BACKGROUND The human hand is the most vulnerable part of the body prone to a variety of injuries especially in industries, agricultural fields and adding to this increased road traffic accidents resulting in high incidence of phalangeal and metacarpal fractures particularly mutilating hand injuries, open fractures, comminuted fractures and intra-articular fractures. The purpose of the study is to evaluate the overall functional outcome of hand treated with JESS fixation for metacarpal and phalangeal fracture and to study the complications associated with their management. MATERIALS AND METHODS We have studied 30 patients with 37 fractures of metacarpals and phalanges of hand with JESS mini external fixator at Department of Orthopaedics, Rangaraya Medical College. The study was done from October 2012 to August 2014. Age of the patients range from 10-60 yrs. with most of the patients belong to 21-40 yrs. age group. The majority of the patients were male (M:F = 26:4). The sample size reflected the population visiting the trauma section of our department. Most of the fractures are caused by RTA and on right hand. Majority of the fractures are occurred in proximal phalanx, followed by metacarpal. RESULTS All patients were followed for a minimum of 6 months and the mean follow-up period was 33.77 wks. The mean fracture healing in our study was 12.77 weeks. Reviewing the literature, the average radiological healing of phalanges and metacarpals is 4-5 months, which ranges from 1-17 months. The fracture healing time in our study compares favourably with those reported in the literature. Mean duration of implant (JESS) application was 4.42 wks. Complications like pin-tract infection encountered in five patients, three pin loosening, one total stiffness and 10 of them had partial stiffness. CONCLUSION JESS fixation provides an adequate basis for bone healing is a good and simple alternative to standard treatment especially in open, intraarticular, comminuted and multiple phalangeal and metacarpal fractures.
BACKGROUNDOsteoarthritis commonly affects the medial compartment of knee giving rise to varus deformity in majority of cases. Significant varus deformity further aggravates the pathology due to medialisation of the weight bearing line osteotomy of the proximal tibia realigns this weight bearing axis, thereby relieving pressure on the damaged medial compartment. OWHTO is a promising option in this scenario because it is associated with high accuracy in correcting the deformity and less number of complications when compared to lateral closing wedge HTO or UKA. In this study, we evaluate the functional outcome of HTO in patients with unicompartmental osteoarthritis.
Introduction: Enchondroma is a solitary, benign, and intramedullary cartilaginous tumor occurring most commonly in small bones of hands and feet contributing to 3–10% of all bone tumors. They originate from the growth plate cartilage which later on proliferates to form enchondroma. Lesions are central or eccentric and metaphyseal involvement is most common for long bones. We report a case of atypical occurrence of enchondroma in the head of femur in a young male. Case Report: A 20-year-old male patient presented with a history of pain in the left groin for 5 months. Radiological examination showed a lytic lesion in the head of femur. The patient was managed by safe surgical dislocation of the hip, curettage with autogenous iliac crest bone graft with countersunk screw fixation. Histopathology confirmed the lesion to be enchondroma. At the latest follow-up after 6 months, the patient was symptom-free and there was no evidence of any recurrence. Conclusion: Lytic lesions in the neck femur can have a good prognosis provided timely diagnosis and interventions are done. The present case of enchondroma in the head of femur represents a very rare differential diagnosis for the same and this must be kept in mind. So far, no such case has been reported in the literature. Magnetic resonance imaging and histopathology are of the essence to confirm this entity. Keywords: Enchondroma, atypical presentation, safe surgical dislocation of hip.
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