Overt metabolic bone failure as the initial manifestation of neglected primary hyperparathyroidism: An unusual presentation and review of current practice guidelines.

Varied symptomatology exists in hyperparathyroidism. The current approaches and evaluation of altered calcium homeostasis have led to the practice of early identification and subsequent management of the adenomas. Hence, bony manifestations (deformities, lesions, and fractures) termed to be end stage of bone metabolism failure, have rarely been encountered in the last two decades.

Treatment of Locked Pubic Symphysis by Distraction Osteotomy of the Superior Pubic Ramus: A Case Report.

Case: An 18-year-old adolescent sustained a lateral compression injury to the pelvis that featured a locked pubic symphysis with plastic deformation of the sacrum. The pubic bone was entrapped in the opposite obturator foramen and required a novel distraction osteotomy of the superior ramus to restore the symphysis. The patient developed a urethral stricture 3 months after injury that required urethroplasty.

Anomalous Brachial Artery Bifurcations Can Be at Increased Risk for Entrapment in Pediatric Supracondylar Humerus Fractures, but Do Not Alter Practice Guidelines.

Limb-threatening events arising subsequent to fixation of pediatric supracondylar humerus (SCH) fractures are infrequent. We experienced an untoward pulseless hand in a 9-year-old boy subsequent to reduction and fixation of a SCH fracture with unremarkable preoperative neurovascular examination. A dilemma persists in consideration of parameters to assess limb perfusion from an array of investigations.

Posterior tension band plate osteosynthesis for unstable sacral fractures: A preliminary study.

Introduction: Stable reduction and rigid fixation of the sacrum and posterior ring structures are of paramount importance in the management of complex pelvic ring disruptions, Tile B and C. The major concern with the use of conventional methods, like iliosacral screws and iliolumbar fixations is the increased risk for surgical and implant-related morbidity, especially in difficult situations, such as comminuted, bilateral sacral fractures, and fractures in the dysmorphic sacrum. Although various biomechanical studies have reported the posterior trans-iliac plates to provide maximum resistance to distracting forces by the principle of tension band, the literature pertaining to this implication in clinical studies has been limited.

Acute Traumatic Pseudo-pointing Index Finger Due to an Isolated Second Metacarpal-Trapezoid Dislocation: A Case Report.

Introduction: An isolated second metacarpal dislocation is one of the least reported injuries of the hand. This particular injury assumes clinical significance as they occur subsequent to high energy direct trauma and are usually missed with associated carpal and metacarpal bone fractures. We describe this unique case of an isolated metacarpal-trapezoidal disruption with clinical presentation as the pseudo-pointing index finger and also describe a novel radiological sign to ascertain the rotational deformity of metacarpals on plain radiographs.