Management of chronic scapholunate ligament injury.

Scapholunate ligament is the most commonly injured ligament in the wrist and requires accurate diagnosis and treatment. It presents with pain, stiffness and can lead to carpal instability as well as degenerative arthritis if left untreated, with subsequent loss of function and disability. There are several management options currently available but there is no consensus on how best to manage a wrist with chronic sequelae of scapholunate ligament injury. This review explores available evidence in the literature on optimal treatment options including non-operative and operative procedures, relevant surgical techniques and their associated outcomes. A summary of the current concepts in the management of Chronic Scapholunate ligament injury is presented.

Dupuytren's Contracture - Current Concepts.

Dupuytren's contracture is a common condition that has the potential to be debilitating. It presents in a variety of manners and can be mild or more aggressive in its progression. There are a large number of management options currently available. In this review of the evidence, non-operative and operative management options are examined, with a consideration of post-operative rehabilitation and complications. A summary of the current concepts in the management of Dupuytren's contracture is presented.

Pelvic Osteomyelitis in a Child - A Diagnostic Dilemma.

INTRODUCTION: Pelvic osteomyelitis presents a diagnostic challenge due to its rarity and non-specific presentation. Early advance imaging in the form of magnetic resonance imaging (MRI) is warranted if clinical suspicion is high. We present an unusual case of pubic rami osteomyelitis, presenting with clinical findings of septic arthritis treated appropriately with early imaging and intravenous antibiotics with satisfactory outcome. CASE REPORT: A 9-year-old boy presented to accident and emergency with 2 days history of the left-sided groin and thigh pain, inability to weight bear, and feeling generally unwell following a rugby match. There was no history of trauma or recent infection. On examination, the child had fever, limp on weight-bearing, tender groin, and signs of an irritable hip. Laboratory report showed raised inflammatory markers and blood culture showed Staphylococcus aureus. Presumptive diagnosis of septic hip joint was made as there was effusion on ultrasound examination. Specialist opinion was sought and MRI confirmed changes of the left pubic rami osteomyelitis. The child was treated with intravenous antibiotics, with excellent clinical response after 48 h. CONCLUSION: Pelvic osteomyelitis in a child is a rare occurrence. This case highlights the significance of having a wide differential diagnosis for non-specific hip pain in a child. An MRI will help with the diagnosis if there is any uncertainty of the underlying cause. Early treatment with IV antibiotics is ideal for uncomplicated recovery. A multidisciplinary team approach is of utmost importance.