An HIV-positive man with hepatitis B co-infection, naïve to highly active antiretroviral therapy, with a CD4 of 594 copies/mL and HIV-1 viral load of 140,070 copies, presented with right-sided facial weakness and hearing loss. He had been treated for secondary syphilis three months earlier when his rapid plasma reagin (RPR) result was 1:16, this had fallen to neat. At presentation, his RPR had risen to 1:16 again. A magnetic resonance imaging scan showed enhancement of the internal auditory canal and right cochlea. His cerebrospinal fluid examination was normal. He was treated with acyclovir and prednisolone before the syphilis serology was known. He was then treated for syphilis with doxycycline. He made an excellent recovery.
<p class="abstract"><strong>Background:</strong> Distal femur fractures are common and need to be treated operatively and for optimal functional outcome. Multiple implants are available for fixation e.g. angled blade plate, dynamic condylar screw, buttress plate, antegrade nailing, retrograde nailing, locking distal femoral plates, external fixator etc. We have designed this study to analyse clinico-radiological outcome and competency of locked plating for all varieties of distal femur fractures.</p><p class="abstract"><strong>Methods:</strong> We conducted a prospective interventional study on 79 consecutive patients with fractures of distal femur operated with locking distal femur plate from January 2015 to February 2018. Patients were regularly followed up with x-rays and clinical examination. At the end of clinicoradiological union, patients were evaluated with Neer’s score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Total 79 distal femur fractures were studied based on inclusion and exclusion criteria. There were 63 (79.75%) males and 16 (20.25%) females. As per AO classification fracture of type A were 39 (49.36%), type B were 10 (12.65%) and type C were 30 (37.97%). Average time period from injury to surgery was 8.2 days. In our study, the average period of clinicoradiological union was 16 weeks. 62 (78.48%) patients had excellent to satisfactory outcome, 13 (16.45%) patients had unsatisfactory and 4 (5.06%) patients had poor outcome.</p><p class="abstract"><strong>Conclusions:</strong> Distal femur fractures are common, complex injuries and different implant option are available for fixation. All types of distal femur fractures can be fixed using distal femur locking compression plate. If fixed following basic principles of fracture fixation good results can be obtained.</p>
Background: Giant cell tumour of bone remains a difficult and challenging management problems because there are no absolute clinical radiographic or histologic parameters that accurately predict the tendency of any single lesion to recur or metastasize.Methods: We performed surgery on 12 patients of GCT with radical curettage and bone cement over a period of 5.8 years. Results were evaluated using the musculoskeletal skeletal grading system.Results: The present series consists of 12 case of GCT age ranging from 16-45 years. Painful swelling was the commonest presentation, limitation of motion was seen in 9 cases and pathological fracture was seen in 1 case. 9 of the tumour occurred around knee joint. Rare involvement of talus was seen in 1 case. Overall 9 patients had a perfect functional score of 30 points and 1 patient scored less than 20 points.Conclusions: Acrylic cement reconstruction is safe and effective procedure that provides local adjuvant therapy, the cement field defect is mechanically stable. Patient can bear weight immediately and rehabilitate quickly.
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