Double Tension Band Osteosynthesis in Inter-Condylar Humeral Fractures.

INTRODUCTION: Intercondylar humerus fractures are uncommon in orthopaedic practice. The treatment for the same has been described in the literature and include paragonal and orthogonal fixation by using plates. Tension band wiring as a treatment for the same is sparsely described in the literature. AIM: To evaluate the effectiveness of "Double Tension Band wiring" method for the treatment of intercondylar fractures of humerus and compare the results with studies involving treatment with locked plates. MATERIALS AND METHODS: Twenty patients, all presenting with fresh fractures of the distal humerus, treated with double tension band wiring were retrospectively evaluated over a period of three years. Fractures were classified according to Jupiter classification of distal humeral fractures. There were 5 high T fractures, 13 low T fractures and 2 Y fractures. According to AO classification, all were C1 fractures. Average age of the patients was 56.20 years (32-70 years). There were 13 males and 07 females. RESULTS: Out of 20 cases treated with this method, rigid fixation and union was achieved in all of them. The average tourniquet time was 69 minutes with minimum of 50 minutes and maximum of 120 minutes. Radiological union was achieved at an average of 10.8 weeks (8-14weeks). Average range of motion was 104.5 degrees with maximum range of motion 120 degrees (10-130) and minimum of 70 degrees (30-100). Excellent or good results were obtained in 80% of the patients in our study. CONCLUSION: Double tension band is a reliable, less demanding and cost effective method of fixation of intercondylar fractures of humerus.

Evaluation profile of thyroid nodule by fnac in the rural population of khanpur kalan, sonepat, haryana.

BACKGROUND: Thyroid disease is most common endocrine disorder and is different from other endocrine diseases because of its visible swelling and ease of diagnosis. If left untreated, thyroid disease makes a person more prone for heart disease, infertility and osteoporosis. In India, significant burden of thyroid diseases exist with an estimation of around 42 million cases. The thyroid status and autoimmune status of adult Indian population in the post iodinization phase is largely unknown. AIM: The main objective of this study was to generate valuable epidemiological data regarding the prevalence of thyroid disorders in rural population of Khanpur Kalan, Sonepat in the post-iodinisation era in India. To assess whether thyroid autoimmunity or goitrogens along with environmental factors play role in the development of thyroid.This paper is being presented in view that no such study has been carried out in the rural population of this region in Haryana. MATERIALS AND METHODS: The present study was conducted in Department of Pathology, Bhagat Phool Singh Medical College for Women, Khanpur Kalan, Sonepat between August 2011 to July 2013. It included retrospective analysis of cytomorphology of fine needle aspiration cytology material of 206 patients presenting with thyroid nodule in the Department of Pathology. RESULTS: The commonest age group affected was 31-40 yrs. The female patients (93.4%) outnumbered the male patients (6.6%).The cytomorphological analysis of 206 patients revealed 190 cases (92.2%) of neoplastic lesions, 10 cases (4.8%) were neoplastic and 6 cases (2.9%) had indeterminate cytomorphology. Maximum number (65.5%) of patients was suffering with goiter followed by lymphocytic thyroiditis (26.2%). Amongst the malignant cases three cases were of papillary carcinoma and one case of medullary carcinoma. Two out of the six cases of follicular neoplasm proved to be follicular adenoma on histopathology. Four patients with high T3 levels were under treatment with neomercazole. They showed change in cytomorphology from hyperplasia to colloid goiter. Only one case of acute suppurative thyroiditis was reported which shows rarity of its type. CONCLUSION: The increased prevalence of goiter in this post iodinisation era can be attributed to goitrogens, autoimmune thyroid disease and micronutrient deficiency of iron and selenium. Higher prevalence of autoimmune thyroiditis in females is linked with both genetic and environmental factors such as infection, stress.

Spindle cell carcinoma of the tongue: a rare variant of squamous cell carcinoma.

