<p class="abstract">Femur shaft fractures are the most common fractures requiring hospitalization in children. Management of these fractures mainly depend on the age of the child. Associated injuries, fracture pattern, weight of the child and overlying soft tissue condition also influence the management. Still, the definitive treatment remains controversial in children between 5-16 years. We present our experience in management of 5 year old boy with mid shaft femur fracture and its complications. In his paper we want to highlight the importance of sticking to the basic principles and the recommendations in the management of the paediatric femur shaft fractures.</p>
Introduction:Complex femur fractures are defined as combined fractures of shaft and proximal of or the distal femur. Restoration of anatomical alignment is the primary goal of the management of these fractures. In this report, we describe the management of complex femur shaft fractures in three pediatric patients.
Case Report: This report includes three patients. The first patient was a 10-year-boy with comminuted proximal femur shaft fracture extending into the subtrochanteric area, managed with minimally invasive sub-muscular plating. The second patient was a 12-year-boy with comminuted femur shaft extending into subtrochanteric area, treated with combined retrograde and anterograde Titanium Elastic Nail System. A 12-year-old boy with femur shaft with intertrochanteric fracture managed with K-wire fixation for intertrochanteric fracture and plating with dynamic compression plate for femur shaft was our third patient. All patients had excellent radiological and functional outcome.
Conclusion: Complex femur shaft fractures in children are very rare and challenging injuries. With proper pre-operative planning and use of appropriate implants excellent outcomes can be obtained.
Keywords:Complex femur fractures, pediatric orthopedics, sub-muscular plating, titanium elastic nailing.
<p>Traumatic acetabular labral tears causing hip instability are rare. Surgical management of posterior labral tear is essential to prevent chronic hip instability and secondary arthritis. We report a 27-year-old female presented following RTA, with posterior hip dislocation along with posterior labral avulsion, managed by surgical repair using suture anchors. Patient had excellent functional outcome at 12 months of follow-up. High index of suspicion for labral injuries is required in patients with posterior hip dislocation and posterior wall fractures. Early surgical repair of torn labrum is must for excellent functional outcome.</p>
Introduction:Tuberculosis (TB) involving the shoulder joint is rare. Early diagnosis is difficult but essential to prevent severe joint damage. In this report, we present variable presentation and management of TB of shoulder joint in three patients. Case Report:This report includes three patients. First patient was a 58-year-old male with severe muscle wasting around the shoulder with restriction of all movements had dry form of TB. Second patient was 55-year-old female with pain and swelling in the shoulder had wet form of TB with submuscular bursitis with rice bodies. A 50-year-old female presented with pain in the right shoulder with restricted active movements only was diagnosed with mobile form of TB was our third patient. Shoulder TB was diagnosed on the basis of histopathological examination in all three patients and was treated with 12 months of anti-tubercular therapy (ATT). All patients had good recovery and were back to their routine activities. Conclusion:TB of the shoulder has variable presentation; histopathological examination is the gold standard for diagnosis. Early diagnosis and treatment with ATT help in prevention of the severe joint damage. Keywords:Skeletal tuberculosis, shoulder joint, histopathology, anti-tubercular therapy.
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