the amount of graft within the femoral socket available for incorporation, and allow retensioning of the graft. Apart from these advantages, certain complications are associated with the use of adjustable-loop devices.

A Rare Case of Complex Carpal Injury: Divergent Trapezium-Trapezoid Fracture Dislocation.

Divergent trapezium-trapezoid fracture dislocation is a rare and complex injury. The authors present an unusual case of dislocation of the trapezium-trapezoid complex with scaphoid fracture. A 25-year-old man suffered a road traffic accident leading to complex carpal injury due to axial and rotation forces (steer wheel injury) on the left wrist.

Bicondylar conjoint Hoffa's fracture with patella entrapped in the fracture: A rare case report.

Bicondylar Hoffa fracture involving both the femoral condyles is a rare injury. Conjoint variety with intact bone bridge between condyles in intercondylar notch area is even rare. We report a conjoint variety of bicondylar open grade III A Hoffa's fracture with patella entrapped in the fracture with quadriceps rupture in an adult which was surgically treated with initial debridement and later open reduction with fixation and quadriceps repair.

Pediatric conjoint Hoffa's fracture: An uncommon injury and review of literature.

Coronal plane fracture of femoral condyles was first elaborated by Hoffa. These are difficult articular injuries, often described in adult skeleton and very rarely in pediatric age group. Conjoint variety with intact bone bridge between condyles in intercondylar notch area is rare.

Arthroscopic-assisted fixation of Hoffa fracture: A case report and description of technique.

Medial condyle Hoffa fractures are intra articular injuries, which require prompt anatomical reduction and internal fixation. Arthroscopy-guided fixation of these fractures has also been advocated; the advantages include avoidance of soft tissue dissection, fast recovery and mobilization. We describe a case of a 28-year-old male patient presenting with a 10-day-old medial condylar Hoffa fracture.

Tuberculosis of wrist joint in an 8-year-old child presenting as hamate osteitis: A rare case report.

Tuberculosis rarely involves wrist joint and is usually diagnosed in arthritic stage. We, hereby, describe a case of TB afflicting wrist joint in a young child. To our knowledge, similar presentation has never been reported.

Displaced Posterior Cruciate Ligament Avulsion Fractures: A Retrospective Comparative Study Between Open Posterior Approach and Arthroscopic Single-Tunnel Suture Fixation.

Purpose: To retrospectively compare the clinical outcomes of displaced tibial-side posterior cruciate ligament (PCL) avulsion fractures treated with open reduction and screw fixation versus arthroscopic suture fixation.

Methods: From 2005 to 2013, all displaced PCL tibial-side avulsion fractures treated surgically-initially by an open posterior approach and later by arthroscopic-assisted suture fixation-were retrospectively reviewed. The cases with radiographic evidence of greater than 3 mm of displacement and/or grade II or III laxity on the posterior drawer test were included in the study group.

Partial tears of anterior cruciate ligament: Results of single bundle augmentation.

Background: Partial tears of the anterior cruciate ligament (ACL) are common and usually present with symptomatic instability. The remnant fibers are usually removed and a traditional ACL reconstruction is done. But with increased understanding of ACL double bundle anatomy, the remnant tissue preservation along with a single bundle augmentation of the torn bundle is also suggested.

Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation.

Late rupture of extensor pollicis longus (EPL) tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP). He was managed with extensor indicis proprius (EIP) transfer to restore thumb extension.

Inadvertent advancement of guide wire across the knee caused by incarcerated bone fragment at the nail tip during femoral nailing.

Fracture of femoral shaft in adults is common and mostly managed with intramedullary interlocking nails. Complications during closed intramedullary femoral nailing are uncommon, and mostly of them are caused by technical reasons. We describe a case of closed nailing for a femoral shaft fracture in which a jammed intramedullary guide wire, due to an incarcerated bone fragment at the nail tip, was inadvertently advanced across the knee.

We need a break: Bisphosphonates.

Bone is a dynamic tissue. It remodels, thereby maintaining serum calcium, repairing micro damage and maintaining strength. A reduction in the strength of bone leads to osteoporosis that may manifest clinically as low energy vertebral and non-vertebral fractures.

An unusual monteggia equivalent: a case report with literature review.

Monteggia fracture dislocations are uncommon in childhood. Over a period of time, various equivalents of this entity have been described. These fractures with concomitant elbow injuries are exceedingly rare in young children.

Isolated involvement of the posterior elements in spinal tuberculosis: a review of twenty-four cases.

Background: The literature on tuberculosis of the posterior spinal elements without involvement of the vertebral body is scarce. In this study we report our experience with twenty-four cases of neural arch tuberculosis that were treated at our center.

Methods: We performed a retrospective review of the clinical and radiographic data of twenty-four consecutive patients who had tuberculosis of the posterior spinal elements with total sparing of the vertebral bodies and intervertebral disc space.

Nerve injury during hamstring graft harvest: a prospective comparative study of three different incisions.

Purpose: To compare the incidence, extent of sensory loss, its clinical effect and natural course caused by three different skin incisions used for autogenous hamstring graft harvest during anterior cruciate ligament (ACL) reconstruction.

Methods: One hundred and twenty patients who underwent hamstring graft harvest during ACL reconstruction, participated in the study. All patients were randomized into 3 groups as per the 3 incisions used-vertical, transverse and oblique.

Scurvy: An unusual presentation of cerebral palsy.

Scurvy is caused by prolonged severe dietary deficiency of ascorbic acid, in which the breakdown of intercellular cement substances leads to capillary hemorrhages and defective growth of fibroblasts, osteoblasts and odontoblasts, resulting in impaired synthesis of collagen, osteoid and dentine. It is characterized by hemorrhagic gingivitis, subperiosteal hemorrhages, perifollicular hemorrhages, and frequently petechial hemorrhages (especially on the feet). People with abnormal dietary habits, mental illness or physical disability are prone to develop this disease.

Neonatal separation of distal humeral epiphysis during Caesarean section: a case report.

We report a rare injury of distal humeral epiphyseal separation in a newborn during a Caesarean section. The diagnosis was made using magnetic resonance imaging. Emergency Caesarean deliveries with considerable traction applied to extract the baby can be the risk factor of such an injury.