Spindle cell carcinoma (SpCC), a rare, aggressive variant of squamous cell carcinoma (SCC), is characterised by proliferation of epithelial and mesenchymal components. It is important to diagnose this variant of SCC, because of its tendency to recur and early metastasis. It accounts for 1% of all tumours in the oral cavity. In this paper, we have reported a case of SpCC of the tongue in a 65-year-old male who presented with a polypoidal growth over the lateral border of his tongue with a short history of one month. Immunohistochemical expression of cytokeratin was strongly positive in the epithelial component and focally in the spindle cell component. The spindle cell component showed a strong positivity for vimentin.

Leukaemic pleural effusion as a manifestation of acute myeloid leukaemia: a case report and review of literature.

Haematologic malignancies such as acute and chronic leukaemias rarely present with or develop pleural effusion during their clinical course. We present a case of a young female who presented with unilateral pleural effusion and was diagnosed with haematologic malignancy on pleural fluid cytology. On further workup, a diagnosis of acute myeloid leukaemia was established. The patient was put on chemotherapy thereafter. This case clearly highlights the importance of cytopathology aids in making a diagnosis of rare and unusual presentation in haematologic malignancies.

Lipoma on palmar aspect of thumb: a rare case report.

Lipomas account for approximately 16% of soft tissue mesenchymal tumours. They are uncommon in hand and those which involve the fingers are very rare, with a reported incidence of 1%. In extremities, they often arise from the sub-fascial tissues of the hands and feet, where they may be mistaken for ganglion cysts. A careful dissection is necessary during the surgical procedure, in order to avoid recurrence. Here, we are presenting the case of an 8 years old boy who had Lipoma on palmar aspect of thumb.

Plexiform neurofibroma in the submandibular gland along with small diffuse neurofibroma in the floor of the mouth but without neurofibromatosis-1: a rare case report.

Plexiform neurofibroma is more commonly seen in the orbit, neck, back, and inguinal region. It is extremely rare in the submandibular gland. These lesions rarely transform into malignancy but are locally infiltrative and can lead to haemorrhage. Therefore, plexiform neurofibroma should always be considered during differential diagnosis while excising a submandibular gland mass. We present here a case of plexiform neurofibroma in the submandibular gland and diffuse neurofibroma in the floor of the mouth in a 27-year-old female, not associated with neurofibromatosis-1.

Steatocystoma multiplex-a rare genetic disorder: a case report and review of the literature.

A 17 years old female presented with multiple asymptomatic cutaneous cysts all over body, sparing the head and neck region. The microscopic examination of the cysts showed the features of steatocystoma multiplex. This disorder, although it is asymptomatic, is a cosmetic threat to the patient. Only a few cases of the patients with an autosomal dominant mutation, who had keratin 17, have been reported. We are reporting here, a case of steatocystoma multiplex in a 17 years old female, along with its review of literature.

Myxoid leiomyoma of cervix.

Leiomyoma, a benign smooth muscle tumour of uterus, is the most common pelvic tumour which occurs in women of reproductive age group. Uterine leiomyomas are frequently seen in women who are older than 30 years of age and they are very rarely seen in women who are below the age of 18 years. They tend to regress after menopause. Incidence is 4% in women who are below 30 years of age. However , lifetime risk of fibroids in women who are over the age of 45 years is more than 60%, with an incidence which is higher in blacks than in whites Cervical leiomyomas constitute 1-2% of the total leiomyoma cases and they rarely occur. There are three types of cervical leiomyomas, namely; interstitial, supravaginal, and polypoidal. Supravaginal leiomyoma is the commonest type. Large cervical fibroids present with abdominal masses, incarcerated procidentia, uterine inversion, cervical malignancy, etc. The prevalence of fibroids during pregnancy, irrespective of site, has been reported to be 1-4%. Degeneration in leiomyomas have been described in 65% of the cases. Myxoid leiomyoma is characterized by absence of mito tic activity and the presence of myogenic phenotype. The higher end of prevalence for a myxoid degeneration has been reported in upto 50% of all degenerations in uterus, but myxoid leiomyoma has been rarely described in cervix. Cause of a myxoid change in pregnancy is unknown.