Epidemiologic pattern of paediatric supracondylar fractures of humerus in a teaching hospital of rural India: A prospective study of 263 cases / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>This prospective study aimed to investigate the epidemiologic parameters of supracondylar humeral fractures in children admitted to a teaching institution of a developing country primarily catering to rural population, to find any preventable cause of such injuries.</p><p><b>METHODS</b>All suspected cases of supracondylar humeral fracture reporting to emergency or outpatients department were analysed for various epidemiologic parameters including age, sex, laterality, time of presentation, associated injuries, neurovascular complications and classification over a period of four years.</p><p><b>RESULTS</b>We analysed a total of 263 patients and most of the fractures were seen in 5-8-year age group with a mean of 7.9 years. A total of 157 cases were males and non-dominant extremity was involved in 65% of fractures in our series. Fall on outstretched hand was the predominant cause of injury and fall from rooftop was the predominant mode. In all patients, 36.12% reported to our hospital 1 week after injury, 39.92% presented to hospital within 48 h after trauma and the remaining 23.95% presented 48 h to 1 week after trauma. None had a bilateral injury. Gartland type 3 fractures constituted 54.37% of patients, followed by type 1 (23.95%) and type 2 (21.67%).</p><p><b>CONCLUSION</b>Almost one fourth of supracondylar humeral fractures in children can be prevented by installing railing of rooftops and stairs. It is necessary to educate people on hazards of treatment by traditional bonesetters. Moreover, the children with supracondylar humeral fractures should be screened for associated injuries.</p>

Bilateral Mirror Image Cervical Neurofibroma in an Adult with Neurofibromatosis Type 1

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder characterised by various phenotypic features like hyperpigmented spots, neurofibromas, Lisch nodules, skeletal abnormalities and tendency to develop neoplasms. Only few cases of Non-Familial Spinal Neurofibromatosis-1 (Non-FSNF1) have been described in literature with tumors involving the spinal roots at every level being even rarer. We reported an interesting case of bilateral symmetrical cervical neurofibroma with multiple spinal neurofibromas appearing as mirror image on CT, associated with non familial NF-1 as a rare presentation in a 25-year-old adult male.

Lateral cervical meningocele

Lateral cervical meningocele is an extremely rare developmental anomaly. We could find only one such case protruding from an enlarged C2-3 intervertebral foramen. It may be confused with an extradural cyst or cystic hygroma. Direct needling may introduce infection and thereby pyogenic meningitis and so should be avoided. Similarly, incision and drainage may transform it into cerebrospinal fluid fistula. A computed tomography scan is the most fruitful form of investigation for confirmation and localization of the disease. A lumboperitoneal shunt or water tight closure of the dural sac at the neck is the recommended procedure of choice.

Ossifying fibroma of the sella turcica

Ossifying fibroma of the sellar turcica is extremely rare. There are only sporadic case reports in the literature. One such case simulating pituitary adenoma is presented in an 18-year-old girl.

Cystic meningiomas in infancy

A suprasellar meningioma with multiple intratumoral cysts in a 6-month-old boy is reported. A review of literature disclosed only 11 cases so far. They showed a characteristic predominance in males and predominance of fibroblastic type on pathological examination. Intratumoral cystes are less common than peritumoral cysts. The various hypothesis regarding cyst formation are discussed.

Osteoclastoma of occipital bone

Osteoclastoma of the calvarial bone of membranous origin is a rare entity. This paper presents a case of osteoclastoma of the occipital bone and a brief review of literature.

Cervical intramedullary neurofibroma

Intramedullary spinal neurofibroma is extremely rare. A case of cervical intramedullary neurofibroma is presented in a 21-year-old man. Only 20 case have been previously reported in the literature. The site of origin is discussed with various hypotheses.