Musculoskeletal injuries by bone setters

To highlight, evaluate and analyze the complications associated with the treatment of fractures, joint dislocations and limb deformities by bone setters in a suburban population of district Kasoor. Prospective descriptive study. This study was conducted at the Department of Trauma and Orthopaedics, Central Park. Medical College based at Bhatti International Teaching Hospital, Kasoor. This was a six month prospective study involving eighty six [86] consecutive patients presenting with complications related to treatment of their musculoskeletal injuries by bone setters. Eighty six patients with complications associated with previous treatment by bone setters were seen 62.7 [%] were male while 37.2 [%] were female. The age range from 4 months to 76 years [mean 34 years]. out of eighty six patients, 15 [17.4%] patients had non union, 21 [24.4%] had malunion, 9 [10.4%] had avascular necrosis, 15[17.4%] had chronic osteomyelitis, 4[4.6%] patients had gangrene, 8[9.3%] had contractures, 2[2.3%] had persistent dislocations, 4[4.6%] had Leg ulcers and 8[9.3%] had wound infections. The major reasons for going to bone setters were the perceived low cost of treatment [45%], pressure and advice from the elders and friends [38%], fear of surgery [5%] and assumption of faster healing by the bone setters [12%]. The methods used by the bone setters include splintage, bandage, plaster, stretching, massage and suturing. Bone setters create very difficult problems for orthopaedic surgeons. Many patients develop complications and loose their limbs due to inappropriate treatments. Awareness programs regarding inadequate treatment given by bone setters are necessary and their Patronization should be discouraged to avoid these types of complications

Bilateral adductor abcess following grion injury

Pubic pain is a common symptom in athletes and in soccer players.Its cause can be difficult to determine. We report a case in a 14-year-old boy who presented with bilateral adductor muscle abcesses following a trivial injury to the groin. The etiology, radiological findings and treatment, along with literature review are discussed. The main causes of pubic pain after sports are thought to be sports related microtrauma to the pubic rami or symphysis and lesions of the oblique, rectus or adductor muscles or their tendons1, 2. Osteitis pubis refers to a painful inflammation of the periosteum, bone, cartilage and ligamentous structures of the anterior half of the pelvis. Pubic osteomyelitis is an uncommon entity, accounting for less than 1% of all cases of Heamatogenous osteomyelitis. We report a case of bilateral adductor muscle abcess six week after a trivial injury in sports

Risk factors for dislocation of HIP

Dislocation after total hip arthroplasty is part of spectrum ranging from neck impingement to subluxation before frank dislocation occurs. To assess various parameters as potential risk factors for postoperative hip dislocation. Department of Orthopaedics in Merlin Park Regional Hospital, Galway. 5 years Observational. In our study we reviewed 1096 patients who underwent primary total hip arthroplasty in a consecutive period of five years. We assessed various parameters as potential risk factors for dislocation. During this period 16 [1.45%] patients dislocated their hips. According to our study the Important factors that led to these dislocations were Retroverted cup [5 cases], trochanteric malunion/ avulsion [5 cases], Epilepsy [1 cases], Confusion/ Dementia [2 cases] Parkinsonism [2 cases]. Abduction angle was found to be greater than 50 degrees in 8 cases. Familiarity with the risk factors assists in prevention and dictates aspects requiring further assessment, when dislocation occurs. Protection of the hip by bracing should be considered following revision surgery but is of questionable use in primary cases

Radial metaphysis fractures; community based treatment for un-displaced greenstick distal fractures

Greenstick / torus fracture of distal radial metaphysis are quite common in children. It has been seen that these fractures are stable and splintage is necessary for comfort and pain relief. To reduce the number of visits to clinics, which is logistically difficult in a rural community population of a large catchment's area. Prospectively. Accident, Emergency and orthopaedics Departments, General Hospital Letterkenny. 65 cases with green stick fractures treated with Soft cast, which was easily removable at home. All patients in this study showed good results with no complications. The parent satisfaction rate was 97.3%. Our findings suggest that it is clinically safe, cost effective and convenient to parents to treat undisplaced green stick fractures within the community