Angular deformities are common presentations in childhood and adolescent age group. It is important to differentiate a true deformity from a physiological deformity, this requires measurement of the intercondylar and intermalleolar distance. Once a true deformity is diagnosed, the apex of the deformity requires to be established. Lower limb frontal plane deformities are evaluated with a true AP standing radiographs of the entire lower limb from hip to ankle. Mechanical or anatomical axis calculation gives the apex (CORA) as well as the magnitude of deformity. Frontal plane deformities require surgical intervention. In younger children, growth modulation surgery allows correction of the deformity with minimal morbidity and without the need for osteotomy. Older children, adolescents and adults require corrective osteotomy. The corrective osteotomy can be closed wedge, open wedge, or a dome osteotomy. The osteotomy may be stabilized with internal fixation with plate and screws or an intramedullary implant as is dictated by the level of osteotomy and the local bony anatomy. External fixators allow gradual and precise correction of the deformity.
Background: Globally, tuberculosis remains an important cause of morbidity and mortality for children. Diagnosis and management of childhood TB especially Extra pulmonary tuberculosis is challenging. Method: A cross-sectional study was conducted on 0-14 year children who were registered and being treated, in district Tarn Taran, Punjab from 1st January 2018 to 31st December 2018. The treatment outcome with their clinico-demographic determinants was ascertained. Data management and analysis was done by using Microsoft excel and SPSS. Results: Out of 62 registered patients, 62.9% of the children were in age group of 11-14 years. 67.7% were females. The various treatment outcomes observed were-cured 32.3%, treatment completed 61.3%, lost to follow up 1.6%, regimen changed 1.6%, not evaluated 3.2%. The success rate (cured+ treatment completed) was 93.6%. On statistical analysis, it was observed that age (p= 0.002), site of disease (p=0.000), contact history (p=0.012) and diagnostic method (0.000) was significantly associated with the treatment outcome whereas gender, area of residence and type of case had no association with the treatment outcome in children. Conclusions: We also found that the overall treatment success rate was 93.6%. Increased focus be on those with household contact with TB.
Background: The aim of this study was to evaluate the effect of proximal fibular osteotomy in relieving pain and functional improvement in patients of osteoarthritis knee.Methods: We selected 38 patients with KOA, out of which 30 patients gave written informed consent and underwent proximal fibular osteotomy. The median time of follow-up was 13.3 months. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity (tibio-femoral angle) and ratio of the knee joint space (medial/lateral compartment). Assessment of knee pain was done using a visual analogue scale, and knee functional activities were evaluated using the American Knee Society score (KSS 1 and 2) preoperatively and postoperatively.Results: Pain relief was observed in almost all patients after proximal fibular osteotomy. Weight-bearing lower extremity radiographs showed significant change in tibio-femoral angle an average increase in the postoperative medial knee joint space. Additionally, obvious change in alignment was observed in the whole lower extremity radiographs in 24 out of 30 patients. In three patients tibio-femoral angle showed progressive more varus alignment after proximal fibulectomy.Conclusions: In short-term study, proximal fibular osteotomy provides pain relief and functional wellbeing to the patients of KOA.
Intraosseous hemangiomas are one of the rarest lesion of jaw bones (0.5–1%) occurring most commonly in vertebral column, skull bone, and rarely in mandible. Mainly occurs in the second decade of life with female: male predilection (2:1). Origin of hemangiomas is still debatable. World Health Organization considers it as a true benign neoplasm of vascular origin, and many authors believe it to be a hamartoma. It is very difficult to diagnose due to variable clinical and radiological features. A biopsy is not done on a routine basis due to a higher risk of hemorrhage. Management is very difficult because of massive vascular network in that region. Here, we are presenting a case report of a 14-year-old boy with intraosseous hemangioma of right body of mandible, which was treated with en bloc surgical resection of mandible and followed by reconstruction.
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