Congenital scoliosis: management and future directions.

Congenital scoliosis remains an interesting and challenging diagnostic entity. Vertebral absence, partial formation or lack of segmentation may cause asymmetrical growth and resultant deformity. Because of the high frequency of associated anomalies within and outside the spine, a detailed history and physical examination are mandatory.

High-grade infiltrative myxofibrosarcoma in the forearm presenting as acute carpal tunnel syndrome.

Myxofibrosarcoma is one of the most common sarcomas in the extremities of elderly people and is characterized by a high frequency of local recurrence. We report a rare case of high-grade myxofibrosarcoma involving the forearm and presenting as acute carpal tunnel syndrome where absence of a discrete mass lesion and diffuse infiltrative nature precluded early recognition of tumor. To our knowledge, such a presentation with an extreme infiltrative growth pattern in the forearm has not been reported before.

Rapidly destructive osteoarthritis of the hip joint: a case series.

Background: Rapidly destructive arthrosis of the hip is a rare and incompletely understood disorder with scarce literature about variations in natural history within a population.

Methods: A series of cases from North Wales with rapid progressive joint destruction and extensive subchondral bone loss in the femoral head and acetabulum are presented. Radiographic findings mimicked those of other disorders such as septic arthritis, rheumatoid and seronegative arthritis, primary osteonecrosis with secondary osteoarthritis, or neuropathic osteoarthropathy, but none of the patients had clinical, pathologic, or laboratory evidence of these entities.

Airbag-induced fatal subaxial cervical spinal cord injury in a low-velocity collision.

The effectiveness of airbags as a modern restraining system for car occupants in frontal collisions has been well demonstrated in experimental studies and real accidents; however, they can themselves be responsible for injuries, fatal in some circumstances. We hereby report a lethal cervical spinal cord injury in a patient with ankylosed cervical spine, caused by a hyperextension injury after a motor vehicle collision, in which the airbag had been deployed in the absence of shoulder or lap belt harnesses. This led to fatal injuries resulting from the inflating airbag striking against the face and chin of the victim.

Ipsilateral compound distal radius fracture with missed elbow dislocation. A rare injury pattern.

A rare injury pattern of compound distal radius fracture associated with a missed posterolateral elbow dislocation in an adult is described. To the best of our knowledge, this has not been previously described in the literature. The probable mechanisms of injury are speculated to include longitudinal compressive force along with valgus and external rotatory stress to the semiflexed elbow leading to elbow dislocation.

Immediate unprotected weight-bearing of operatively treated ankle fractures.

The objective of this study was to determine whether immediate mobilisation and unprotected weight-bearing of rigidly internally fixed fractured ankles had a significant effect on ankle function or whether it predisposed the ankle to loss of reduction or hardware failure. Twenty five patients with operated Weber A/B/C fractures were allowed immediate full weight-bearing without a plaster and were compared with matched historical controls treated in a non-weight-bearing plaster cast. Matched-pair analysis revealed no differences for hospital stay and functional outcome on Olerud and Molander scoring system but significant difference in time until return to work (mean: 91.

Can carpal malalignment predict early and late instability in nonoperatively managed distal radius fractures?

The purpose of this study was to assess the frequency of carpal instability as a concomitant lesion in distal radius fractures and identify other factors including carpal malalignment in an attempt to predict the final radiological outcome more accurately following conservative treatment of distal radius fractures. An observational study from patient records and standardised radiological follow-up examinations as data sources was used. The alignment of each wrist was checked radiographically immediately post-reduction and subsequently at 1- and 6-week follow-up assessments.

Sequential traumatic bilateral extensor pollicis brevis rupture: a case report.

We present an interesting and rare case of a sequential bilateral traumatic rupture of the extensor pollicis brevis tendons distal to the first extensor compartment in a patient with no underlying systemic condition or pathology around the wrist. Satisfactory thumb function was restored by bilateral transfer of the extensor indicis proprius.

Thromboprophylaxis following cast immobilisation for lower limb injuries--survey of current practice in United Kingdom.

The risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) is well documented in patients following cast immobilisation for injuries of lower extremities. There are no generally accepted approaches to preventing this complication and hence there remains substantial practice variation amongst surgeons regarding the use of anticoagulation measures. The present survey was conducted to investigate the current chemothromboprophylaxis practice among UK orthopaedic departments for patients immobilised with plasters for lower extremity injuries and establish any variations in practice.