A linear constricting scar around the wrist in the presence of a discharging sinus raises clinical suspicion of a forgotten band around the wrist. A 3-year-old girl presented with an encircling scar, swelling and discharging sinus over the right wrist since last three months. There were no trophic ulcers and gross sensations were intact. Wrist radiographs showed the "constriction" sign in the radial epiphysis. MRI confirmed the diagnosis of encircling band inside wrist abutting the bone. A coloured rubber band was surgically extracted lying deep to restored and continuous tendons and neurovascular structures. Wound healing was uneventful. Examination at 14 months revealed residual ulnar nerve palsy. If aware, the clinical diagnosis is fairly accurate in rubber band syndrome. MRI aids in establishing diagnosis preoperatively. The reparative potential of a child's tissues is amazing. Although the lesion heals well after extraction of encircling band, the clinician should be wary of residual neurological changes.
Purpose. To review 10 children with calcaneal tuberculosis in terms of presentation, healing, and functional outcome. Methods. Medical records of 7 boys and 3 girls aged 7 to 12 (mean, 9.8) years who presented with calcaneal tuberculosis were reviewed. The erythrocyte sedimentation rate of all patients was elevated. All patients presented with pain and swelling around the lateral malleolus and a 'healup' sign; 7 of them presented with an additional discharging sinus. Three patients had palpable lymph nodes in the right inguinal or left popliteal region. Symptoms had lasted for one month to 1.5 years. Two patients had healed tuberculosis in the lungs; 8 patients had no pulmonary involvement. Seven patients had a single lytic lesion in the calcaneal body (n=1), tuberosity (n=3), and extension to anterior process (n=3). Three patients had multiple lytic lesions in the calcaneum; one of them had bilateral involvement who had lesions in
Purpose. To review the clinical and radiological features and treatment outcome in 22 children who underwent one-year antitubercular multidrug treatment for tuberculosis of the cervical spine. Methods. Records of 13 boys and 9 girls aged 2 to 12 (mean, 9.1) years who underwent one-year antitubercular multidrug treatment for tuberculosis of the cervical spine were reviewed. Tuberculosis involved the atlantoaxial region (C1-C2) in 7 patients, mid-cervical region (C3-C7) in 8, cervicodorsal region (C6-T3) in 3, contiguous multilevels in 2, and non-contiguous multifocal areas in 2. The mean number of vertebrae involved was 2.8 (range, 1-8). The mean symptom duration was 2.5 (range, 0.25-6) months. Three patients had neurological deficits. Antitubercular multidrug treatment included an intensive phase for 2 months and a continuation phase for 10 months, using isoniazid, rifampicin, pyrazinamide, and ethambutol.
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