Management of Femoral Shaft Fracture in Klippel-Trenaunay Syndrome with External Fixator.

Klippel-Trenaunay syndrome (KTS) is a rare complex malformation characterized by the clinical triad of capillary malformations, soft tissue and bone hypertrophy, and venous/lymphatic malformation. Fractures of long bones in such cases are challenging to treat. A 12-year-old female with this syndrome presented with femoral shaft fracture of right thigh. She was initially kept on skeletal traction for two weeks and then she underwent closed reduction and immobilization with external fixator with uneventful intraoperative and postoperative period. Fracture united at four and half months.

Risk Factors For Necrotizing Fasciitis And Its Outcome At A Tertiary Care Centre.

BACKGROUND: Necrotizing fasciitis (NF) is a serious and potentially fatal condition where there is rapid progression of inflammation of skin, subcutaneous tissue, and superficial fascia and can be mono-microbial or poly-microbial. The disease is rapidly progressive in nature and if not promptly treated leads to significant morbidity or even mortality. This study was designed to explore the various risk factors commonly present and study the outcome of the disease. METHODS: This was a cross sectional study done in tertiary centre over period of one year from April 2014 to March 2015. Patient admitted with soft tissue infection were presumptively made diagnosis of NF based on clinical features and final diagnosis was made after pre-operative surgical findings. RESULTS: Forty two (40.38%) patients had final diagnosis of NF out of 102 soft tissue infections. Twentynine (69%) of 42 patients with NF fully recovered with surgical and medical management. Eleven (26.2%) of these patients succumbed to their illness and two (4.8%) needed amputation of limb to control the infection. The most common co-morbid condition was alcoholism, followed by diabetes mellitus. CONCLUSIONS: The incidence of necrotizing fasciitis in patients admitted with soft tissue infection was 40.38%. Mortality and morbidity due to this condition was found to be high.

Compound fracture of humeral shaft associated with two-part fracture dislocation of ipsilateral shoulder: a rare combination.

Humerus fracture is very rarely associated with ipsilateral shoulder dislocation. Here, we have reported probably the first case of compound fracture of humerus associated with a two-part fracture dislocation of ipsilateral shoulder. A 30-year-old female presented to the emergency department after a road traffic accident. The vehicle in which she was travelling skidded off the road and she got trapped. She had degloving injury over her left arm with a fracture of left humerus and anterior dislocation of ipsilateral shoulder and greater tuberosity fracture. She was managed initially with wound debridement, external fixation over humerus, closed reduction of shoulder dislocation, and open reduction and internal fixation of greater tuberosity fracture. Skin grafting was done over the wound later on. Fracture united at 4 months with a good range of movement at shoulder at the final follow-up.