Common elbow injuries in children.

Elbow injuries are one of the commonest paediatric musculoskeletal injuries. Their spectrum varies from pulled elbow to elbow dislocation. Supracondylar fractures are the most common type of paediatric elbow fractures accounting for 65-75 % of all paediatric elbow injuries.

Spinal dysraphism in congenital scoliosis and kyphosis: a retrospective analysis in an Indian population.

Purpose: Early recognition is crucial for occult spinal dysraphism associated with congenital spinal deformities. There is limited literature available on its occurrence in congenital scoliosis and kyphosis in the Indian population.

Methods: Our study involved a retrospective review of 247 children who presented at a single centre.

Multiple Metacarpal Loss Secondary to Tuberculous Dactylitis: Challenges and Management: A Case Report.

Tuberculous dactylitis is infrequently seen after the age of 6 years. The index and middle fingers are the most common sites. Early diagnosis is essential to eradicate the infection.

Closed Reduction Technique for Severely Displaced Radial Neck Fractures in Children.

Background: The described technique is useful for achieving closed reduction of severely displaced (i.e., Judet Type-III and IV) pediatric radial neck fractures.

Patellar Tendon Rupture During Postoperative Physiotherapy for Crouch Gait: A Case Report.

Introduction: A 14-year-old adolescent girl with spastic diplegic cerebral palsy underwent bilateral distal femur extension osteotomy and patellar tendon plication. Two and a half months after surgery, during physiotherapy, she sustained mid-substance tear of the left patellar tendon. The girl was successfully managed with patellar tendon repair and augmentation with tensor fascia lata autograft.

Challenges in Management of Proximal Humerus Diaphyseal Fracture in a Patient with Brachial Plexus Birth Injury: A Case Report.

Case: Two-and-a-half-month-old boy, a known case of brachial plexus birth injury, sustained proximal humeral diaphyseal fracture. Fracture healed in varus malunion and failed to remodel subsequently. Challenges were faced in the course of the management because of progression of the deformity.

Management of Post-osteomyelitic Large Ulna Defect in a Pediatric Patient.

Osteomyelitic sequelae in forearm pose challenges in management. Bone resorption leading to gap nonunions is further difficult to manage. We present a case of post-osteomyelitic ulna defect of 16 cm in a 6-year-old boy managed by non-vascularized fibular grafting with simultaneous correction of radius deformity and its functional outcome after 1 year.

Brachial Plexus Birth Injury due to Proximal Humeral Physeal Separation: A Case Report.

Case: A 9-day-old male neonate presented with swelling over his left shoulder and reduced movements of the left upper extremity since birth. Radiographs raised a suspicion of a shoulder dislocation. Ultrasonography confirmed the diagnosis of proximal humeral physeal separation.

Hip Spica Table: A Technical Note.

Introduction: Hip spica is a widely used treatment modality in the management of various paediatric orthopaedic conditions. A standardized hip spica table is not universally available and various centerres have devised their own designs. In collaboration with the local engineering team, we have designed a light weight yet sturdy, economical and portable hip spica table.

Clinical Diagnosis of the Infantile Shoulder Subluxation in Residual Brachial Plexus Birth Injury and Its Correlation With Ultrasound Diagnosis.

Introduction And Aims Of Study: Timely detection of shoulder subluxation in infants with brachial plexus birth injury (BPBI) is essential to prevent the progression of glenohumeral deformity. Shoulder ultrasonography (USG) is routinely used to detect an infantile subluxation/dislocation, but its use is limited because of the paucity of expert radiologists in developing countries. The aim of this study was to determine the clinical examination predictors to determine shoulder subluxation in patients with BPBI correlating with ultrasound confirmation.

The GALNS p.P77R variant is a probable Gujarati-Indian founder mutation causing Mucopolysaccharidosis IVA syndrome.

