Solitary infantile myofibromatosis of the skull

This is the report of a 6 months old boy presenting with a firm, solitary mass on the temporal region, associated with lysis of local bone. Investigations lead to a diagnosis of infantile myofibromatosis [IM]. Wide local excision was performed. At one year follow-up, no recurrence was noted

Open fracture of the tibial shaft, results of management with external fixator followed by casting or nailing

To compare the results of management by secondary intramedullary nailing and POP casting in stable open tibial fractures of Gustilo-IIIA of winquist type-I and II and to assess which is the better mode of treatment after removal of fixator, whether POP casting or intramedullary nailing in our hospital our setup and resources in terms of union and likelihood of complications like malunion, non-union and infection. This randomized cohort study was conducted in the Department of Orthopaedic, Nishtar Hospital, Multan during the period from April 2005 to December 2006. A total of 50 patients were included in the study. The age range was 20-40 years. The patients included were who had fracture of Gustilo type-IIIA open fractures of winquist criteria-I and II. Out of 50 patients, 37 [74%] were injured as road traffic accident, 3 [6%] patients sustained fire arm injury, 2 [4%] patients injured on domestic accident with fall of wall on their body. Out of 50 patients, 12 [24%] had age from 11-20 years, 14 [28%] from 21-30 years, 18 [36%] from 31-40 years and 6 [12%] patients had 41-48 years. While considering the major complications in present study, it was found that these are less marked in secondary nail group as compared to secondary casting group. Wound infection developed in 9 [36%] cases and non-union occurred in 1 [4%] cases of secondary nailing. While in secondary casting group wound infection developed in 8 [32%] cases and non-union occurred in 2 [5%] cases. It is concluded that both methods can be used for the treatment of open type-IIIA tibial diaphyseal fractures

Across the ankle joint external fixator for soft tissue healing

To avoid POP cast complications and improve healing of soft tissue injuries. Department of Orthopaedic Surgery, Nishtar Hospital, Multan. From April 2005 to April 2006. Thirty patients were selected for this mode of treatment. All patients were within the age of 20 to 30 years with no systemic illness. These patients were having open soft tissue injuries with or without bony injuries around the ankle joint and having no vascular injury at this level, which could have threatened the viability of the foot. Open soft tissue injuries around the ankle joint are difficult to stabilize with plaster splints or casts due to difficulty of wound dressings and associated complications like heel equinus deformity and heel sores. Postoperative cast is cumbersome for the patients and associated with lack of care after patient is discharged from hospital. External fixator across the ankle joint is one of the modalities for such injuries. In an intervention study, 12 patients having fresh severe open soft tissue injuries at ankle Joint were selected- External fixator was applied initially and soft tissue injuries were further managed subsequently with fixator in place. External fixator was removed after the tissue healing was complete. One pin tract infection and no equinus or heel sore was encountered. Patients were also satisfied with this mode of treatment. It is concluded that External Fixator across the ankle joint is a good option for soft tissue healing

Intracapsular fracture neck of femur

To evaluate these methods of treatment, in search of providing patients a better quality of life. This prospective study was carried out on fifty patients of displaced femoral neck fractures admitted in Orthopaedic Department, Nishtar Hospital, Multan during period November 1991 to December 1993. Fifty non-pathological displaced femoral neck fracture in patients above forty years were treated either with Austin Moore hemiarthroplasty or internal fixation with DHS, Cancellous screws or Moor's pins. Weight-bearing was allowed after two weeks in hemianhroplasty group and after 6 weeks in internal fixation group. After two -years follow up, there was no significant difference in mortality in two groups. Early [Technical] complications were more with internal fixation. [25% compared to 6.6% with Moore hemiarthroplasty]. Reoperation rate within the first year was significantly high for internal fixation i.e. 45% compared with 6.6%. It was concluded that endoprosthetic replacement in displaced femoral neck fractures in elderly patients is a reliable treatment method for selected indications, and gives good short to medium term functional results when employed with careful preoperative technique and proper postoperative care and rehabilitation