Purpose
Reduction and fixation in femoral neck fracture in young patients have a problem of nonunion, requiring additional procedures like valgus osteotomy; but fixation devices are technically difficult for inexperienced surgeons. We aims to assess the results of valgus osteotomy in femoral neck fracture in our setup.
Methods
We reported a series of 20 patients of higher Pauwel's angled fracture of femoral neck fracture presenting late wherein valgus osteotomy was added to reduction fixation which was secured with a commonly available 135° dynamic hip screw and plate.
Results
Femoral neck fractures united in 16 patients (80%). Excellent to good results (Harris hip score >80) were seen in 70% patients. Angle of correction of preoperative Pauwels has been changed from 68.3 to 34.3.
Conclusion
The 135° dynamic hip screw and plate provides rigid internal fixation after valgus osteotomy and being a more familiar fixation device simplifies the procedure with good results.
Osteosarcoma of calcaneum is of rare occurrence. Infrequent occurrence produce dilemma and challenge to it's diagnosis, leading to a delayed treatment. Here we present a rare case of chondroblastic variety of calcaneal osteosarcoma in an adolescent that produced a dilemma for diagnosis. Here also we have discussed the available literature regarding the clinical, radiological and histological features of calcaneal osteosarcoma.
Background: Vaginal bleeding is a serious cause which needs an emergency consultation. Major causes are abortion, ectopic pregnancy and molar pregnancy others like cervical erosion, polyp and carcinoma. The objective is to identify cause, assess the prognosis and institute appropriate management.Methods: Prospective study in MMC and RI, OBG, Mysore from November 2015 to September 2017. General physical and pelvic examination done for provisional clinical diagnosis and subjected to Ultrasound. Clinical diagnosis and ultrasound diagnosis were correlated.Results: 100 cases of first trimester bleeding evaluated by Ultrasonography with an incidence 2.37%. Most common cause was abortion (81.6%) then molar (10%) and ectopic pregnancy (9%). Out of 100 cases, 72 cases confirmed, 28 cases proved by ultrasound which was misdiagnosed on clinical examination with disparity of 72 between clinical and ultrasound diagnosis. 13 cases viable pregnancy by ultrasonography with sensitivity, specificity, NPV and PPV of 100% and 69 cases nonviable pregnancies with sensitivity, specificity and NPV of 100%. 9 cases ectopic pregnancy were diagnosed on ultrasound with sensitivity 100%, specificity 98.9%, PPV 99% and accuracy 99%. Clinical diagnosis in diagnosing viable pregnancies has sensitivity 76.92%, specificity 64.36% and PPV 24.39%. In diagnosis nonviable pregnancies, clinical diagnosis, poor statistical correlation with sensitivity 77.58, specificity 83.33%, PPV 86.53% and NPV 72.91%. Ultrasonographic diagnosis proved as very accurate on statistical correlation.Conclusions: Ultrasound is sensitive, cost effective and non-invasive diagnostic tool in first trimester bleeding. In this study, it helped in correct diagnosis of clinically misdiagnosed cases apart from confirming the diagnosis in others.
Frequent knee locking is an incapacitating condition that requires a thorough clinical, radiological and arthroscopic evaluation. The common causes are meniscal injury followed by torn anterior cruciate ligament and osteochondral loose bodies in the joint space. Our case describes an unusual case of frequent left knee locking. After clinical and radiological examinations the provisional diagnoses of medial meniscus tear was done. A diagnostic arthroscopy of the left knee revealed normal meniscus, cruciates and a medial patello femoral plica slipping into the patellofemoral joint causing the locking sensation. The plica was resected. At 6 month follow up there is no recurrence of symptoms.
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