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.

Prediction of posttraumatic femoral head osteonecrosis by quantitative intraosseous aspirate and core biopsy analysis: a prospective study.

Twenty-two patients with unreduced hip dislocation or fracture dislocation were prospectively evaluated. Intraosseous aspiration, marrow fluid analysis and core biopsy histological analysis was performed from the supero-lateral (test group) and central part (control group) of the femoral head. After appropriate surgical treatment and postoperative management, they were followed up for 2 years by clinical, radiological and magnetic resonance imaging evaluation.

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).

Regeneration of the Achilles tendon after percutaneous tenotomy in infants: a clinical and MRI study.

We aimed to study the regeneration potential of tendo-achilles after percutaneous tenotomy in 34 clubfeet treated by Ponseti's technique. Clinical and MRI evaluation was done after 6 weeks and 6 months of tenotomy to assess the regeneration of the tendon. At the follow-up, Achilles tendon was palpated like a cord in all the feet.

Premature epiphyseal fusions in beta thalassaemia.

Thalassemia patients are now living longer due to better transfusion methods and diagnostic awareness. To see whether this longevity is associated with orthopaedic disability, especially physeal growth defects, we examined 105 patients aged between 5-25 years for evidence of clinically detectable premature epiphyseal fusions (PEF). Ours is a center focussed on transfusion dependent beta thalassemia (TDBT) patient management, and so detailed transfusion records related to age at first transfusion, regularity of transfusions and pre-transfusional haemoglobin (Hb) levels were available.

Is there a need for reconstruction after excision of the distal ulna for giant-cell tumour?

Giant cell tumour rarely involves the distal ulna; the literature has sporadic cases reported, and the need for reconstruction after distal ulnar resection remains controversial. The uncommon presentation often leads to diagnostic delays, and some of the cases reported have attained large sizes prior to diagnosis, leading' to procedures which range from soft tissue stabilization to bone graft reconstruction of the surgical defect. We analyzed our cases with specific reference to the need for additional reconstruction; the radiological and functional outcome of extraperiosteal distal ulna resection without reconstruction in 4 patients with giant cell tumour of the distal ulna was assessed at a mean follow-up of 9 years post surgical excision.

Outcome of varus derotation closed wedge osteotomy in Perthes disease.

The aim of this study is to evaluate the clinical and radiological outcome of varus derotation osteotomy in Perthes disease. We studied 45 children with a mean age of 9.2 years, belonging to Herring's lateral pillar group B and C treated with varus derotation osteotomy.

Results of dorsal approach in surgical correction of congenital vertical talus: an Indian experience.

We present our experience in the correction of congenital vertical talus deformity in a single stage using dorsal approach. We operated on 20 feet using the dorsal approach and the average age of patients at the time of surgery was 16 months. Talonavicular reduction was achieved in all the feet and there was significant improvement in postoperative talo-calcaneal and talo-first metatarsal angles, which were well maintained at a follow-up of 4 years.

Efficacy of indigenously developed single vial kit preparation of 99mTc-ciprofloxacin in the detection of bacterial infection: an Indian experience.

Objective: To investigate the diagnostic efficacy of indigenously developed single vial kit preparation of Tc-ciprofloxacin (Diagnobact) for the detection of orthopedic infections.

Methods: Seventy-seven patients [25 with clinical suspicion of diabetic foot osteomyelitis (DFOM), 25 with orthopedic device-related infection (ODRI) and 27 with tubercular bone infection] underwent three-phase Tc-methylenediphosphonate bone scintigraphy followed by static Tc-ciprofloxacin imaging at 1, 4 and 24 h. Imaging (anterior and posterior views) was performed under a dual-head gamma-camera using a low-energy, high-resolution, parallel-hole collimator.

Bacterial load in tissues and its predictive value for infection in open fractures.

The role of quantitative bacteriology is considered controversial for the prediction of infection in open fractures. A study was done in 20 patients with open fractures. Post debridement pieces of skin, muscle and periosteal tissue were obtained for quantitative bacterial counts.