Treatment options for unstable trochanteric fractures: Screw or helical proxima femoral nail.

PURPOSE: To compare treatment outcome of screw proximal femoral nail (PFN) system with that of a helical PFN. METHODS: The study included 77 patients with closed unstable intertrochanteric fracture classified as AO 31A2&31A3, between June 2008 to August 2011. Inclusion criteria were: all mature skeletons above 50 years of age; closed unstable trochanteric fracture classified as AO 31A2&A3. Exclusion criteria were: immature skeleton, pathological fracture of any cause other than osteoporosis, inability to walk inde- pendently prior to injury. Patients were randomized to 2 treatment groups based on admission sequence. Forty patients were treated with screw PFN and thirty seven were treated with helical PFN. RESULTS: Both groups were similar in respect of time of surgery, blood loss and functional assessment and duration of hospitalization. In screw PFN group 2 patients had superficial wound infection, 1 patient had persistent hip pain and 1 patient had shortening>1 cm but<2 cm, while in helical PFN group 1 patient had superficial wound infection. CONCLUSION: Both screw and helical PFN are very effective implants in osteoporotic and unstable trochanteric fractures even in Indian patients where the bones are narrow and neck diameter is small. It is an implant of choice for osteoporotic and unstable trochanteric fractures.

Low-grade fibromyxoid sarcoma around the knee involving the proximal end of the tibia and patella: A rare case report.

Low-grade fibromyxoid sarcoma (LGFMS) is a distinctive variant of fibrosarcoma. LGFMS is a rare soft tissue tumor that tends to develop in the deep soft tissue of young adults and has the potential for local recurrence or distant metastasis. The current case report presents a 22-year-old male complaining of a slow growing painless mass in the right knee over a period of 10 years. Following complete evaluation by radiological and histopathological examination, a diagnosis of LGFMS was confirmed and a wide excision was performed. Currently, the patient has been under follow-up for the last five years without any evidence of metastasis. The present case report provides further information concerning the diagnosis, imaging and management of LGFMS.

Klippel Feil Syndrome: A Rare Case Report.

INTRODUCTION: In Klippel Feil syndrome, classically there is a triad of short neck, a low posterior hairline and a limited range of neck movements especially of lateral bending. In fewer than 50% of cases have all the three elements. CASE REPORT: In the present case we have found congenital Scoliosis, Sprengel deformity and there were no evidence of renal disease, congenital heart disease and neurological impairment. The present case has classical triad low posterior hairline, short neck and limited cervical range of motion. CONCLUSION: A rare case of Klippel Feil Syndrome is being presented with the aim that such cases should be identified and treated at an early stage to minimize cosmetic & social stigma to her and to her parents.

Rare presentation of giant cell tumor of bone in the lateral end of the clavicle.

PATIENT: Male, 30 FINAL DIAGNOSIS: Giant cell bone tumor Symptoms: Bone swelling • pain MEDICATION: - Clinical Procedure: - Specialty: Oncology. OBJECTIVE: Unusual clinical course. BACKGROUND: Cooper first reported giant cell tumors (GCT) in the 18(th) century. The clavicle is a rare site for tumors. Metastatic tumors are more common than benign. This is the first case of GCT lateral end of clavicle to be reported in the literature. CASE REPORTS: A 30-year-man was admitted with a 1-year history of progressively increasing swelling and pain over the left lateral end of the clavicle. The plain radiograph and PET scan revealed an expansile radiolucent lesion in the lateral end of the clavicle. Swelling was epiphsio-metaphyseal in location. It demonstrated geographical type of destruction with a narrow zone of transition. There was no periosteal reaction or soft-tissue component. The mitotic activity was found to be 0-1/10 HPF. Diagnosis was confirmed histopathologically. A wide excision of the mass, including 3 cm of healthy tissue of the clavicle, was performed. CONCLUSIONS: The presence of an expansile lytic lesion of the lateral end of the clavicle should be taken seriously and complete radiological and histopathological investigation should be done and giant cell tumor of the bone should be kept in mind despite its rarity.

Clinical correlation of magnetic resonance imaging with symptom complex in prolapsed intervertebral disc disease: A cross-sectional double blind analysis.

INTRODUCTION: Low backache (LBA) is one of the most common problems and herniated lumbar disc is one of the most commonly diagnosed abnormalities associated with LBA. Disc herniation of the same size may be asymptomatic in one patient and can lead to severe nerve root compromise in another patient. OBJECTIVE: To evaluate correlation between the clinical features of disc collapse and magnetic resonance imaging (MRI) finding to determine the clinical importance of anatomical abnormalities identified by MRI technique. SUMMARY: From January 2010 to January 2012, 75 otherwise healthy patients (43 males 32 females) between the age of 19 and 55 years (average age was 44.5 years) with low back pain and predominant complaint of root pain who presented to our clinic were included in the study. MATERIALS AND METHODS: Proper screening was done to rule out previous spine affection and subjected to MRI. RESULTS: The results were analyzed under four headings viz. disc herniation, disc degeneration, thecal sac deformation and neural foramen effacement. All patients had a visual analog score (VAS) score more than 6. The interrater correlation coefficient kappa was calculated to be k=0.51. There were total 44 patients with herniation, 25 patients had mild, one patient had moderate degree of thecal sac deformation, 21 patients had one or more levels of foraminal effacement by the herniated tissue, 100% of the patients had disc degeneration ranging from grade 1 to 3 at different levels; and 48 patients (64%) had radiculopathy, six (8%) patients had bilateral and others had ipsilateral affection. CONCLUSION: In our study, the correlation was made between clinical findings and MRI findings. It can safely be concluded that treating physician should put more emphasis on history, clinical examination, and make the inference by these and then should correlate the clinical findings with that of MRI to reach a final diagnosis.