<p class="abstract">42 years old female who was operated for rheumatoid arthritis elbow right side with revision of total replacement. Her elbow was primarily replaced 10 years before this surgery. She had severe metallosis and breakage of ulnar stem, loosening of cement (ulnar). Humerus stem was well fixed. Massive metal debris in soft tissue was removed. humerus side cement and stem were removed by splitting the bone. Revision stem was fixed with cement and circumferential wiring. On 6 yrs following surgery, patient is doing well in terms of pain relief and range of motion around elbow. She is doing almost all activities of daily life. Early detection and removal primary implant are the need of hour to save the ill effects of metallosis and bone resorption.</p>
52 years old man presented with open dislocation of elbow due to road traffic accident was not complaining of another joint injury or pain was radiographed as per protocol of including the adjacent shoulder joint and incidentally discovered with anterior dislocation of shoulder was treated with close reduction of shoulder dislocation and debridement as well as reduction and trans fixation of ulno-humeral joint with k-wires. Skin coverage later was done. Patient recovery was excellent in terms of motion at both joints. The purpose of reporting of this case is to convey a message that ipsilateral dislocation of shoulder and elbow is a very rare occurrence but do occur and a high degree of suspicion and imaging protocol can save from missing this event.
<p>The bony pelvic ring is constituted of the sacrum and bilateral innominate bones and stabilized by the sacroiliac, sacrospinous and sacro tuberous ligaments. Secondary stabilization is provided by the iliolumbar ligaments. Injury to the posterior ring structures brings more severe clinical instabilities. Assessment of mechanisms and mode of injuries is necessary for management of pelvic injury. Twelve patients were involved in this study of different kinds of injuries by classification and methods of treatment four patients were treated by anterior fixation. Three by posterior and three by anterior as well as posterior. One was by conservative means. Anterior includes symphysis plating, posterior includes intrapelvic plates as well as sacroiliac percutaneous screw fixation. Combined includes posterior plating and sacroiliac screw and external fixator anteriorly. All patients showed good results in terms of stability, union of fracture, relief of pain and movements. Two patients had some residual neurological deficit as foot drop. Pelvic ring injuries need a specialized approach for management and outcomes. Application of appropriate classification for management plays a significant role in outcomes.</p>
<p>Present case report is about a male patient who met with a road traffic accident sustained an open crush, contaminated, injury of lower end femur of right side with significant loss of lower thigh bone (8 cm). He had fracture of inter condylar femur with fracture upper end tibia and lower third tibia with impending vascular insufficiency of leg and foot. Operated after correction of anaemia by debridement, fixation of femur with plate and inter condylar screw. Upper end tibia and Lower half tibia were fixed with separate plates and fasciotomy of leg. After 2 months femoral plate was replaced with intramedullary locking nail and superadded with monorail fixator. Corticotomy at proximal femur for bone transportation. Bone gap was corrected within 4 months and bone grafting was done at distal docking site. Union achieved and fixator removed after 4 months of this. Patient showed good results till last follow up 28 months, having good range of motion of knee.so critical bone loss at femur was treated by distraction osteogenesis over intramedullary nail with monorail external fixator system.</p>
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