Management of giant cell tumour of bones: Report of 16 cases

A retrospective review was conducted on sixteen giant cell tumours which had mostly occurred in the extremities. These tumours were treated as three groups operated on by three different surgical techniques. The treatment was mainly aggressive curettage with the use of local adjuvant therapy. The cavity was then filled with bone grafting or acrylic cement or both. The functional results were critically analyzed according to the system of Enneking. One lesion recurred twice, probably due to insufficient surgical excision of the tumour. However, the authors emphasized the importance of the surgical margin with the use of local adjuvant therapy and cement reconstruction, which facilitated quicker rehabilitation

Osteofibrous dysplasia

In this report, we describe an 18-year-old girl who presented with tender swelling above the right ankle which developed over 6 months. X-ray examination showed an osteolytic lesion consisting of uniform multiloculated bubbles of a ground glass-appearance. The age, site, radiological and initial histological appearance was suggestive of non-ossifying fibroma or monostotic fibrous dysplasia. Local resection was followed by recurrence of the tumor one year later. Review of the histological sections showed fibrous tissue containing scattered bone trabeculae surrounded by active osteoclasts which is consistent with osteofibrous dysplasia [OFD]. The latter bone tumor is a disease with very frequent recurrence if treated with local resection or simple curettage as compared to the other two bone diseases

Abnormal presentation of osteoid osteoma

We describe a rare location of Osteoid Osteoma in the diaphysis of the ulna in a 12 year old girl. The lesion was missed initially due to difficult identification of the nidus by radiography and CT Scan, The patient was treated with wide surgical excision in order to avoid recurrence

Treatment of non-united tibial fractures by Kuntscher nailing

Non-union of the tibial shaft was treated by Kuntscher intramedullary nailing in 32 patients. Ten patients were treated with closed intramedullary nailing and twenty-two required open nailing to realign the fracture or to remove a failed implant. Bone grafting was undertaken in sixteen patients and sixteen patients also had fibular osteotomy. The average time from injury to surgery was 11 months, and the average healing time, as determined radiologically, was 6 months following surgery. One patient had a postoperative infection which cleared with debridement, drainage and antibiotic therapy and subsequently united. All the fractures went on to union. Most of our patients had the full range of knee, ankle and foot movement. Intramedullary nailing is an effective method of managing non-union of the tibial shaft fracture

Parathyroid adenoma associated with multiple tendon rupture; a case report

A rare and unusual case is described of multiple lower limb fractures and complete closed tendon ruptures, following trivial trauma, in a 50 years old woman who had been complaining of low back pain and generalised weakness for two years. She had generalised osteoporosis and bilateral nephrolithiasis. Investigations revealed hyperparathyroidism as the underlying cause. The diagnosis of the cause was difficult. It was elucidated by blood biochemical and hormonal assays. The parathyrod adenoma was detected only by ultrasonography of the neck. The pathological manifestations rapidly improved after surgical reconstruction of the skeletal and tendinous lesions, and after excision of the hyperactive parathyroid adenoma, together with appropriate medical and supportive treatment

Closed versus operative treatment of supracondylarintercondylar fractured femur

A retrospective study of thirty three fractures in adult patients involving the supracondylar-intercondylar areas of the femur was made. The average follow up was twenty two months. The majority of the patients were victims of road traffic accidents. Many patients had associated knee and other skeletal injuries. Fourteen patients were treated operatively by rigid internal fixation and nineteen were treated by traction for an average of eleven weeks, then followed by plaster of paris. The results were analysed, compared and discussed. It was found that the operative treatment is superior to non-operative method provided the surgeon applies the proper surgical principles

unusual gas-forming infection with mixed escherichia coli and klebsiella: a case report

A case is described of a rare gas forming infection of the lower limb with a mixed Escherichia coli and Klebsiella. The patient was a male, fourty years old, insulin dependent diabetic for the last six years. He had a severe infection with toxaemia, associated with a compartment syndrome of the lower limb. Above-knee amputation was undertaken due to the severe and extensive myonecrosis, as a life saving procedure