The scope of upper limb surgery for tetraplegics: Role of tendon transfers and Universal Cuff.

Objective: The aim of this study was to evaluate the role of tendon transfers and universal cuff in restoring hand function in tetraplegic patients.

Methods: Twenty-one upper limbs on 12 tetraplegic patients (9 males and 3 females); mean age: 42.2 years (range 22-58 years) with a spinal cord injury at or distal to C6, were included in this study.

Limited laminectomy and restorative spinoplasty in spinal canal stenosis.

Study Design: Prospective cohort study.

Purpose: Evaluation of the clinico-radiological outcome and complications of limited laminectomy and restorative spinoplasty in spinal canal stenosis.

Overview Of Literature: It is critical to achieve adequate spinal decompression, while maintaining spinal stability.

Surgical rehabilitation of a tetraplegic hand: comparison of various methods of reconstructing an absent pinch and hook.

Background: Since complete functional restoration after spinal cord injury may not always be possible, the major focus in such cases has to be on rehabilitation. We performed surgery in such patients to reconstruct important absent hand functions viz. pinch and hook using various methods described in literature and compared their outcome.

Joint salvage using sandwich technique for giant cell tumors around knee.

The most common site for giant cell tumors (GCT) is knee, where the tumor characteristically extends right up to the subarticular bone plate. Extensive curettage with preservation of the joint should be done wherever possible. The alternatives for filling the void left after curettage are either bone graft or bone cement.

Partial-limb salvage after persistent infection in the distal femoral prosthesis: straight-plasty--a novel technique.

A 35 years old female had giant cell tumour (GCT) of the distal femur for which wide resection and distal femoral endoprosthetic replacement was performed. Massive infection of prosthesis required removal and replacement of the prosthesis with nail antibiotic cement spacer, which also proved to be futile. Ultimately the whole of the infected thigh had to be excised.

Evaluation of interadductor approach in neurolytic blockade of obturator nerve in spastic patients.

Background: Spasticity is a syndrome associated with a persistent increase in involuntary reflex activity of a muscle in response to stretch. Adductor muscle spasticity is a common complication of spinal cord and brain injury. It needs to be treated if it interferes with activities of daily living and self-care.

Ankle fusion with centralisation of the fibula after distal tibia bone tumour resection.

Background: Management of distal tibial tumours with limb salvage surgery poses a challenge for the orthopaedic surgeon. This study was done to evaluate the results of fibular centralisation as a technique to reconstruct defects that occurred after resection at this site.

Materials And Methods: Nine patients with a mean age of 23.

Proximal humeral reconstruction using nail cement spacer in primary and metastatic tumours of proximal humerus.

Limb salvage surgery for malignant tumours of proximal humerus is an operative challenge, where the surgeon has to preserve elbow and hand functions and retain shoulder stability with as much function as possible. We treated 14 consecutive patients with primary malignant or isolated metastasis of proximal humerus with surgical resection and reconstruction by nail cement spacer. There were 8 females and 6 males, with a mean age of 28.

Radiological and functional outcome in unstable, osteoporotic trochanteric fractures stabilized with dynamic helical hip system.

A dynamic hip screw (DHS) remains the implant of choice for stabilization of trochanteric fractures because of its favourable results and low rate of non-union or hardware failure, but complication rates of the DHS are higher in unstable and osteoporotic trochanteric fractures. The proponents of the dynamic helical hip system (DHHS) report that it has the potential to decrease the cut-out rates in such fractures as helical blade allows compaction in osteoporotic femoral head which in itself improves anchorage. The purpose of the present study was to evaluate the radiological and functional outcome of DHHS in unstable and osteoporotic trochanteric fractures.

Curettage of benign bone tumors and tumor like lesions: A retrospective analysis.

Background: Curettage is one of the most common treatment options for benign lytic bone tumors and tumor like lesions. The resultant defect is usually filled. We report our outcome curettage of benign bone tumors and tumor like lesions without filling the cavity.