Background: Mucopolysaccharidosis IVA (Morquio syndrome A, MPS IVA) is an autosomal recessive lysosomal storage disorder caused due to biallelic variants in the N-acetylgalactoseamine-6-sulfate sulfatase (GALNS) gene. The mutation spectrum in this condition is determined amongst sub-populations belonging to the north, south and east India geography, however, sub-populations of west Indian origin, especially Gujarati-Indians, are yet to be studied. We aimed to analyse the variants present in the GLANS gene amongst the population of Gujarat by sequencing all exons and exon-intron boundaries of the GALNS gene in patients from 23 unrelated families.

Hip Spica Stroller: A Technical Note.

Background: Care of the child after hip-spica application is the most challenging issue faced by parents. Reduced mobility and recumbency can cause respiratory problems, skin irritation and discomfort for the child. Parents need to lift the child in a spica to make him upright and to mobilize.

Modified Velpeau Sling Application for the Treatment of Fractures Around Shoulder in Infants.

Background: Fractures around the shoulder region in infants are treated by arm-chest bandaging, adhesive strapping, or sling application. These conventional treatment methods are associated with issues like skin irritation, excoriation, movement of bone fragments causing muscle spasm, and difficulty in nursing care. We describe the technique of modified Velpeau sling application and reviewed its efficacy at a long-term follow-up.

Reconstruction of post-osteomyelitis 1 ray phalangeal loss by reverse dermis cross toe flap and fibula bone grafting: A rare case report.

Osteomyelitis is defined as infection of the bone and its marrow. It is more common in children due to growing bones and rich blood supply. Although long tubular bones are most common to get involved, no bone is exempted from acute hematogenous osteomyelitis and metatarsals account for 2% of all cases of acute hematogenous osteomyelitis.

Close Reduction Technique for Severely Displaced Radial Neck Fractures in Children.

Introduction: Radial neck fractures account for 5-10% of paediatric elbow trauma. Radial neck fractures have been classified by Judet into five types (I-IVb). There is a global agreement to reduce radial neck fractures with angulation more than 30° (Type III, IVa and IVb).

Protrusio acetabulae as a sequel to septic arthritis of the hip with obturator internus pyomyositis.

Pyomyositis is defined as a pyogenic infection of skeletal muscles principally caused by Staphylococcus aureus. It can present either primarily without any associated soft tissue or bone infection or secondary to any surrounding or distant infection focus. Hip pericapsular pyomyositis is one of the most common types of primary pyomyositis.

Total calcanectomy: Treatment for non-healing plantar ulcer with chronic osteomyelitis of the calcaneus.

Non-healing neuropathic heel ulcer provides a challenge to salvage the limb from a below-knee amputation. Total calcanectomy can prove a reliable option for limb salvage. Given a well-designed orthosis, patients with total calcanectomy do well at any age.

Primary Epiphyseal Osteomyelitis (PEO) in 18 Children: A Rare Entity With Atypical Features.

Objectives: The purpose of this study is to discuss the natural history and management of primary epiphyseal osteomyelitis (PEO), to differentiate clinico-radiologic features of PEO caused by Mycobacterium and other organisms, and to discuss their intermediate-term outcomes.

Methods: Between 2006 and 2017, 18 patients of PEO were managed at our center. Blood investigations, x-rays, and magnetic resonance imaging of affected part were carried out.

An unreported case of septic arthritis of wrist in a neonate.

Septic Arthritis of the wrist is rare in the paediatric population due to its extraarticular metaphysis. We report here a case of wrist septic arthritis in a neonate caused by an uncommon causative organism, A 15 days old male child was referred with the complaint of swelling and decreased movement of the left wrist for 5 days. Local examination revealed warm, tender, erythematous and fluctuant swelling over the dorso-ulnar aspect of the left wrist.

An Unreported Variant of Convergent Dislocation of Elbow.

Introduction: Pediatric traumatic elbow dislocation is an uncommon injury accounting for 3-% of all pediatric elbow injuries. It can present as an isolated injury or in association with fractures of radius, ulna, or humerus. Posterolateral type is the most common accounting for 70% of all pediatric elbow dislocations.