Introduction: Fracture of lateral condyle of humerus is known for nonunion, if not treated properly in children, often leads to a cubitus valgus deformity. For the late presenting cases with deformity and restricted range of motion, surgical management is often challenging, and an appropriate preoperative planning is required. Case Report: We report a case of an un-united fracture of the lateral condyle of the humerus in an adult with a cubitus valgus deformity with early tardy ulnar nerve palsy. He was treated by corrective osteotomy with bone grafting of the nonunion and internal fixation with contoured plates. A virtual preoperative surgical planning was done using 3D printing to define the exact location and direction of the osteotomy, plate contouring and likely place of screw placement to achieve full correction of the elbow deformity. Results: There was good correction of deformity, with union of the nonunion and osteotomy, at three months follows- up. At one year, there was complete recovery of ulnar nerve palsy with excellent function of the elbow and hand. Conclusion: 3D printing is effective in treating complex orthopedic cases and deformity correction. Virtual preoperative surgical planning on the computer and on a 3D model help to study the exact site of osteotomy, plate contouring and screw placement to achieve accurate correction of the deformity. Virtual preoperative planning and 3D printing help in reducing the surgical time and help to achieve desired correction of the deformity.
Introduction: Osteoarthritis (OA) is a progressive and disabling joint disease. It is one of the most frequently occurring health problems for middle-aged and older people. [1,2] OA can occur in every synovial joint, but is most common in hip, knee, hand, foot and spine.[3] It is characterized by joint pain and limited function of the joint. In a synovial joint several structures can cause these clinical symptoms. The Kellgren and Lawrence (K&L) classification criteria are the most widely used radiographic classification criteria to identify and grade OA. Objectives: To evaluate the role of High Resolution Ultrasonography in knee osteoarthritis. Material and Methods: Fifty patients attending the outpatient orthopaedics department of our institute with unilateral or bilateral knee pain were included. 32 patients had bilateral symptomatic knee OA and 18 patients had unilateral symptomatic OA. All knees were subjected to radiographic examination and HRUS assessment. Conclusion: HRUS plays a significant role in early diagnosis of knee osteoarthritis, as well as its progression and therapy monitoring. It is desirable as a quick and easy method of screening for articular cartilage abnormalities and extra-articular abnormalities. Its cost effectiveness, dynamic scanning capabilities and therapeutic guidance providing abilities make it valuable in all settings.
Objective: Chronic osteomyelitis is the infection and inflammation of the bone. Inappropriate use of antibiotics and multidrug resistance has raised the morbidity and mortality rate in chronic osteomyelitis. This study aims to determine the bacterial profile and antimicrobial susceptibility patterns of chronic osteomyelitis with special mention to various resistant mechanisms. Methods: The study is a prospective design. Hundred (100) clinically diagnosed cases of chronic osteomyelitis of all age group and both sex admitted in a tertiary care hospital at central India, in one year were included. Samples like pus, sinus discharge or exudates were collected aseptically and sent for microbiological investigation. Antimicrobial susceptibility of bacterial isolates to the commonly used antibiotics was done by using modified Kirby Bauer disc diffusion method. Results: The aerobic bacteriological study of chronic osteomyelitis showed Staphylococcus aureus is being continued to be major etiological agent followed by Pseudomonas aeruginosa and Staphylococcus epidermidis. Gram-positive isolates were sensitive to linezolid, teicoplanin while gram-negative isolates were sensitive to colistin, ciprofloxacin in the majority. The disease occurs mostly due to traumatic injuries commonly affecting the middle age group. In present study prevalence of methicillin-resistant Staphylococci aureus and β Lactamase producing (ESBL, Amp-C and MBL) gram-negative bacilli is found to be on the higher side. Conclusion: It has been the major cause of morbidity for a long time. The emerging multidrug-resistant strain is a major concern for the treatment. Identification of causative isolates and using a judicious selection of antibiotics will help the clinician in starting the empirical treatment accordingly would limit the multidrug resistance strains in the hospital as well as the community.
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