A Neglected Markedly Displaced Medial Epicondyle Fracture with Simultaneous Ulnar Nerve Palsy in an Adolescent

Humeral medial epicondyle fractures constitute around 15% of pediatric elbow fractures. Up to 60% occur in association with elbow dislocations. Knowledge of potential imaging pitfalls when examining acute elbow fractures in children contributes significantly to accurate diagnosis. Nevertheless, management of missed pediatric medial epicondyle fractures has rarely been reported. We present an 11-year-old boy with a neglected and severely displaced medial epicondyle fracture with concurrent ulnar nerve palsy. We performed neural decompression, fragment excision, and muscular and capsuloligamentous reconstruction of the medial elbow. This study demonstrates that the surgical outcome of a late presenting fracture can be satisfactory in terms of function and neural recovery. It also underscores the importance of careful interpretation of elbow imaging including normal anatomic variants.

Effect of platelet-rich plasma intra articular injection on patients with primary knee osteoarthritis

Background: Osteoarthritis [OA] is the most common type of arthritis. It is a degenerative joint disease. OA is usually defined according to radiographic changes. Conventional radiographs [CR] were considered the most relevant outcome measure to assess the progression of OA in clinical trials and epidemiological studies. Many modalities are used in treatment of knee OA. There is a distinct need for new procedures that are cost effective by reducing the need for pharmaceutical and surgical management, while targeting the biochemical process of OA. Platelet-rich plasma [PRP] is one of these new procedures. PRP was found to increase hyaluronic acid [HA] concentration, stabilizing angiogenesis in patients with osteoarthritic knees

Aim of the study: Was to assess the value of intra articular injection of autologous platelet rich plasma in management of knee osteoarthritis

Patients and methods: This study was conducted on 40 patients with primary knee osteoarthritis, divided into 2 groups; study group treated with 3 injections of PRP, and control group treated with single dosed high-molecular weight HA. Clinical assessment and visual analogue scale [VAS] scoring were done pretreatment and 3 months post treatment

Results: Clinical improvement and reduction of VAS in both groups which is significant at the study group

Conclusion: PRP injection could be considered as a simple, safe, effective and non-palliative treatment that may promote cartilage healing in knee osteoarthritis as it improve the clinical condition and the function of the joint. Hence, it may represent a useful addition to the available therapeutic options for knee osteoarthritis