Introduction: The dynamic compression screw with plate implant used to treat fractures of the distal femur. The distal femoral lock compression plate fixation is designed as an alternative surgical option to treat these fractures. The objective of this study was to assess the comparative endurance of both devices. The objective of the study is to compare the outcome of DF-LCP and DCS fixation in distal femoral fractures. Materials and Methods: This prospective comparative study was conducted in the Department of Orthopaedics, Sylhet MAG Osmani Medical College Hospital, Sylhet between January 2011 and December 2012. Thirty patients with AO type 33-B and 33-C fracture were selected and were divided randomly into group-A and group-B by odd and even number. Dynamic condylar screw (DCS) fixation was used in group-A and distal femoral locking compression plate (DF-LCP) fixation in group-B. Results: DCS group [9 male, 6 female; mean age, 44.9 ± 12.9 years] and DF-LCP group [10 male, 5 female; mean age, 42.6 ± 15.7) years] were similar in age (p=0.660) and sex (p=0.705). The total operation (minutes) [92.3 ± 7.5 versus 90.4 ± 6.9; p=0.484], length of postoperative hospital stay (days) [6.0 ± 0.9 versus 5.9 ± 0.9; p=0.695] and union time (weeks) [20.6 ± 5.0 versus 18.7 ±3.3 weeks; p=0.238] did not differ significantly between two groups. Total complications [6 (40.0%) versus 4 (26.7%); p=0.439] was also similar in both groups. Functional outcome was excellent in 13.3%, good in 33.3%, fair in 33.3% and poor in 20.0% cases in DCS group; while excellent in 53.3%, good in 20.0% fair in 6.7% and poor in 20.0% of cases in DF-LCP group; different was not significant (p=0.080). Conclusion: Dynamic condylar screw with plate and distal femoral locking compression plate fixation are equally effective for achieving satisfactory union and functional outcome in AO type 33-B, 33-C fracture distal femur. Medicine Today 2021 Vol.33(1): 45-49

Introduction: Aim of this study to evaluate the clinical efficacy and highlight their relevance in present orthopedics practice where multiple newer choices have been become famous. Accordion maneuver design with modified Ilizarov apparatus, a single stage procedure in femoral shaft non-union and re-fracture with quiescent infection place dynamic compression plate (DCP) in situ. Femoral shaft fractures (FSFs) are frequently occurring injury due to RTA. Infection (0.4%) and non-union (1.1 - 14%) are the morbid complications of femur fractures. The healing rate for femora shaft non-unions is too high (90%).1 Accordion Maneuver (AM) is the “Bloodless Stimulation” of bone healing described by Professor G. A. Ilizarov. It comprises of alternate compression and distraction which produce stress in living tissue and also convert biologically inactive scar tissue at non-union site into tissue capable of neo-osteogenesis.2 The suggested treatment for quiescent type of infected non-union is a single stage procedure with minimal or no debridement and if implant is provide sufficient stability it placed in situ.3 Case Report: In the case, a 26 years man treated by DCP with MIPO for his Gustilo type – Ⅰ open, comminuted fracture of mid femoral shaft (Left) following RTA. Post-operative infection occurred within 2 weeks of operation. Infection controlled by exploration and surgical toileting with antibiotic. After four (4) months later he was sustained re-fractured with bending plate due to fall again. Finally he was diagnosed as H. Rosen`s type 3 Quiescent infected non-union (Oligotrophic) and Romano stage -1 post-implant infection with re-fracture mid shaft of left femur. Then he was treated following accordion principles with modified Ilizarov frame. AM was applied according to protocol of Baruah and Patowary of non-union treatment. Result: After complete union and consolidation, substantiated by radiological evidence Ilizarov apparatus was dispelled six (6) months later of installation without removal of plate and four (4) months of that finally plate was removed. After one (1) year and four (4) months of mounted Ilizarov frame, the patient was in full free movement of knee and hip. He had no problem during walking even running. Conclusion: We pursue for the treatment, accordion maneuver with Ilizarov apparatus, a single stage procedure in femoral shaft non-union and re-fracture with quiescent infection kept plate in situ. Few authors reported, Accordion Maneuver (AM) techniques with Ilizarov apply over intramedullary nail (IMN) in situ for aseptic non-union of femur. In this study, we discussed the role of this tool (AM) for the treatment of femoral shaft non-union and re-fracture with quiescent infection place plate (DCP) in situ.

Fibrosarcoma is a rare malignant mesenchymal neoplasm’s of the fibroblasts which are represents 1% of all malignancies in the head and neck region. In this article we described a case of primary fibrosarcoma of the gingiva in right sided alvulas of the mandible in 16 years old male. Who was presented with a rapidly growing painful lump. Microscopically the tumor mass was composed with atypical proliferation of spindle cells arranged in intersecting fascicles and sterioform pattern. In immunohistochemically the cells showed immuno-reactivity for SAM, while negativity towards the others markers. On the basis of clinical histological and immunohistochemistry our case was diagnosed as a low grade primary fibrosarcoma of gingiva. We performed radical resection with wide margin as a primary treatment of choice without neck dissection. After primary treatment there is no signs of recurrence and metastasis was observed last 3 years follow up. J Bangladesh Coll Phys Surg 2022; 40: 310-313

Introduction: Chronic osteomyelitis is a surgical disease that can require significant dedication from both patient and surgeon to eradicate. Treatment requires isolation of pathogen, significant debridement for removal of all infective and necrotic material, then bony and soft tissue reconstruction. Objective: We shall try to highlight the option of management of a pan-Diaphyseal osteomyelitis of a children in the new era of osteosynthesis by Ilizarov. Discussion: A two years old baby presented to us with the H/O chronic discharging sinus and arm sling for around 3 months. After clinical history taking and examination, radiography and pus testing (C/S) and sequestrum and pathological fracture was the identifying points we took the plan for exploration curettage and drainage. Finally we fix the arm by Ilizarov osteosynthesis for more than 3 months. The wound healed and osteomyelitis resolved. Conclusion: Use of Ilizarov osteosynthesis for fixation and wire tension effect to resolve the infection1,2 Medicine Today 2022 Vol.34(2): 157-158

The young to the middle-aged group is most affected in peripheral nerve injuries (PNI) and male gender shows predominance among the patients. Upper extremities are most likely to get injured which is three-fourth of total patients. This case report is about repairing of median and ulnar nerve by autologous sural nerve grafting. A 28-year-old man had an alleged history of a stab wound at his right arm 3 months ago. He had clinical features of complete injury of his right ulnar and median nerve. Nerve electrophysiology and magnetic resonance imaging also supported the diagnosis. Neuromas were formed in both the upper ends and the gap between the ends was more than 2 centimetres. The nerve was repaired under an operating microscope by sural nerve and musculocutaneous nerve grafting with very thin monofilament suture. His postoperative recovery was uneventful. Sensory recovery was earlier than motor recovery.