Complex elbow dislocation with ipsilateral segmental fracture of radius and ulna in a young boy: a complex injury with multiple fractures.

Complex elbow dislocation1 (fracture of lateral condyle and avulsion fracture of medial epicondyle) with ipsilateral segmental fracture of radius and ulna without distal neurovascular deficit following machinery rolling belt injury in a 14 years boy presenting to emergency room of BP Koirala Institute of Health Sciences, is reported due to its complex nature of injury and good outcome after adequate follow up. The literature is reviewed for complex elbow dislocation to show its rarity.

Treatment of grade IIIB opens tibial fracture by ilizarov hybrid external fixator.

OBJECTIVE: We evaluated the results of patients who were treated with Ilizarov hybrid external fixator for type IIIB open tibial fractures. MATERIALS AND METHODS: 35 Gustilo grade IIIB tibial fractures of age between 18 to 42 years (22 male and 13 female) in which 12 distal fourth tibia (D/4) of C1.1 (6), C1.3 (6), 12 upper fourth Tibia (U/4) of A2 (8) and A3 (4) according to AO classification and 11 Tibial plateau fractures of Schatzker type VI (5) , V(5), IV(1) . All tibial plateau, proximal fourth fractures and lower fourth fractures of tibia and fibula (Reversed Hybrid), treated with Ilizarov hybrid fixator using two Ilizarov 5/8 rings and AO External fixator were followed up to 12-52 months. RESULTS: D/4 fractures were united at 31.16678.3046 wks, U/4 at 24.005.2915 and Tibial plateau at 15.5454.160 weeks (p-0.00). ROM in tibial plateau type IV 130 degrees +/-00, type V 124 degrees +/- 8.94 degrees, type VI 125 degrees +/-7.0711 degrees, D/4 of type C1.1 (50 degrees +/-0.00), type C1.3 (43 degrees +/- 5.7755) whereas full ROM in U/4 fractures. Pin tract infection occurred in 21% of cases. Pain on walking in 20% of cases of type VI tibial plateau fractures and 80% of cases of type IV and V. Problem free in rest of parameter of function of VI and 100% problem in IV and V. Pain at rest observed in 20% of cases in type V. In 66.67% U/4 fractures had pain on walking but no other functions were compromised. In 33% D/4 fractures of C1.1 type had pain on walking only and had 1cm of shortening. CONCLUSION: On the basis of our experience, we suggest adopting this method for functional limb salvage after extensive complex high-energy injuries. This fixator is safe and versatile, effective in providing stability and allowing early rehabilitation, although the indications for its use are very relatively specific.

Medial peritalar dislocation in a volleyball player.

We report a medial peritalar dislocation, which was treated with closed reduction and cast for 3 weeks. At follow up 12 months later, there was normal range of motion and mild pain after prolonged walking.

Polyarticular tuberculosis in a young boy: a rare presentation.

Polyarticular tuberculosis involving bilateral hip and bilateral knee joints without obvious pulmonary or disseminated form of tuberculosis in a young boy is presented along with literature review.

Osteosarcoma in pregnancy.

Osteosarcoma in pregnant women is rare. Delay in diagnosis may be due to lack of any signs or symptoms during gestation, clinical misdiagnoses, religious attitude and refusal of the patients. Most cases soft-tissue and bone tumors during pregnancy can be managed successfully with surgery during gestation. Therapies with fetal toxicity were more likely to be deferred to postpartum period. This case is rare and liable to be missed, hence is reported.

Fungal osteomyelitis of tibia and fibula with bony ankylosis of ankle; Intertarsal and tarsometatarsal joints- A rare presentation

We present a rare case of fungal osteomyelitis of tibia and fibula with extensive involvement of ankle; intertarsal and tarsometatarsal joints leading to bony ankylosis of all joints over a four years duration. Diagnosis was confirmed with histological and microbiological examinations; which showed Aspergillosis osteomyelitis. The patient was treated with Amphotericin B for 6 weeks. The outcomeafter the therapy was good after adequate follow up. The clinical; pathologic; and therapeutic features of aspergillosis osteomyelitis are described and compared with previously published cases