Benign lytic lesions of the femoral neck: mid-term results of extended curettage and sartorius muscle pedicle bone grafting.

Introduction: Benign lytic lesions of bone encompass a group of neoplastic or developmental disorders of human skeleton. They may involve different sites with varied clinical presentation and pattern of aggressiveness for which the treatment strategy needs to be tailored accordingly. Planning a treatment protocol for a lytic lesion in the femoral neck is a matter of concern for the operating surgeon with due consideration to the risks involved.

Simultaneous bilateral trochanteric fractures---a report of four cases.

Simultaneous bilateral intertrochanteric fractures are very rare. There is a paucity of data in current literature documenting patients with such kind of hip fractures. It is severe and potentially life-threatening, associated with a high morbidity.

Obturator neurolysis using 65% alcohol for adductor muscle spasticity.

Spasticity is motor alteration characterized by muscle hypertonia and hyperreflexia. It is an important complication of spinal cord injury, traumatic brain injury, cerebral palsy, and multiple sclerosis. If uncorrected, fibrosis and eventually bony deformity lock the joint into a fixed contracture.

Neglected locked vertical patellar dislocation.

Patellar dislocations occurring about the vertical and horizontal axis are rare and irreducible. The neglected patellar dislocation is still rarer. We describe the clinical presentation and management of a case of neglected vertical patellar dislocation in a 6 year-old boy who sustained an external rotational strain with a laterally directed force to his knee.

Simultaneous use of cannulated reamer and schanz screw for closed intramedullary femoral nailing.

Introduction. Closed reduction is a critical component of the intramedullary nailing and at times can be difficult and technically challenging resulting in increased operative time. Fluoroscopy is used extensively to achieve closed reduction which increases the intra-operative radiation exposure.

Bladder management methods and urological complications in spinal cord injury patients.

Background: The optimal bladder management method should preserve renal function and minimize the risk of urinary tract complications. The present study is conducted to assess the overall incidence of urinary tract infections (UTI) and other urological complications in spinal cord injury patients (SCI), and to compare the incidence of these complications with different bladder management subgroups.

Materials And Methods: 545 patients (386 males and 159 females) of traumatic spinal cord injury with the mean age of 35.

Intra-operative migration of dynamic hip screw into the pelvis.

The authors report a rare per-operative complication of intra-pelvic migration of dynamic hip screw, during osteosynthesis of an inter-trochanteric fracture. Possible reasons of migration are analyzed along with the importance of careful execution of the surgical technique to avoid such iatrogenic complications and medico-legal implications.

An unusual case of sciatic neuropraxia due to melorheostosis.

Melorrheostosis is a rare osteosclerotic bone dysplasia of obscure etiology. The typical radiographic features are flowing candle wax, sub-periosteal bone and streaky endosteal bone formation in diaphyseal and epiphyseal area with sclerotomal pattern mainly involving appendicular skeleton. It is rarely associated with nerve palsies.

Internal fixation of proximal humeral fractures with locking proximal humeral plate (LPHP) in elderly patients with osteoporosis.

Background: Different operative techniques used for treating displaced proximal humeral fractures could result in malunion, non-union, osteonecrosis of humeral head, loosening of screw and loss of reduction particularly in comminuted and osteoporotic fractures. Locking compression plate (LPHP) has been proposed for open reduction and internal fixation of these fractures and is associated with less complication rate.

Materials And Methods: We prospectively assessed the functional outcome and the complications after an average follow-up of 24.

Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods.

Background: No consensus exists regarding the optimal treatment of ipsilateral femoral neck and shaft fractures. The three major issues related to these fractures are the optimal timing of surgery, which fracture to stabilize first, and the optimal implant to use. In an effort to find answers to these three key issues, we report our experience of managing 27 patients with ipsilateral femoral neck and shaft fractures by using two different treatment methods, i.