Computed tomography versus plain radiography in diagnosis of bone tumours

25 patients suspected to have bone tumours on clinical examination, were subjected to laboratory and radiological examination including plain X-ray and computed tomography [CT]. Pathological examination after biopsy was done to confirm the final diagnosis. 16 [64%] out of 25 cases were diagnosed by plain x-ray, 15 [60%] of them showed intramedullary extension, while CT was useful in establishing the primary diagnosis in 22 [88%] patients with intramedullary extension in all of them. CT is an effective method in the diagnosis of bone tumours providing excellent data about the exact anatomical locations and intra and extra-osseous extensions of bone tumours

effect of prostaglandin E2 [PG E2] modulation on fracture repair: a preliminary study

Fracture repair is a complex process mediated by local regulators including PG E2. A preliminary study was undertaken on the effect of exogenous PG E2 on fracture repair to clarify the PG E2 controvarsed action of being potent bone stimulator resorbant autocoid [local hormone] aiming to reduce the morbidity of fracture healing by accelerating the healing process and shortening the repair period. fourty three male rabbits of average weight 2.0 kgms were selected and were classified into four comparable groups of ten rabbits after loss of three during the study. The control group was given daily s.c. 1 ml placebo. The PG E2 group received daily s.c. 5 ugm/kg body weight PG E2 [Dinoprostine]. L.A.S. group received daily s.c. 12.5 mg L.A.S. [Aspegic] 1kg. The PG E2-L.A.S. group received daily s.c. dose of 12.5 mgm L.A.S. and 5 U.gm. PG E2. The PG E2 dose level used showed prolonged healing period and modified repair pattern in favour of production of chondroosseouscallus with significant blood biochemical changes. This result was not apparent in the control group and was less apparent in the PG E2-L.A.S. group. It seems that the PG E2 delayed healing effect could be counteracted by L.A.S. L.A.S. group showed retarded healing process and small callus formed of thin bone trabeculae with significant blood biochemical changes. L.A.S. was not beneficial for fracture healing. In conclusion, PG E2 in the dose used was non beneficial to fracture repair and in a higher dose it could have important role in delay or non union of the fracture. This study suggest that the rate and type of bone healing activity could markedly be PG E2 dose related and dependent i.e. potent bone stimulator in small dose and bone inhibitor in higher dose

Experience with supracondylar humeral osteotomy [SCHO] for correction of late cubitus varus deformity [CVD] clinical and practical consideration

Seventeen corrective supracondylar humeral osteotomy [S.C.H.O] was performed for post traumatic late cubitus varus deformity [CVD] in 16 patients. The average age at injury was 4.5 years [range 3-10 years] and at S.C.H.O was 8 years [range 4-16 years] and the average follow up period was 2.5 years [range 6 months-5 years].The main indication for operation was the unsightly deformity caused by malunion. Early correction is advisable because deformity will not going to be corrected by remodelling and to provide prophylaxis against late ulnar nerve palsy S.C.H.O was a difficult operation and had significant incidence of complications and operative risk. Difficulty was encountered in maintainence of the correction [14 cases had K. wire fixation and 3 had only external plaster immobilisation]. The average varus deformity was 20 degrees [range 10-40 degrees]. Refinement of the technique was necessary simple wedge corrective osteotomy was carried out with no attempt for correction of mild rotational deformity. The average correction was 30 degrees. Relative higher success rate [47% excellent result] was attributed to equal limb osteotomy, varus correction alone, preservation of intact medial hinge, preoperative wedge tracing and accurate pin placing the operation is deceptively simple but it had a significant complication rate [47%] including: recurrence [255], neuropraxia [18%], sepsis [18%], bad scarring [11%] but no case had non union. Post operative well filled back elbow slab in extension was important and highly recommended to achieve good hold of the fragments and higher satisfactory result. Cosmetic result could have been improved by operative medial shift of the distal fragment. The result of the study stress on the prevention or C.V.D. to avoid unnecessary secondary difficult operation

Anterior capsulotomy for management of post-traumatic elbow flexion contracture

Eighteen patients [11 males and 7 females] with different degree of flexation contracture of the elbow joint after local trauma, constituted the material of the present study. Their ages ranged from 11-47 years [mean 26 years]. A limited anterior capsulotomy combined with post operative splintage and early exercise program has been shown to be a safe and effective means of decreasing post traumatic flexion deformity of the elbow that is resistance to conservative means. Although flexion contracture was decreased [67% improvement]. The best results were noticed in patients with no or little post traumatic arthrosis [72.3% improvement]

Disorders of the first metatarsal sesamoids

143 cases with metatarsalgia presented with pain, tenderness and sometimes swelling under the head of the first metatarsal bone were examined clinically and radiologically, two cases of which were examined histopathologically and 75 asymptomatic feet were examined as a control. Their assessement revealed that : 16 cases [11.1%] with dysplasia, 32 cases [22.5%] with malformation, 54 cases [37.8%] with malposition, 13 cases [9%] with osteochondritis, 19 cases [13.3%] with sesamoidometatarsal arthritis, 6 cases [4.2%] with osteomyelitis, and 3 cases [2.1%] with fracture. The suggested radiological assessements were noted and discussed