Pattern of bony injuries among civilian gunshot victims at tertiary care hospital in Karachi, Pakistan / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Firearm injuries impose a continuous economic burden on society and hospital resources. The aim of this study was to assess the pattern of bony injuries among victims of gunshots.</p><p><b>METHODS</b>A retrospective study was conducted in the Department of Orthopedics, Dow University of Health Sciences and Civil Hospital Karachi from January 2011 to December 2012. Patients with isolated bony injuries were included while patients with other systemic injuries were excluded.</p><p><b>RESULTS</b>There were 90 cases and the majority of them were male (84.4%). Mean age was (32.52 ± 10.27) years. Most of the patients (72.2%) belong to the younger age group. A low velocity weapon was used in 61 (67.8%) cases and a high velocity weapon was used in 29 (32.2%) cases. Armed robbery (64.4%) was the cause of conflict in more than half of the cases. Lower limb was involved in 72.2%. Fifty eight (64.4%) patients remained hospitalized for 15-20 days and others for more than 20 days. Internal fixation with intramedullary nailing was done in 35 patients while K-wire was used in 5 patients. Fifty patients were managed with external fixation, either uniplanar or multiplanar ilizarov. Deep wound infection and nonunion were observed more often in high velocity injuries.</p><p><b>CONCLUSION</b>Armed robbery was the leading cause of gunshot bony injuries in our hospital. Young males were victimized in a majority of cases. High velocity injuries were associated with more complications.</p>

Solitary plasmacytoma; osteolytic lesion of clavicle-case report

Solitary plasmacytoma of bone is one of the subtypes of plasma cell neoplasms. Solitary plasmacytoma is a kind of malignant tumor characterized by localized collection of monoclonal plasma cells. It is most frequently seen in vertebrae and long bones. Plasmacytoma of clavicle is very rare. We report a case of solitary plasmacytoma of lateral end of clavicle in a 30 year old male presented with complaint of pain and swelling around the right shoulder region, though SPB can involve any bone of body but SPB involving the lateral end of clavicle is very rare presentation

Primary diaphyseal tuberculous osteomyelitis of tibia

Diaphyseal tubercular osteomyelitis of long bone is extremely rare and few cases have been reported in literature. We are presenting a case of 17 years old girl presented with pain and swelling over lower half of leg for 7 months. There was often low grade fever but no history of weight loss or pulmonary symptoms. X-ray chest was normal. X-rays and MRI of involved leg were suggestive of osteomyelitis. Curettage and biopsy was done, report was suggestive of tuberculous osteomyelitis. As tuberculosis is still common in developing countries, for an osteolytic lesion in bone, tuberculous osteomyelitis should be considered in differential diagnosis

Comparative study of bone mineral density in high and low income school children

To compare the bone mineral density [BMD] and associated dietary and physical activity factors in low and high socio economic status [SES] groups of children. This is a cross sectional, prospective, descriptive study. This study was conducted at two different socio-economic level schools. The low socio-economic school was Major Sultan Shaheed Primary School in North Nazimabad, Karachi, while the high socioeconomic school was Horizon School in Gulshan-e-Iqbal Karachi. This study was conducted in September 2007. The perfomas were filled and the tests were done during one week. One hundred children of age 10-12 years of both sexes were selected randomly from two schools of Karachi representing the two different socioeconomic classes. Fifty children each were recruited from either school. Each group included 25 from either sex. A questionnaire was designed to include basic demographic features, weight, height, BMI, dietary habits and physical activities. BMD was measured at the heel using a portable quantitative ultrasound [QUS] densitometry machine. The results were expressed as T-score. The data was analyzed on SPSS version 11.5. For data comparison and calculation of significance ANNOVA and ETA were used. The mean T-scores in high SES group were significantly lower at-2.82 than the low SES group which was-2.36 [p-value < 0.05]. This is despite the fact that the high SES group had a significantly higher BMI and better overall dietary calcium and other minerals consumption. However, the high SES group children also consumed significantly higher quantities of carbonated soft drinks and chocolates. The high intensity activities were comparable in both groups [p-value 0.83]. However, the moderate intensity activities were observed 2.5 folds more frequently in low SES than in high SES group. Lower BMD values were noted in high SES group of children despite having higher BMI and better overall mineral consumption. This could be because of concomitantly higher consumption of carbonated soft drinks and other junk food that may hinder calcium and minerals absorptions and sedentary lifestyle observed in high SES group children

Cystic swellings on hands and wrist common pitfalls

To determine the etiopathological causes of simple cystic swellings of Hand and wrist. Prospective / retrospective descriptive study. Orthopaedic Department of Sindh Government Lyari General hospital, Dow University of Health Sciences Karachi and Remedial Centre Hospital Karachi from January 2005 to April 2006. A total of 87 patients, who had cyctic swellings in hand and wrist were operated. Apart from simple ganglian, other pathological lesions were found. In 87 patients who had surgery, 63 [72.4%]had wrist swelling while 24 [27.6%] had hand swelling. In 71 [81.6%] patients the cystic swelling was ganglion while 16 [18.4%] had other pathology. Out of that 10 were giant cell tumors of tendon sheath, 1 was spindle cell carcinoma, 1 was fibroma, 3 cases were tuberculosis and 1 case of lipoma. All cystic swellings in hand and wrist are not ganglion, they could be, from infection to malignancy