Wide resection and arthrodesis of knee using fibular graft in aggressive giant cell tumor of distal femur

This prospective study was conducted to evaluate the outcome of resection and massive allograft arthodesis in the management of aggressive giant cell tumor of distal femur. 10 Patients with mean age 37.8 years [30-46] with Giant cell tumor, Enneking stage-Ill of distal femur were treated by wide resection and reconstruction allograft arthodesis using free fibular graft and fixed with suitable hardware from July 1999 to 2008. There were 6 female patients and 4 male. Follow up period ranged from 30 to 65 months with an average of 45.3 months. At the final follow up, functional score ranged from 18-27 out of a total of 30. Average was 80.4%, range 66-90%. At the end of follow up all the patients were alive and disease free. All the patients achieved union. The mean union time was 16.4, ranged 14-20 weeks. Two patients had fall and fractured the graft. We had to do revision and additional cancellous grafting. Later on healed full union was achieved. One patient developed superficial wound infection which was treated with systemic antibiotics. In selected patients of giant cell tumor of distal femur, resection arthodesis of knee using fibular graft is an effective reconstructive method. It offers biological reconstruction alternative to amputation in selected patients where mobile joint reconstruction can not be carried out

Wide subtalar release in congenital talipes Equino Varus deformity of foot

There is controversy regarding preferred operative procedure for correction of Congenital Talipes Equino Varus [CTEV]. Objective of this study was to determine the efficacy of wide subtalar release as described by Mackay in 1983 in children having CTEV. Twenty patients up to the ages of 3 with grade-Il, Ill congenital club foot were treated with this procedure; those having deformity secondary to diseases like CP, arthrogryposis multiplex congenital were excluded. Patients were followed for a minimum of one year after operation. Results were graded as per Frank and Hem criteria. Clinical and radiological evaluations were done and compared with other soft tissue procedures. 72.41% patients had satisfactory, 17.24% moderate and 10.34% poor results. Club foot surgery is instituted when well planned cast correction fails. Children up to the age of 3 years can be successfully treated with this method under skilled hands