Fenton syndrome in an adolescent

Scapho-capitate fracture [Fenton syndrome] is a rare lesion and is even less well-documented in adolescents. The most frequent mechanism is possible forced extension and hyperextension of the wrist. We report a case of 15 years old boy with hyperextension injury to the wrist. The true diagnosis was made 2 weeks later. Treatment involved open reduction and internal fixation with K-wires and Herbert screws. It went on to heal well and at 6 months follow-up, there was no infection or avascular necrosis and wrist function was good

Evaluation of the predisposing factors and causative organisms of chronic osteomyelitis

To determine the important predisposing factors and common organisms responsible for chronic osteomyelitis in our area. Design: It is a descriptive study. Place and Duration: The study was conducted at the Department of Orthopaedic Surgery, Liaquat University Hospital, Jamshoro, Hyderabad between July, 2001 to June, 2002. Subject And All the patients, irrespective of age and sex, admitted in the orthopaedic surgery ward with the diagnosis of chronic osteomyelitis were included in the study. On arrival a thorough history was taken, physical examination and investigations were performed. Radiological examination of the affected part was also done to note the features of chronic osteomyelitis such as sequestra, involucrum and sclerosis etc. The specimens which were sent for culture and sensitivity testing consisted of either or a combination of purulent fluid, sequestra, soft tissue, bone curettings or tissues surrounding an implant. A total of 61 patients were included during one year period. The disease was more common in males around the age of 30 years. Adults were mainly affected by non-hematogenous osteomyelitis as compared to children who were mainly affected by hematogenous osteomyelitis. The commonest predisposing factor was trauma due to road traffic accidents and firearm injuries. Post-operative infection also resulted in chronic osteomyelitis in a number of patients. Staphylococcus aureus was found to be the commonest organism involved. As trauma was found to be the most common type of pre-disposing factor steps should be taken to provide early and proper medical management to victims of trauma, to keep the wounds free of infection. Bacteriological samples should be routinely taken before the start of antibiotic therapy