Introduction:An isolated coronal fracture of either or both femoral condyles is a rare entity and is usually associated with high-energy injury trauma. Such fractures should be meticulously fixed for a good functional outcome as they involve the articular surface of a weight bearing joint. A modified swashbuckler approach provides adequate exposure for appropriate reduction and fixation of such fractures.Case Presentation:A 32-year-old male sustained a bicondylar Hoffa fracture of the right femur which was treated by open reduction and internal fixation using a modified swashbuckler approach. At two years of follow-up, the patient had excellent radiological and functional outcome.Conclusions:In our study, we treated this rare fracture successfully using a modified swashbuckler approach and found it to be a good approach for such fractures as compared to the conventional approach.
<p class="abstract"><strong>Background:</strong> The femoral neck-shaft angle is the measurement of the angle formed between the oblique oriented neck with the vertical shaft and is an important anatomic measurement for the evaluation of biomechanics of hip.<span> The neck shaft angle is important in surgeries that involve the neck of femur, Intertrochanteric fractures, slipped capital femoral epiphysis, and developmental dysplasia of hip. Different variation of neck shaft angle has been seen in different literature and all the orthopedic implants are designed according to the values of the western literature which is different from the Indian subcontinent</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span>Pelvic radiographs of patients who presented to Accident and emergency care or the outpatient department were used in the study</span> 110 patients radiographs were assessed in the study. There were 55 males and 55 females in our study. The mean age for males was 46.5 years and that for females was 43.2 years. The pelvis radiographs were studied for neck shaft angle .The measurements were performed bilaterally on the digital screen using the PACS (picture archiving and communication system) with handheld 360 degree goniometer.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean neck shaft angle in our study was129.26 degree for males and 126.62 degree for females .The overall mean neck shaft angle in 110 radiographs was 128.60 degree<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">We conclude that consideration of neck shaft angles in orthopedics surgery and designing of implant can give more angle options for the surgeons which can improve the overall prognosis of the patient.</span></p>
A swelling was noticed over the right scapula of a four year old boy by his parents since the past one year, which showed progress since past 6 months [Table/ Fig-1]. On examination, no similar swe ll ing was seen, which arose from else where in the body. Family history was not significant. On examination, a 4x3cm bony swelling which arose from body of left scapula was noticed. The swelling was hard in consistency, it had a smooth surface and it was immobile, but it moved with scapula. Skin over the swelling was normal and there were no neurological deficits. Forward flexion, abduction and extension of shoulder joints were restricted terminally.Plain radiograph of right shoulder revealed a mushroom shaped, solitary osteochondroma. MRI showed a bony swelling of size, 30x17mm, which arose from the dorsal surface of the body of the scapula. The cartilage cap thickness was 5mm. The cortex and the medullary cavity were continuous with the scapula. There was no associated soft tissue mass or pathological fracture.He was taken up for excisional biopsy, as the swelling restricted his shoulder movements and was cosmetically not acceptable [Table /Fig-2]. Under general anaesthesia in prone position, an oblique incision was made and the entire tumour was excised. Histopathological examination concurred with our preoperative diagnosis. There was no evidence of malignant changes. Postoperative period was uneventful and the boy regained appreciable shoulder range of motion with physiotherapy. After six months of follow-up, there was no evidence of recurrence. Histopathological examination showed normal appearing chondrocytes which were covered by hyaline cartilage. There is no evidence of any malignant transformation [Table/ Fig-3]. Orthopaedics section aBstRaCtOsteochondromas are the most common benign tumours of bone. These are most commonly seen on the metaphysis of a long bone, but they can arise from any bone which is preformed from cartilage. To best of our knowledge, very few cases of osteochondroma scapula have been reported in literature. We hereby report a very rare case of osteochondroma which arose from scapula in a four year old boy, which was treated by excisional biopsy.[table/ Fig-1
IntroductionPosterior hip dislocation of the hip with acetabular fracture is a challenging problem to treat. Such dislocations are associated with avascular necrosis of the femoral head if neglected. Managing such conditions with total hip replacement (THR) is very difficult because of associated altered anatomy.Case PresentationWe hereby report a two-year neglected hip dislocation with associated acetabular fracture successfully treated with uncemented THR. The patient was successfully treated with uncemented THR and experienced significant improvement in his functional status, with a Harris hip score of 82 at the two-year follow up. Radiologically, there were no radiolucent areas or osteolysis, with good consolidation of the bone graft.ConclusionsA neglected hip dislocation with acetabular fracture can be managed satisfactorily with uncemented THR. Bone reconstruction using chunk grafts and use of cementless components ensures long-term survival and also preserves adequate bone stock for revision, especially in young patients.
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